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Liu Y, Lyu K, Liu S, You J, Wang X, Wang M, Zhang D, Bai Y, Yin C, Jiang M, Zheng S. Predictive value of total cholesterol to high-density lipoprotein cholesterol ratio for chronic kidney disease among adult male and female in Northwest China. Chronic Dis Transl Med 2024; 10:216-226. [PMID: 39027193 PMCID: PMC11252436 DOI: 10.1002/cdt3.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/12/2024] [Accepted: 03/27/2024] [Indexed: 07/20/2024] Open
Abstract
Background Studies have found that the ratio of total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) was associated with the development of chronic kidney disease (CKD). However, the relationship in different genders was rarely discussed. The aim of this study was to explore this relationship and assess its predictive power for both males and females. Methods Based on a prospective cohort platform in northwest China, 32,351 participants without CKD were collected in the baseline and followed up for approximately 5 years. Cox proportional hazard model and restricted cubic spline regression analysis were performed to investigate the association between TC, HDL-C, TC/HDL-C and CKD in adult female and male. The clinical application value of the indicators in predicting CKD was evaluated by the receiver operator characteristic curve. Results During a mean follow-up of 2.2 years, 484 males and 164 females developed CKD. After adjusted for relevant confounders, for every one standard deviation increase in TC, HDL-C and TC/HDL-C, the hazard ratios (HRs) and 95% confidence intervals (95% CIs) for CKD were 1.17 (1.05-1.31), 0.84 (0.71-0.99), and 1.15 (1.06-1.25) for males, 0.94 (0.78-1.13), 0.58 (0.35-0.95), and 1.19 (1.01-1.40) for females, respectively. The results also showed that TC, HDL-C, and TC/HDL-C were associated with CKD in a linear dose-response relationship. The TC/HDL-C had the largest area under the curve (AUC) compared to TC and HDL-C, and the AUC among the females was larger than that among males. Conclusions The TC/HDL-C was significantly associated with CKD in adult males and females and has better clinical value in predicting CKD than TC and HDL-C, especially in females.
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Affiliation(s)
- Yanli Liu
- School of Public Health, Institute of Epidemiology and StatisticsLanzhou UniversityLanzhouGansuChina
| | - Kang Lyu
- School of Public Health, Institute of Epidemiology and StatisticsLanzhou UniversityLanzhouGansuChina
| | - Shaodong Liu
- School of Public Health, Institute of Epidemiology and StatisticsLanzhou UniversityLanzhouGansuChina
| | - Jinlong You
- School of Public Health, Institute of Epidemiology and StatisticsLanzhou UniversityLanzhouGansuChina
| | - Xue Wang
- School of Public Health, Institute of Epidemiology and StatisticsLanzhou UniversityLanzhouGansuChina
| | - Minzhen Wang
- School of Public Health, Institute of Epidemiology and StatisticsLanzhou UniversityLanzhouGansuChina
| | - Desheng Zhang
- Workers' Hospital of Jinchuan Group Co. Ltd.JinchangGansuChina
| | - Yana Bai
- School of Public Health, Institute of Epidemiology and StatisticsLanzhou UniversityLanzhouGansuChina
| | - Chun Yin
- Workers' Hospital of Jinchuan Group Co. Ltd.JinchangGansuChina
| | - Min Jiang
- Wuwei People's HospitalWuweiGansuChina
| | - Shan Zheng
- School of Public Health, Institute of Epidemiology and StatisticsLanzhou UniversityLanzhouGansuChina
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Suh SH, Oh TR, Choi HS, Kim CS, Bae EH, Oh KH, Han SH, Ma SK, Kim SW. Serum triglycerides level is independently associated with renal outcomes in patients with non-dialysis chronic kidney disease: Results from KNOW-CKD study. Front Nutr 2022; 9:1037618. [PMID: 36505239 PMCID: PMC9729769 DOI: 10.3389/fnut.2022.1037618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/11/2022] [Indexed: 11/25/2022] Open
Abstract
To investigate whether high serum triglycerides (TG) level is associated with adverse renal outcomes in patients with non-dialysis chronic kidney disease (CKD), a total of 2,158 subjects from a prospective cohort study (Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease) were divided into the quartile by serum TG level. The primary outcomes were composite renal events, which is defined as a composite of decline of kidney function (the first occurrence of > 50% decline of estimated glomerular filtration rate or doubling of serum creatinine from the baseline) or onset of end-stage renal disease (initiation of dialysis or kidney transplantation). During the median follow-up of 6.940 years, the cumulative incidence of composite renal event was significantly differed by serum TG level in Kaplan-Meier curve analysis (P < 0.001, by Log-rank test). Cox regression analysis demonstrated that, compared to that of the 1st quartile, the risk of composite renal event was significantly higher in the 4th quartile (adjusted hazard ratio 1.433, 95% confidence interval 1.046 to 1.964). The association between high serum TG level and adverse renal outcome remained consistent in the cause-specific hazard model. Subgroup analyses revealed that the association is modified by age, estimated glomerular filtration rate, and spot urine albumin-to-creatinine ratio. In conclusion, high serum TG level is independently associated with adverse renal outcomes in patients with non-dialysis CKD. Interventional studies are warranted to determine whether lowering serum TG levels may alter the natural course of CKD.
