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Low HDL may raise diabetic nephropathy risk

September 4, 2012 in News

HDL, or high-density lipoproteins, are a form of cholesterol. HDL is often referred to as the “good cholesterol,” since many studies have suggested that higher levels of HDL may help reduce the risk of heart disease. Low-density lipoproteins, LDL, are the form of cholesterol that can build up in the arteries, raising the risk of cardiovascular disease.

Your doctor should be testing your blood cholesterol levels (lipids) regularly, at least every five years. According to the American Diabetes Association, it’s a good idea to aim for a level of LDL cholesterol that is below 100mg/dL. For HDL cholesterol, healthy levels are above 40mg/dL for men, and above 50mg/dL for women. To get the maximum benefit from HDL’s ability to protect against cardiovascular disease, it’s recommended to aim for above 60mg/dL.

New research is suggesting that striving for healthy HDL levels may be especially important for those with diabetes. A team working out of the Heart Research Institute in Sydney found evidence that HDL is not only linked to cardiovascular disease risk, but to the risk of developing diabetic nephropathy (small blood vessel damage in the kidneys) as well.

The researchers studied patients who had both type 2 diabetes and very low levels of HDL, following them for 5 years. They looked specifically for signs of any new or worsening microvascular diseases, such as nephropathy and retinopathy. Microvascular damage is a common complication of diabetes; the researchers were looking to see if patients with lower HDL values experienced more of these complications than other diabetics.

28 percent of the participants with low HDL cholesterol experienced symptoms of diabetic nephropathy, but only 6% developed symptoms of retinopathy. The study found that those with both type 2 diabetes and the lowest HDL levels were at a 17% higher risk of developing microvascular disease. A big part of this increased risk came from the 19% higher risk of developing nephropathy.

The study did not find any association between HDL levels and retinopathy.

The authors of the study concluded that low HDL cholesterol is an independent risk factor for the development and progression of diabetic neuropathy. This suggests that for diabetics, watching your HDL may be a good way to not only protect your heart, but your kidneys as well.

If you haven’t spoken to your doctor about your cholesterol levels lately, ask if you should have them checked, and how often she or he recommends repeating the tests.

If your HDL is low, and your doctor recommends trying to raise your levels, she or he may recommend lifestyle changes to boost your HDL. Many of these lifestyle changes are already recommended for managing your diabetes!

  • Don’t smoke: quitting smoking may raise your HDL level by up to 10%
  • Maintain a healthy weight: For those who are overweight, every 6 pounds lost towards a healthy goal weight can boost HDL levels by 1mg/dL
  • Be physically active: 30 minutes of activities like brisk walking, 5 times per week, can not only help manage your weight and blood sugar. Within two months of starting routine brisk exercise, HDL can increase by up to 5%
  • Pick healthy fats: Usually, between 25 and 35 percent of the calories in a healthy diet should come from fat (unless your doctor says otherwise), but the typeof fat is important. Saturated fats, like those in butter and red meat, should make up less than 7 percent of your total calories. Instead, choose fats like olive, peanut, or canola oil, which are rich in healthier monounsaturated and polyunsaturated fats. These fats can both help raise HDL and help it be more effective in the body. Nuts, fish, and other foods that contain omega-3 fatty acids are other good choices, but as always, portion control matters.
  • Pick whole grains: Whole grains, like oatmeal, bran, and whole-wheat products, might help raise HDL. Whether they do or not, picking whole grains is still a good way to get extra fiber, and can help manage your blood sugar as well.

You can find more information that can help you talk to your doctor about what you can do to raise your HDL through the Mayo Clinic’s website. The ADA also has excellent information about HDL and LDL.

If you’d like to read the source article from Health News, you can find it through the Physician’s Briefing. The abstract of the original article is available free through Diabetes Care; you can also purchase the whole article through their website.

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