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Clinical Correlation between ApoB/ApoA1 Ratio in Type 2 Diabetic Nephropathy-A Tertiary Centre Experience

Background- The aim of this study was to evaluate the lipid abnormalities associated with different stages of albuminuria and also examine role of ApoB lipoprotein as a predictor of early diabetic nephropathy in type 2 diabetic patients. Methods and Results- A total 100 diabetic patients (58 men and 42 women) with mean age group 59.15±10.4 years were studied. Normoalbuminurea (n=36), microalbuminurea (n=42) and macroalbuminurea (n=22) were defined as 300 mg/day respectively. Lipid parameters included, total cholesterol, triglyceride (TG), high and low density lipoprotein cholesterol, apolipoproteins A1, and Apo B. Result showed that Apo B differed significantly (P<0.05) between normoalbuminurea and micro and macroalbuminurea. Triglyceride increases progressively with increasing albuminurea. In multivariate logistic regression analysis, with 24 hours urinary albumin levels was dependent on triglyceride, total cholesterol, HDL, LDL, VLDL, Apo-B, Apo-A1 , Apo-B/Apo-A1 and for triglyceride, none of the other variables were significantly associated with the outcome. The model had an excellent explanatory power (r 2 =0.674). Conclusion-. In conclusion during the development of diabetic nephropathy atherogenic lipoproteins may play significant role. Apo B was associated with the early development of microalbuminuria and remained elevated throughout the course of abnormal albuminuria. Apo-B/Apo-A1ratio may be early indicator of diabetic nephropathy.