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Affiliation(s)
- Sang Heon Suh
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, South Korea
| | - Tae Ryom Oh
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, South Korea
| | - Hong Sang Choi
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, South Korea
| | - Chang Seong Kim
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, South Korea
| | - Eun Hui Bae
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, South Korea
| | - Kook-Hwan Oh
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Seung Hyeok Han
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, South Korea
| | - Seong Kwon Ma
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, South Korea,*Correspondence: Seong Kwon Ma
| | - Soo Wan Kim
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, South Korea,Soo Wan Kim
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Guan CL, Liu HT, Chen DH, Quan XQ, Gao WL, Duan XY. Is elevated triglyceride/high-density lipoprotein cholesterol ratio associated with poor prognosis of coronary heart disease? A meta-analysis of prospective studies. Medicine (Baltimore) 2022; 101:e31123. [PMID: 36397319 PMCID: PMC9666180 DOI: 10.1097/md.0000000000031123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Elevated triglycerides (TG) and reduced high-density lipoprotein cholesterol (HDL-C) are recognized as essential and independent hazard factors for total death and major adverse cardiovascular events (MACE) in patients with coronary heart disease (CHD). However, whether the increased TG/HDL-C forecasted the prognosis of CHD is still unknown. Therefore, we performed a meta-analysis to investigate the relationship between the elevated TG/HDL-C ratio and poor prognosis of CHD. METHODS A systematic literature search was conducted in PubMed, Web of Science, EMBASE, and The Cochrane Library, until August 30, 2021. Prospective observational studies regarding the association between TG/HDL-C and long-term mortality/MACEs in CHD patients were included. RESULTS In total, 6 independent prospective studies of 10,222 participants with CHD were enrolled in the systematic and meta-analysis. Our outcomes of the meta-analysis indicated that the elevated TG/HDL-C group had a significantly increased risk of long-term all-cause mortality (hazard ratio [HR] = 2.92, 95% confidence interval [CI]: 1.75-4.86, P < .05) and long-term MACEs (HR = 1.56, 95%CI 1.11-2.18, P < .05). CONCLUSION In patients with CHD, the present study showed that the high TG/HDL-C was associated with increased risk of long-term all-cause mortality and MACE.
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Affiliation(s)
- Chun-Li Guan
- Department of General Pratice, Shenzhen Longhua District Central Hospital, The Affiliated Central Hospital of Shenzhen Longhua District, Guangdong Medical University, Shenzhen, China
| | - Hong-Tao Liu
- Department of Cardiology, Shenzhen Longhua District Central Hospital, The Affiliated Central Hospital of Shenzhen Longhua District, Guangdong Medical University, Shenzhen, China
| | - Dong-Hui Chen
- Department of General Pratice, Shenzhen Longhua District Central Hospital, The Affiliated Central Hospital of Shenzhen Longhua District, Guangdong Medical University, Shenzhen, China
| | - Xiao-Qing Quan
- Department of General Pratice, Shenzhen Longhua District Central Hospital, The Affiliated Central Hospital of Shenzhen Longhua District, Guangdong Medical University, Shenzhen, China
| | - Wei-Liang Gao
- Department of General Pratice, Shenzhen Longhua District Central Hospital, The Affiliated Central Hospital of Shenzhen Longhua District, Guangdong Medical University, Shenzhen, China
- *Correspondence: Wei-Liang Gao and Xue-Yan Duan, Department of General Practice, Shenzhen Longhua District Central Hospital, The Affiliated Central Hospital of Shenzhen Longhua District, Guangdong Medical University, Shenzhen 518110, China (e-mail: , )
| | - Xue-Yan Duan
- Department of General Pratice, Shenzhen Longhua District Central Hospital, The Affiliated Central Hospital of Shenzhen Longhua District, Guangdong Medical University, Shenzhen, China
- *Correspondence: Wei-Liang Gao and Xue-Yan Duan, Department of General Practice, Shenzhen Longhua District Central Hospital, The Affiliated Central Hospital of Shenzhen Longhua District, Guangdong Medical University, Shenzhen 518110, China (e-mail: , )
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Non-High-Density Lipoprotein Cholesterol and Progression of Chronic Kidney Disease: Results from the KNOW-CKD Study. Nutrients 2022; 14:nu14214704. [PMID: 36364966 PMCID: PMC9656579 DOI: 10.3390/nu14214704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/01/2022] [Accepted: 11/04/2022] [Indexed: 11/11/2022] Open
Abstract
As the relation between serum non-high-density lipoprotein cholesterol (nHDL) level and renal outcomes has never been investigated in patients with non-dialysis chronic kidney disease (CKD) yet, we here aimed to unveil the association of nHDL with CKD progression. A total of 2152 patients with non-dialysis CKD at stages 1 to 5 from the KNOW-CKD study were categorized into the tertile (i.e., 1st (T1), 2nd (T2), and 3rd (T3) tertiles) by nHDL, and were prospectively analyzed. The primary outcome was the composite renal event, defined as a composite of decline of kidney function or onset of end-stage renal disease. Kaplan–Meier survival curves analysis demonstrated that the cumulative incidence of the composite renal event was significantly increased in T1 and T3, compared to T2 (p = 0.028, by Log-rank test). Cox regression analysis revealed that both T1 (adjusted hazard ratio 1.309, 95% confidence interval 1.074–1.595) and T3 (adjusted hazard ratio 1.272, 95% confidence interval 1.040–1.556) are associated with significantly increased risk of a composite renal event, compared to T2. The restricted cubic spline plot demonstrated a non-linear, U-shaped association between nHDL and the risk of a composite renal event. In conclusion, both low and high serum nHDL levels are associated with increased risk of CKD progression.
