{"id":"258e5490298c","type":"article","url":"https://hartvaat.nl/2026/11/01/verhoogd-idl-cholesterol-en-ldl-tocoferol-geassocieerd-met-nierfunctieverlies-bi/","title":"Verhoogd IDL-cholesterol en LDL-α-tocoferol geassocieerd met nierfunctieverlies bij type 2 diabetes","title_en":"Associations of IDL cholesterol and LDL α-tocopherol with diabetic kidney disease in type 2 diabetes.","category":"cholesterol","category_label":"Cholesterol","professions":["cardioloog","internist"],"tags":[],"journal":"Diabetes research and clinical practice","doi":"10.1016/j.diabres.2026.113571","source_url":"https://doi.org/10.1016/j.diabres.2026.113571","authors":["Yuji Hirowatari","Tatsuya Iwasaki","Daisuke Manita","Mariko Hakoshima","Hisayuki Katsuyama","Hidekatsu Yanai"],"significance":4,"published":"2026-10-16","source_date":"2026-11-01","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/","https://hartvaat.nl/kennis/lipiden/lp-a-verhoogd/"],"congress":"","summary_en":"In a cross-sectional study of 188 outpatients with type 2 diabetes, researchers examined the association between intermediate-density lipoprotein cholesterol (IDL-C), LDL-α-tocopherol, and renal function (eGFR). Lower eGFR tertiles were independently associated with higher IDL-C levels and an elevated LDL-α-tocopherol/LDL-C ratio, while statin or fibrate use correlated with more favorable lipid profiles. These findings highlight altered lipoprotein metabolism and increased LDL oxidation potential in declining renal function, underscoring the need for targeted lipid management and cardiovascular risk assessment in patients with diabetic kidney disease.","created":"2026-10-10T00:56:02Z","updated":"2026-10-10T00:56:02Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"In een observationele studie van 188 patiënten met type 2 diabetes onderzochten onderzoekers de relatie tussen IDL-cholesterol en LDL-α-tocoferol met de nierfunctie (eGFR). Naarmate de eGFR daalde, namen beide markers significant toe en toonde multivariaat analyse een onafhankelijke inverse correlatie, terwijl statine- of fibratetherapie gepaard ging met gunstigere lipidprofielen. De bevindingen wijzen op een verstoorde lipoproteïne-metabolisme en verhoogde LDL-oxidatie bij nierfunctieverlies, wat extra aandacht vraagt voor lipidmanagement en cardiovasculaire risicobeheersing bij diabetische nefropathie.","abstract_original":"AIMS: Patients with type 2 diabetes mellitus (T2DM) commonly exhibit atherogenic dyslipidemia and increased oxidative stress, which may contribute to the development and progression of diabetic kidney disease (DKD). We investigated the associations of intermediate-density lipoprotein cholesterol (IDL-C) and α-tocopherol in low-density lipoprotein (LDL-α-tocopherol) with renal dysfunction in T2DM. METHODS: A total of 188 outpatients with T2DM were categorized into tertiles according to estimated glomerular filtration rate (eGFR). Lipoprotein fractions (HDL-, LDL-, IDL-, and VLDL-cholesterol) and LDL-α-tocopherol content were quantified using anion-exchange high-performance liquid chromatography. Arterial stiffness was assessed by brachial-ankle pulse wave velocity. Multivariable analyses were performed to evaluate associations between eGFR, lipoprotein parameters, and lipid-lowering therapy. RESULTS: Declining eGFR was associated with longer diabetes duration and increased arterial stiffness. IDL-C levels and the LDL-α-tocopherol/LDL-C ratio increased significantly across decreasing eGFR tertiles, whereas LDL-C levels showed a decreasing trend. eGFR was independently and inversely correlated with IDL-C and the LDL-α-tocopherol/LDL-C ratio. Statin or fibrate therapy was associated with lower IDL-C levels and higher LDL-α-tocopherol/LDL-C ratios. CONCLUSIONS: In patients with T2DM, declining DKD is associated with atherogenic IDL accumulation and increased LDL α-tocopherol content, suggesting altered lipoprotein metabolism that may influence LDL oxidation and cardiovascular risk."}