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2014 ; 63
(10
): 1287-95
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Decreased plasma levels of select very long chain ceramide species are associated
with the development of nephropathy in type 1 diabetes
#MMPMID25088746
Klein RL
; Hammad SM
; Baker NL
; Hunt KJ
; Al Gadban MM
; Cleary PA
; Virella G
; Lopes-Virella MF
Metabolism
2014[Oct]; 63
(10
): 1287-95
PMID25088746
show ga
OBJECTIVE: Sphingolipid metabolism is altered in diabetes and we analyzed the
plasma concentrations of sphingolipid species to investigate their association
with the development of albuminuria in type 1 patients with diabetes. MATERIALS
AND METHODS: Samples were collected from 497 type 1 diabetic patients during
their enrollment into the Diabetes Control and Complications Trial (DCCT). We
determined plasma concentrations of multiple ceramide species and individual
sphingoid bases and their phosphates using high performance liquid
chromatography-tandem mass spectrometry and investigated their association with
the development of albuminuria during 14-20 years of follow-up. RESULTS: Patients
exhibited normal albumin excretion rates (AER <40 mg/24h) at the time of plasma
sampling. Although the majority of patients (N = 291; 59%) exhibited normal
levels of albuminuria throughout follow-up, 141 patients (28%) progressed to
microalbuminuria (40 mg/24h ? AER<300 mg/24h), while 65 (13%) progressed to
macroalbuminuria (AER ? 300 mg/24h). To test the association of log transformed
plasma sphingolipid level with the development of albuminuria, generalized
logistic regression models were used where normal, micro- and macroalbuminuria
were the outcomes of interest. Models were adjusted for DCCT treatment group,
baseline retinopathy, gender, baseline HbA1c %, age, AER, lipid levels, diabetes
duration, and the use of ACE/ARB drugs. Increased plasma levels of very long, but
not long chain ceramide species measured at DCCT baseline were associated with
decreased odds to develop macroalbuminuria during the subsequent nineteen years
(DCCT Baseline to EDIC year 8). CONCLUSION: These studies demonstrate,
prospectively, that decreased plasma levels of select ceramide species are
associated with the development of macroalbuminuria in type 1 diabetes.
|Adult
[MESH]
|Albuminuria/blood/etiology
[MESH]
|Ceramides/*blood
[MESH]
|Clinical Trials as Topic
[MESH]
|Diabetes Complications/blood/etiology
[MESH]
|Diabetes Mellitus, Type 1/*blood/*complications
[MESH]