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TG/HDL-C Ratio Is a Risk Factor Associated with CKD: Use in Assessing the Risk of Progression of CKD. PATHOPHYSIOLOGY 2022; 29:374-382. [PMID: 35893599 PMCID: PMC9326757 DOI: 10.3390/pathophysiology29030029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/14/2022] [Accepted: 07/14/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Dyslipidemia is highly prevalent in patients with chronic kidney disease (CKD), and the relationship between dyslipidemia and renal function in these patients remains controversial. Our objectives were to determine the triglycerides/HDL-cholesterol ratio (TG/HDL-C), evaluate the correlation between TG/HDL-C and the urine albumin/creatinine ratio (ACR), and estimate the glomerular filtration rate (eGFR) according to MDRD in CKD patients. Methods: A descriptive cross-sectional study was conducted on 152 patients with CKD at the Endocrine Clinic, the University of Medicine and Pharmacy Hospital, Ho Chi Minh City, Vietnam. Study subjects were medically examined and recorded information on the data collection form. Subjects were tested for total cholesterol, triglycerides, HDL-C, LDL-C, urea, creatinine and albumin, urine creatinine, and eGFR according to the MDRD formula. Data were analyzed using SPSS Statistics version 20.0. Results: The average age was 58.08 ± 15.69 years, and the overweight and obesity rate was 54%. Most patients had comorbidities, among which the most common diseases were hypertension and diabetes mellitus. Among the subjects, 57.3% were CKD stage 3 patients, and ACR was in the range of 30−300 mg/g. According to the classification of CKD using GFR and ACR categories, 40.8% of patients were at very high risk. The average TG/HDL-C ratio was 5.09 ± 4.26. There was a medium negative correlation between TG/HDL-C and eGFR (R = 0.44, p < 0.01) and a weak positive correlation between TG/HDL-C and ACR (R = 0.34, p < 0.01). Conclusions: The TG/HDL-C ratio was a risk factor associated with CKD and was noticeable in monitoring and assessing the risk of progression of CKD.
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6
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Huang F, Wang L, Zhang Q, Wan Z, Hu L, Xu R, Cheng A, Lv Y, Liu Q. Elevated atherogenic index and higher triglyceride increase risk of kidney function decline: a 7-year cohort study in Chinese adults. Ren Fail 2021; 43:32-39. [PMID: 33307922 PMCID: PMC7745844 DOI: 10.1080/0886022x.2020.1853569] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Objective This study explored whether lipid disorders or an elevated atherogenic index of plasma (AIP, a risk factor for cardiovascular diseases) could predict major kidney function decline. Methods We conducted a retrospective 7-year cohort study of 3712 Chinese adults followed up between 2010 and 2017. Major kidney function decline was defined as a ≥ 30% reduction in the estimated glomerular filtration rate (eGFR) from baseline. Multivariable logistic regression models were used to evaluate the relationship between lipid profiles and major kidney function decline. Smoking habits, waist circumference, and physical activity were not assessed. Results During the 7-year follow-up, 1.70% (n = 63) of the participants developed major kidney function decline. After adjustment for potential confounders, the odds ratios (ORs) for developing eGFR decline with per standard deviation increase were 1.23 [95% confidence interval (CI): 1.06–1.43] for triglyceride and 2.55 (95% CI: 1.01–6.42) for AIP in all participants. Furthermore, in the stratified analysis, we found sex-related differences; triglyceride and AIP were only independently associated with the risk of eGFR decline in men (OR, 1.27, 95% CI: 1.08–1.48; OR, 3.98, 95% CI: 1.22–12.99, respectively). When the participants were divided into groups according to the baseline lipid status, association was observed only between abnormal AIP and eGFR decline (all p values < 0.05). Conclusion Our findings suggest that a higher serum triglyceride level or an elevated AIP increases the risk of major kidney function decline in Chinese men with normal kidney function. Thus, assessment of AIP may help identify the risk of eGFR decline.
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Affiliation(s)
- Fei Huang
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Le Wang
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qian Zhang
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhengce Wan
- Department of Health Management Centre, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liu Hu
- Department of Health Management Centre, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ranran Xu
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Anying Cheng
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yongman Lv
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Health Management Centre, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qingquan Liu
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Kim J, Bae YJ, Shin SJ, You HS, Lee JW, Kang HT. The ratio of triglycerides to high-density lipoprotein cholesterol is associated with the risk of chronic kidney disease in Korean men. Lipids 2021; 56:475-483. [PMID: 34089267 DOI: 10.1002/lipd.12314] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/09/2021] [Accepted: 05/17/2021] [Indexed: 11/12/2022]
Abstract
Dyslipidemia is nephrotoxic and can result in the development of chronic kidney disease (CKD). The ratio of triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) (TG/HDL-C ratio) is well-correlated with insulin resistance and cardiovascular events. The aim of this study is to examine the association between the TG/HDL-C ratio and CKD in Korean adults. This study was retrospectively designed based on the National Health Insurance Service-National Health Screening cohort. Seventy three thousand and fifty-two participants aged between 40 and 79 years old at baseline (2009-2010) were included in the final analyses. The study population was classified into three tertile groups (T1 , T2 , and T3 ) according to the TG/HDL-C ratio by sex. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for CKD were calculated using Cox proportional hazard regression models. The median follow-up duration was 5.9 years. Higher tertile groups of the TG/HDL-C ratio had lower estimated glomerular filtration rates in both sexes. The cumulative incidence of CKD of T1 , T2 , and T3 was 11.89%, 12.90%, and 12.91%, respectively, in men and 10.17%, 10.61%, and 14.87%, respectively, in women (all p values < 0.001). Compared with T1 of the TG/HDL-C ratio, the HRs (95% CIs) of T2 and T3 for CKD were 1.212 (1.118-1.315) and 1.183 (1.087-1.287), respectively, in men and 0.895 (0.806-0.994) and 1.038 (0.937-1.150), respectively, in women after being fully adjusted. Higher TG/HDL-C ratios were positively associated with CKD development in men, while middle levels of TG/HDL ratios reduced the CKD incidence in women.
