SHORT COMMUNICATION Sphingomyelin is associated with kidney disease in type 1 diabetes (The FinnDiane Study)

The Author(s) 2011. This article is published with open access at Springerlink.com Abstract Diabetic kidney disease, diagnosed by urinary albumin excretion rate (AER), is a critical symptom of chronic vascular injury in diabetes, and is associated with dyslipidemia and increased mortality. We investigated serum lipids in 326 subjects with type 1 diabetes: 56% of patients had normal AER, 17 % had microalbuminuria (20 B AER \ 200 lg/min or 30 B AER \ 300 mg/24 h) and 26 % had overt kidney disease (macroalbuminuria AER C 200 lg/min or AER C 300 mg/24 h). Lipoprotein subclass lipids and low-molecular-weight metabolites were quantified from native serum, and individual lipid species from the lipid extract of the native sample, using a proton NMR metabonomics platform. Sphingomyelin (odds ratio 2.53, P \ 10-7), large VLDL cholesterol (odds ratio 2.36, P \ 10-10), total triglycerides (odds ratio 1.88, P \ 10-6), omega-9 and saturated fatty acids (odds ratio 1.82, P \ 10-5), glucose disposal rate (odds ratio 0.44, P \ 10-9), large HDL cholesterol (odds ratio 0.39, P \ 10-9) and glomerular fil-tration rate (odds ratio 0.19, P \ 10-10) were associated with kidney disease. No associations were found for polyunsatu-rated fatty acids or phospholipids. Sphingomyelin was a sig-nificant regressor of urinary albumin (P \ 0.0001) in multivariate analysis with kidney function, glycemic control, body mass, blood pressure, triglycerides and HDL choles-terol. Kidney injury, sphingolipids and excess fatty acids have been linked in animal models—our exploratory approach provides independent support for this relationship in human patients with diabetes