Hirano T, Satoh N, Kodera R, et al. - Proteinuria was identified to be linked with an atherogenic subspecies of low-density lipoprotein (LDL), whereas elevated lipoprotein(a) was detected in relation to renal dysfunction. Exacerbation of triglyceride (TG)-rich lipoprotein-related dyslipidemia was independently induced by both proteinuria and renal dysfunction. This is in good agreement with findings from large-scale clinical studies wherein risk of atherosclerotic cardiovascular disease in diabetics was synergistically elevated by proteinuria and renal dysfunction.

• Study of 1,073 diabetes patients enrolled in the regional diabetes cohort (ViNA cohort), to investigate dyslipidemia in different diabetic kidney disease (DKD) phenotypes that have not been fully examined.

• Higher proportion of atherosclerotic cardiovascular disease patients was identified in non-proteinuric DKD and even higher in proteinuric DKD vs non-DKD.

• There existed independent correlations of increased estimated glomerular filtration rate grade and albuminuric stage with higher TG, TG-rich lipoprotein cholesterol and apolipoprotein CIII, thus, the highest of these levels were detected in proteinuric DKD.

• The proteinuria without renal dysfunction group exhibited higher small dense LDL cholesterol and LDL-TG, in the lipid-lowering drug-free subset.

• Irrespective of proteinuria, higher lipoprotein(a) was detected in DKD.