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Affiliation(s)
- Joungyoun Kim
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Yoon-Jong Bae
- Department of Information and Statistics, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Sang-Jun Shin
- Department of Information and Statistics, Chungbuk National University, Cheongju, Chungbuk, Republic of Korea
| | - Hyo-Sun You
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Chungbuk, Republic of Korea
| | - Jae-Woo Lee
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Chungbuk, Republic of Korea
| | - Hee-Taik Kang
- Department of Family Medicine, Chungbuk National University Hospital, Cheongju, Chungbuk, Republic of Korea.,Department of Family Medicine, Chungbuk National University College of Medicine, Cheongju, Chungbuk, Republic of Korea
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Zhao Z, Song L, Yao J. What is the relationship between higher triglyceride and kidney function decline in adults? Ren Fail 2021; 43:533-534. [PMID: 33726617 PMCID: PMC7971290 DOI: 10.1080/0886022x.2021.1896549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Zhifang Zhao
- Department of Medicine, Northwest Minzu University, Lanzhou, PR China
| | - Lei Song
- Department of Medicine, Northwest Minzu University, Lanzhou, PR China
| | - Jibin Yao
- Department of Surgical Oncology, Gansu Provincial Hospital, Lanzhou, P.R. China
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Edes A, Brown J, Edwards K. Testing lipid markers as predictors of all-cause morbidity, cardiac disease, and mortality risk in captive western lowland gorillas ( Gorilla gorilla gorilla). Primate Biol 2020; 7:41-59. [PMID: 33553576 PMCID: PMC7852406 DOI: 10.5194/pb-7-41-2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 10/19/2020] [Indexed: 12/30/2022] Open
Abstract
Great apes and humans develop many of the same health conditions, including cardiac disease as a leading cause of death. In humans, lipid markers are strong predictors of morbidity and mortality risk. To determine if they similarly predict risk in gorillas, we measured five serum lipid markers and calculated three lipoprotein ratios from zoo-housed western lowland gorillas (aged 6-52 years, n = 61 , subset with routine immobilizations only: n = 47 ): total cholesterol (TC), triglycerides (TGs), high-density lipoprotein (HDL), low-density lipoprotein (LDL), apolipoprotein A1 (apoA1), TC / HDL , LDL / HDL , and TG / HDL . We examined each in relation to age and sex, then analyzed whether they predicted all-cause morbidity, cardiac disease, and mortality using generalized linear models (GLMs). Older age was significantly associated with higher TG, TC / HDL , LDL / HDL , and TG / HDL , and lower HDL and apoA1. With all ages combined, compared to females, males had significantly lower TG, TC / HDL , LDL / HDL , and TG / HDL , and higher HDL. Using GLMs, age, sex, and lower LDL / HDL were significant predictors of all-cause morbidity; this is consistent with research demonstrating lower LDL in humans with arthritis, which was the second most prevalent condition in this sample. In contrast to humans, lipid markers were not better predictors of cardiac disease and mortality risk in gorillas, with cardiac disease best predicted by age and sex alone, and mortality risk only by age. Similar results were observed when multimodel inference was used as an alternative analysis strategy, suggesting it can be used in place of or in addition to traditional methods for predicting risk.
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Affiliation(s)
- Ashley N. Edes
- Center for Species Survival, Smithsonian Conservation Biology
Institute, 1500 Remount Rd., Front Royal, VA 22630, USA
- currently at: Department of Reproductive and
Behavioral Sciences, Saint Louis Zoo, St. Louis, MO 63110, USA
| | - Janine L. Brown
- Center for Species Survival, Smithsonian Conservation Biology
Institute, 1500 Remount Rd., Front Royal, VA 22630, USA
| | - Katie L. Edwards
- Center for Species Survival, Smithsonian Conservation Biology
Institute, 1500 Remount Rd., Front Royal, VA 22630, USA
- North of England Zoological Society, Chester Zoo, Upton by Chester,
CH2 1LH, UK
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Xie K, Bao L, Jiang X, Ye Z, Bing J, Dong Y, Gao D, Ji X, Jiang T, Li J, Li Y, Luo S, Mao W, Peng D, Qu P, Song S, Wang H, Wang Z, Xu B, Yin X, Yu Z, Zhang X, Zhang Z, Zhu Z, Gao X, Li Y. The association of metabolic syndrome components and chronic kidney disease in patients with hypertension. Lipids Health Dis 2019; 18:229. [PMID: 31881889 PMCID: PMC6935087 DOI: 10.1186/s12944-019-1121-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 09/30/2019] [Indexed: 02/05/2023] Open
Abstract
Background Hypertension is a highly prevalent disease and the leading cause of chronic kidney disease (CKD). Metabolic syndrome could also be the risk factor for CKD. We sought to study the association between metabolic syndrome components and the prevalence of CKD in patients with hypertension. Methods We carried out a multi-center cross-sectional study from Apr. 2017- Apr. 2018 in 15 cities in China. Results A total of 2484 patients with hypertension were enrolled. Among them, 56% were male and the average age was 65.12 ± 12.71 years. The systolic BP/diastolic BP was 142 ± 18/83 ± 12 mmHg. Metabolic syndrome components turned out to be highly prevalent in patients with hypertension, ranging from 40 to 58%. The prevalence of chronic kidney disease reached 22.0%. Multi-variate logistic analysis revealed that elevated triglyceride (TG) (OR = 1.81, 95% CI 1.28–2.57, p < 0.01), elevated fasting blood glucose (FBG) (OR = 1.43, 95% CI 1.00–2.07, p = 0.05) and hypertension grades (OR = 1.20, 95% CI 1.00–1.44, p = 0.05) were associated with the prevalence of CKD. In sub-group analysis, elevated TG remained strongly associated with CKD in both diabetes (OR = 2.10, 95%CI 1.22–3.61, p < 0.01) and non-diabetes (OR = 1.53, 95% CI 1.09–2.16, p = 0.01). In sub-group analysis of hypertension grades, there was also a graded trend between elevated TG and CKD from controlled blood pressure (BP) to hypertension grade 2 (OR = 1.81, 95%CI 1.06–3.11, p = 0.03; OR = 1.85, 95%CI 1.00–3.43, p = 0.05; OR = 2.81, 95% CI 1.09–7.28, p = 0.03, respectively). Conclusion Elevated TG, elevated FBG and hypertension grades were significantly associated with the prevalence of CKD in patients with hypertension. Particularly, elevated TG was strongly associated with CKD, independent of diabetes and hypertension grades.
