Abstract:Objective To detect the plasma low density lipoprotein (LDL) subtypes in patients with type 2 diabetes mellitus (T2DM) to analyze the relationship between the levels of LDL subtypes and T2DM complicated with diabetic nephropathy. Methods A total of 174 T2DM patients treated in Nanjing Jiangbei Hospital from August 2020 to September 2021 were recruited. According to the urinary microalbumin/creatinine ratio (UACR), the patients were divided into without proteinuria group (n=78), micro-proteinuria group (n=54) and macro-proteinuria group (n=40). In the same period,38 healthy people were served as controls. The following indicators were measured in each group, including the general clinical data, serum creatinine (Scr), cystatin C (Cys-C), LDL, high density lipoprotein cholesterol (HDL-C), total cholesterol (TC), urine biochemistry, BMI, small and dense low-density lipoprotein (sdLDL)/ LDL, estimated glomerular filtration rate (eGFR) to explore and analyze the associations of LDL subtypes levels with the degree of renal function impairment in T2DM patients with diabetic nephropathy. Results The LDL subtypes LDL-3, sdLDL, sdLDL/LDL, LDL, TC, Cys-C and eGFR in three T2DM subgroups were significantly higher than those in control group, and the HDL-C was statistically lower than that in control group (P＜0.05). With the increase of UACR, the levels of LDL-4, LDL-5, sdLDL, sdLDL/LDL, LDL and eGFR were statistically increased in T2DM subgroups (P＜0.05). Logistic regression analysis showed that LDL-3, LDL-4, LDL-5, sdLDL and sdLDL/LDL were the factors influencing the elevation of UACR (P＜0.05). Conclusion The elevated levels of LDL-3, LDL-4, LDL-5, sdLDL and sdLDL/LDL are the independent risk factors for the occurrence and development of T2DM patients with diabetes nephropathy, which is helpful for clinical risk assessment for these patients.