Abstract

Diabetic nephropathy (DN) is a common cause of endstage renal disease
(ESRD) worldwide and a dreaded microvascular complication of Diabetes
mellitus. It has many modifiable and non-modifiable risk factors that contributes
to its development and progression. These include hyperglycemia, hypertension,
dyslipidemia, obesity, smoking, genetic and racial factors. Dyslipidemia and
obesity were studied among overt DN patients.
The prevalence of DN has been studied extensively in Nigeria but data on the
prevalence of risk factors is scanty .This study was aimed at determining the
prevalence and relationship of dyslipidemia and obesity in overt DN patients in
order to establish a basis for recommendation of proactive intervention.
Seventy- two diabetic patients with overt DN being managed at the Nnamdi A
zikiwe University Teaching Hospital Nnewi and General Hospital Onitsha both in
Anamra South-Eastern Nigeria were studied. The patients were made up of 35
males and 37 females with ages ranging between 30 and 80years. Screening for
overt DN was done using urine albumin/ creatinine ratio. Diabetic patients without
clinical evidence of obstructive uropathy, hypothyroidism, glomerulonephritides,
hepatobiliary disease, acute febrile illness, congestive heart failure and not on
lipid altering drugs were recruited for this study. 36 age and sex- matched
normoalbuminuric diabetic patients were also studied as controls. Their fasting
lipid profiles, BMI, Blood pressure and renal function were evaluated.
Triglycerides and total cholesterol were found to be significantly higher in overt
DN patients compared to the controls (66.7% and 62.5% versus 36.1% and
30.6%) respectively. Obesity with a higher mean BMI was found in those with DN
(28.69± 5.77) compared to the controls (27.73± 4.76. Hypertension was also
found to be significantly associated with DN.
In conclusion, dyslipidemia (hypertriglyceridemia and hypercholesterolemia) but
not obesity were significantly prevalent among overt DN patients. Further
prospective studies are recommended to establish association between
dyslipidemia, obesity and DN in this environment and urine albumin excretion,
lipid analysis and BMI estimation should be a routine assessment for all diabetic
patients.