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Affiliation(s)
- Kun Xie
- Cardiology Department, Huashan Hospital, Fudan University, No. 12 Mid Wulumuqi Road, Shanghai, 200040, China
| | - Liwen Bao
- Cardiology Department, Huashan Hospital, Fudan University, No. 12 Mid Wulumuqi Road, Shanghai, 200040, China
| | - Xiaofei Jiang
- Cardiology Department, Huashan Hospital, Fudan University, No. 12 Mid Wulumuqi Road, Shanghai, 200040, China
| | - Zi Ye
- Cardiology Department, Huashan Hospital, Fudan University, No. 12 Mid Wulumuqi Road, Shanghai, 200040, China.,Department of cardiovascular medicine Mayo Clinic, Rochester, USA
| | | | - Yugang Dong
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Danchen Gao
- The First Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Xiaoping Ji
- Qilu Hospital of Shandong University, Jinan, China
| | - Tingbo Jiang
- The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jiehua Li
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yan Li
- Rui Jin Hospital Shanghai Jiao Tong University School of Medical, Shanghai, China
| | - Suxin Luo
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wei Mao
- Zhejiang Provincial Hospital of TCM, Zhejiang, China
| | - Daoquan Peng
- The Second Xiangya Hospital of Central South University, Furong, China
| | - Peng Qu
- The second hospital of Dalian Medical University, Zunyi, China
| | | | - Hui Wang
- Jiangsu Province Hospital, Nanjing, China
| | | | - Biao Xu
- Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Xinhua Yin
- First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Zaixin Yu
- Xiangya Hospital, Central South University, Changsha, China
| | - Xinjun Zhang
- West China Hospital, Sichuan University, Lesha, China
| | - Zixin Zhang
- The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Zhiming Zhu
- Grand ping hospital, third military medical university, Chongqing, China
| | - Xiufang Gao
- Cardiology Department, Huashan Hospital, Fudan University, No. 12 Mid Wulumuqi Road, Shanghai, 200040, China.
| | - Yong Li
- Cardiology Department, Huashan Hospital, Fudan University, No. 12 Mid Wulumuqi Road, Shanghai, 200040, China
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Zhan X, Yang M, Zhou R, Wei X, Chen Y, Chen Q. Triglyceride to high-density lipoprotein cholesterol ratio is associated with increased mortality in older patients on peritoneal dialysis. Lipids Health Dis 2019; 18:199. [PMID: 31729985 PMCID: PMC6858755 DOI: 10.1186/s12944-019-1147-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 11/07/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio (TG/HDL-C) has been suggested as a simple method to identify unfavorable cardiovascular (CV) outcomes in the general population. The aim of this study was to investigate the association between the TG/HDL-C ratio and all-cause and CV mortality in peritoneal dialysis (PD) patients. METHODS We retrospectively analyzed patients on PD from November 1, 2005, to February 28, 2017, with a follow-up period lasting until May 31, 2017. The main outcomes were all-cause and CV mortality. RESULTS Among the 973 PD patients, the mean age was 49.67 ± 14.58 (y). During a median follow-up period of 27.2 months (IQR = 13.4-41.5 months), 229 (23.5%) patients died, with 120 (12.3%) dying as a result of CV diseases. The median serum TG/HDL-C ratio was 1.11 (IQR = 0.71-1.80). In a multivariate Cox regression analysis, patients with higher TG/HDL-C ratio levels (tertile 3) had a higher incidence of CV mortality (adjusted HR = 2.12; 95% CI: 1.21-3.72; P = 0.009) and all-cause mortality (adjusted HR = 2.08; 95% CI: 1.37-3.14; P = 0.001) compared to patients in tertile 1. These associations persisted after excluding the patients who have already taken lipid-lowering medications. For older patients (> 60 years), each 1-unit higher baseline TG/HDL-C level was associated with a 48% (95% CI: 1.06-2.07; P = 0.021) increased risk of all-cause mortality and a 59% (95% CI: 1.03-2.45; P = 0.038) increased risk of CV mortality; however, this association was not observed in patients ≤60 years of age. CONCLUSIONS A higher serum TG/HDL-C ratio was an independent predictor of all-cause and CV mortality in PD patients. Furthermore, an elevated TG/HDL-C ratio was significantly associated with higher all-cause and CV mortality in older PD patients.
