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Circulating Free Fatty Acid and Phospholipid Signature Predicts Early Rapid Kidney Function Decline in Patients With Type 1 Diabetes
- Source :
- Diabetes Care
- Publication Year :
- 2021
- Publisher :
- American Diabetes Association, 2021.
-
Abstract
- OBJECTIVES Patients with type 1 diabetes (T1D) exhibit modest lipid abnormalities as measured by traditional metrics. This study aimed to identify lipidomic predictors of rapid decline of kidney function in T1D. RESEARCH DESIGN AND METHODS In a case-control study, 817 patients with T1D from three large cohorts were randomly split into training and validation subsets. Case was defined as >3 mL/min/1.73 m2 per year decline in estimated glomerular filtration rate (eGFR), while control was defined as RESULTS At individual lipids, free fatty acid (FFA)20:2 was directly and phosphatidylcholine (PC)16:0/22:6 was inversely and independently associated with rapid eGFR decline. When examined by lipid class, rapid eGFR decline was characterized by higher abundance of unsaturated FFAs, phosphatidylethanolamine (PE)-Ps, and PCs with an unsaturated acyl chain at the sn1 carbon, and by lower abundance of saturated FFAs, longer triacylglycerols, and PCs, PEs, PE-Ps, and PE-Os with an unsaturated acyl chain at the sn1 carbon at eGFR ≥90 mL/min/1.73 m2. A multilipid panel consisting of unsaturated FFAs and saturated PE-Ps predicted rapid eGFR decline better than individual lipids (C-statistic, 0.71) and improved the C-statistic of the clinical model from 0.816 to 0.841 (P = 0.039). Observations were confirmed in the validation subset. CONCLUSIONS Distinct from previously reported predictors of GFR decline in type 2 diabetes, these findings suggest differential incorporation of FFAs at the sn1 carbon of the phospholipids’ glycerol backbone as an independent predictor of rapid GFR decline in T1D.
- Subjects :
- medicine.medical_specialty
Endocrinology, Diabetes and Metabolism
Phospholipid
Renal function
Type 2 diabetes
Fatty Acids, Nonesterified
Kidney
chemistry.chemical_compound
Risk Factors
Diabetes mellitus
Phosphatidylcholine
Internal medicine
Internal Medicine
medicine
Humans
Renal Insufficiency, Chronic
Pathophysiology/Complications
Phospholipids
Advanced and Specialized Nursing
chemistry.chemical_classification
Phosphatidylethanolamine
Type 1 diabetes
business.industry
Fatty acid
medicine.disease
Diabetes Mellitus, Type 1
Endocrinology
Diabetes Mellitus, Type 2
chemistry
Case-Control Studies
Disease Progression
lipids (amino acids, peptides, and proteins)
business
Glomerular Filtration Rate
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- Diabetes Care
- Accession number :
- edsair.doi.dedup.....19b29ab9def43af131fb62aeee3f57bf