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Affiliation(s)
- Xiaojiang Zhan
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, 17# Yongwai Street, Nanchang, 330006, China
| | - Mei Yang
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, 17# Yongwai Street, Nanchang, 330006, China
| | - Ruitong Zhou
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, 17# Yongwai Street, Nanchang, 330006, China
| | - Xin Wei
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, 17# Yongwai Street, Nanchang, 330006, China
| | - Yanbing Chen
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, 17# Yongwai Street, Nanchang, 330006, China
| | - Qinkai Chen
- Department of Nephrology, The First Affiliated Hospital of Nanchang University, 17# Yongwai Street, Nanchang, 330006, China.
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Yu L, Zhou L, Zhou D, Hu G. Nonlinear relationship between triglyceride/high-density lipoprotein cholesterol ratio and chronic kidney disease in US adults: a National Health and Nutrition Examination Survey investigation. Int Urol Nephrol 2019; 51:2005-2014. [PMID: 31538278 DOI: 10.1007/s11255-019-02287-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 09/15/2019] [Indexed: 01/06/2023]
Abstract
PURPOSE Published data on the association between triglycerides/high-density lipoprotein cholesterol (TG/HDL-C) ratio and chronic kidney disease (CKD) in US populations are limited. We examined the association between TG/HDL-C ratio and the prevalence of CKD using US National Health and Nutrition Examination Survey (NHANES) database. METHODS This cross-sectional study included 13,780 US adults from NHANES (1999-2006). CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 or albuminuria. Multivariable logistic regression models were used to examine the relationship between TG/HDL-C ratio and CKD. A generalized additive model (GAM) and smooth curve fitting (penalized spline method) and a two-piecewise logistic regression models were also conducted to address for nonlinearity between TG/HDL-C ratio and CKD. RESULTS The prevalence of CKD was 15.8%. Multiple logistic analyses showed that showed that TG/HDL-C ratio was associated with 5% increased prevalence of CKD. Analyses using restricted cubic spline showed a saturation and nonlinear association between TG/HDL-C ratio and CKD. The inflection point for the curve was found at a TG/HDL-C ratio level of 6.68. The ORs (95% CIs) for CKD were 1.08 (1.04, 1.13) and 0.97 (0.89, 1.05) to the left and right of the inflection point, respectively. None of all stratified variables showed significant effect modification on the association between TG/HDL-C ratio and CKD (P-interaction > 0.05). CONCLUSIONS Our study suggested saturated effects of TG/HDL-C ratio on the prevalence of CKD among US adults. TG/HDL-C ratio less than 6.68 was positively and independently associated with CKD.
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Affiliation(s)
- Le Yu
- Department of Rheumatology, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, Jiangxi, 330006, China
| | - Limin Zhou
- Department of Emergency, The First Affiliated Hospital of Nanchang University, No. 17, Yongwaizheng Street, Donghu District, Nanchang, Jiangxi, 330000, China
| | - Di Zhou
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Guiping Hu
- School of Medicine, Beihang University, 37 Xueyuan Road, Haidian District, Beijing, 100191, China. .,Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University, 37 Xueyuan Road, Haidian District, Beijing, 100191, China.
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Risk of Kidney Dysfunction from Polypharmacy among Older Patients: A Nested Case-Control Study of the South Korean Senior Cohort. Sci Rep 2019; 9:10440. [PMID: 31320704 PMCID: PMC6639333 DOI: 10.1038/s41598-019-46849-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 07/03/2019] [Indexed: 12/20/2022] Open
Abstract
Polypharmacy, the concurrent use of multiple medicines, could increase the risk of kidney dysfunction among older adults because it likely burdens the aging kidneys to excrete multiple pharmaceutical ingredients and their metabolites. This study aimed to examine the relation between polypharmacy and kidney dysfunction among older patients. A nested case-control study was conducted using the National Health Insurance Service - Senior Cohort (NHIS-SC, 2009-2013), representative of the Korean senior population. It consisted of all health insurance claims linked to records of mandatory health examination. Kidney dysfunction was defined as having an eGFR lower than 60, with a decline rate of 10% or more compared to the baseline eGFR. Polypharmacy was defined based on daily counts of pharmaceutical ingredients during one year prior to the case's event date. It was classified into polypharmacy (five to 10 ingredients) and excessive polypharmacy (10 or more ingredients). After matching case and control groups based on a range of potential confounders, conditional logistic regression was performed incorporating adjustments on disease-specific, medication-specific, and lifestyle-related risk factors. The matching resulted in 14,577 pairs of cases and controls. Exposure to polypharmacy was significantly associated with increase in the risk of kidney dysfunction; i.e., crude model (polypharmacy: OR = 1.572, 95% CI = 1.492-1.656; excessive polypharmacy: OR = 2.069, 95% CI = 1.876-2.283) and risk adjustment model (polypharmacy: OR = 1.213, 95% CI = 1.139-1.292; excessive polypharmacy: OR = 1.461, 95% CI = 1.303-1.639). The significant associations were robust across different definitions of kidney dysfunction. These findings inform healthcare providers and policy makers of the importance of polypharmacy prevention to protect older adults from kidney dysfunction.
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Wan GX, Xia WB, Ji LH, Qin HL, Zhang YG. Triglyceride to high density lipoprotein cholesterol ratio may serve as a useful predictor of major adverse coronary event in female revascularized ST-elevation myocardial infarction. Clin Chim Acta 2018; 485:166-172. [PMID: 29969621 DOI: 10.1016/j.cca.2018.06.049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 06/29/2018] [Accepted: 06/30/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Elevated triglyceride to high density lipoprotein cholesterol (TG/HDL-C) ratio has been identified as a surrogate marker of insulin resistance and an independent predictor for cardiovascular events in the general population. However, the prognostic value of TG/HDL-C ratio in revascularized ST-elevation myocardial infarction(STEMI) patients remains unclear. We examined the association between TG/HDL-C ratio and clinical outcome of revascularized STEMI patients in the Chinese population. METHODS 464 STEMI patients who underwent successful revascularization were enrolled to determine the relationship between TG/HDL-C ratio and major adverse coronary events(MACEs) with a 30-month follow-up. The Kaplan-Meier analysis and Cox regression proportional hazard model were applied to assess the prognostic value of TG/HDL-C ratio. RESULTS TG/HDL-C ratio was found to be significantly associated with age (p = 0.017), history of diabetes(p = 0.017), heart rate(p = 0.011), TG(p < 0.001), HDL-C(p < 0.001) and Gensini score(p = 0.034). The multivariate Cox regression analysis revealed that elevated TG/HDL-C ratio was an independent prognostic factor for MACE in female patients (HR = 2.624,95%CI = 1.211-5.687,p = 0.014) but not in male patients(HR = 0.756, 95%CI = 0.484-1.179,p = NS) after adjustment with other MACE-related prognostic factors. CONCLUSION The TG/HDL-C ratio may be independently associated with MACEs in female revascularized STEMI patients in the Chinese population.
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Affiliation(s)
- Guo-Xing Wan
- Department of Cardiology, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Cardiovascular Laboratory, Centre for Translational Medicine, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China
| | - Wen-Bin Xia
- Department of Cardiology, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Cardiovascular Laboratory, Centre for Translational Medicine, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China
| | - Li-Hua Ji
- Department of Cardiology, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Cardiovascular Laboratory, Centre for Translational Medicine, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China
| | - Hai-Lun Qin
- Department of Cardiology, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Cardiovascular Laboratory, Centre for Translational Medicine, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China
| | - Yong-Gang Zhang
- Department of Cardiology, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China; Cardiovascular Laboratory, Centre for Translational Medicine, The Second Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China.
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Wang H, Li Z, Guo X, Chen Y, Chen S, Tian Y, Sun Y. Contribution of non-traditional lipid profiles to reduced glomerular filtration rate in H-type hypertension population of rural China. Ann Med 2018; 50:249-259. [PMID: 29473759 DOI: 10.1080/07853890.2018.1445277] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Despite current interest in the unfavourable impact of non-traditional lipid profiles on cardiovascular disease, information regarding its relations to reduced glomerular filtration rate (GFR) in H-type hypertension population has not been systemically elucidated. METHODS Analyses were based upon a cross-sectional study of 3259 participants with H-type hypertension who underwent assessment of biochemical, anthropometric and blood pressure values. Reduced GFR was considered if meeting estimated GFR <60 ml/min/1.73 m2. RESULTS A stepwise multivariate regression analysis indicated that non-traditional lipid parameters remained as independent determinants of estimated GFR (all p < .001). In multivariable models, we observed a 50%, 51%, 31%, and 24% higher risk for decreased GFR with each SD increment in TC/HDL-C, TG/HDL-C, LDL-C/HDL-C ratios and non-HDL-C levels, respectively. The highest quartile of TC/HDL-C, TG/HDL-C and LDL-C/HDL-C ratios carried reduced GFR odds (confidence intervals) of 5.50 (2.50 to 12.09), 6.63 (2.58 to 17.05) and 2.22 (1.15 to 4.29), respectively. CONCLUSIONS The relative independent contribution of non-traditional lipid profiles, as indexed by TC/HDL-C, TG/HDL-C, LDL-C/HDL-C ratios and non-HDL-C, towards reduced GFR putting research evidence at the very heart of lipoprotein-mediated renal injury set a vital example for applying a clinical and public health recommendation for reducing the burden of chronic kidney disease. KEY MESSAGES Non-traditional lipid profiles has been linked with the occurrence of cardiovascular disease, but none of the studies that address the effect of non-traditional lipid profiles on reduced GFR risk in H-type hypertension population has been specifically established. A greater emphasis of this study resided in the intrinsic value of TC/HDL-C, TG/HDL-C, LDL-C/HDL-C ratios and non-HDL-C that integrate atherogenic and anti-atherogenic lipid molecules to predict the risk of reduced GFR among H-type hypertension population and provide insight into the pathophysiology of subsequent cardio-cerebrovascular outcomes. In a large Chinese H-type hypertension adults, the relative independent contribution of non-traditional lipid profiles, as indexed by TC/HDL-C, TG/HDL-C, LDL-C/HDL-C ratios and non-HDL-C, towards reduced GFR putting research evidence at the very heart of lipoprotein-mediated renal injury set a vital example for applying a clinical and public health recommendation for reducing the burden of CKD.
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Affiliation(s)
- Haoyu Wang
- a Department of Cardiology , The First Hospital of China Medical University , Shenyang , Liaoning , People's Republic of China
| | - Zhao Li
- a Department of Cardiology , The First Hospital of China Medical University , Shenyang , Liaoning , People's Republic of China
| | - Xiaofan Guo
- a Department of Cardiology , The First Hospital of China Medical University , Shenyang , Liaoning , People's Republic of China
| | - Yintao Chen
- a Department of Cardiology , The First Hospital of China Medical University , Shenyang , Liaoning , People's Republic of China
| | - Shuang Chen
- a Department of Cardiology , The First Hospital of China Medical University , Shenyang , Liaoning , People's Republic of China
| | - Yichen Tian
- a Department of Cardiology , The First Hospital of China Medical University , Shenyang , Liaoning , People's Republic of China
| | - Yingxian Sun
- a Department of Cardiology , The First Hospital of China Medical University , Shenyang , Liaoning , People's Republic of China
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Kim JS, Kim W, Woo JS, Lee TW, Ihm CG, Kim YG, Moon JY, Lee SH, Jeong MH, Jeong KH. The Predictive Role of Serum Triglyceride to High-Density Lipoprotein Cholesterol Ratio According to Renal Function in Patients with Acute Myocardial Infarction. PLoS One 2016; 11:e0165484. [PMID: 27788233 PMCID: PMC5082929 DOI: 10.1371/journal.pone.0165484] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 10/12/2016] [Indexed: 12/04/2022] Open
Abstract
Objective A high serum triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio has been reported as an independent predictor for cardiovascular events in the general population. However, the prognostic value of this ratio in patients with renal dysfunction is unclear. We examined the association of the TG/HDL-C ratio with major adverse cardiovascular events (MACEs) according to renal function in patients with acute myocardial infarction (AMI). Method This study was based on the Korea Acute Myocardial Infarction Registry database. Of 13,897 patients who were diagnosed with AMI, the study population included the 7,016 patients with available TG/HDL-C ratio data. Patients were stratified into three groups according to their estimated glomerular filtration rate (eGFR), and the TG/HDL-C ratio was categorized into tertiles. We investigated 12-month MACEs, which included cardiac death, myocardial infarction, and repeated percutaneous coronary intervention or coronary artery bypass grafting. Results During the 12-month follow up period, 593 patients experienced MACEs. There was a significant association between the TG/HDL-C ratio and MACEs (p<0.001) in the entire study cohort. Having a TG/HDL-C ratio value in the highest tertile of TG/HDL-C ratio was an independent factor associated with increased risk of MACEs (hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.26–1.93; p<0.001). Then we performed subgroup analyses according to renal function. In patients with normal renal function (eGFR ≥ 90 ml/min/1.73m2) and mild renal dysfunction (eGFR ≥ 60 to < 90ml/min/1.73m2), a higher TG/HDL-C ratio was significantly associated with increased risk of MACEs (HR, 1.64; 95% CI, 1.04–2.60; p = 0.035; and HR, 1.56; 95% CI, 1.14–2.12; p = 0.005, respectively). However, in patients with moderate renal dysfunction (eGFR < 60 ml/min/1.73m2), TG/HDL-C ratio lost its predictive value on the risk of MACEs (HR, 1.23; 95% CI, 0.82–1.83; p = 0.317). Conclusions In patients with AMI, TG/HDL-C ratio is a useful independent predictor of 12-month MACEs. However, this ratio does not have predictive power in patients with moderate renal dysfunction.
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Affiliation(s)
- Jin Sug Kim
- Department of Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Weon Kim
- Division of Cardiology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jong Shin Woo
- Division of Cardiology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Tae Won Lee
- Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Chun Gyoo Ihm
- Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Yang Gyoon Kim
- Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Joo Young Moon
- Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sang Ho Lee
- Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Myung Ho Jeong
- Division of Cardiology, Department of Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Kyung Hwan Jeong
- Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
- * E-mail:
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Sun K, Lin D, Li F, Huang C, Qi Y, Xue S, Tang J, Yang C, Li Y, Ren M, Yan L. Discordant associations of lipid parameters with albuminuria and chronic kidney disease: a population-based study. Lipids Health Dis 2015; 14:152. [PMID: 26607500 PMCID: PMC4660634 DOI: 10.1186/s12944-015-0153-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Accepted: 11/06/2015] [Indexed: 03/15/2023] Open
Abstract
Background Although dyslipidemia is related to the pathogenesis of renal insufficiency, which routinely available lipid measure is more applicable in estimation of kidney function is still uncertain. Our objective was to evaluate inconsistent associations of lipid profiles with both albuminuria and chronic kidney disease (CKD). Methods We performed a population-based study in 9730 subjects aged 40 years or older. Definitions of abnormalities in albumin excretion were according to the latest guidelines of American Diabetes Association’s Standards of Medical Care. CKD was defined as estimated glomerular filtration rate (eGFR) < 60 mL/min per 1.73 m2 or the presence of albuminuria. Results There were 2274 (23.4 %) participants categorized as low-grade albuminuria, 639 (6.6 %) participants categorized as increased urinary albumin excretion and 689 (7.1 %) participants categorized as CKD. Triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), Non HDL-C to HDL-C ratio, TG to HDL-C ratio were significantly correlated with urinary albumin to creatinine ratio (ACR), serum creatinine and eGFR (all P < 0.0001). Compare with other lipid parameters, TG to HDL-C ratio have shown the strongest correlation with increased odds of both increased urinary albumin excretion and CKD. No significant associations between lipid parameters and low-grade albuminuria were observed after adjustments for potential confounding factors. Conclusion Our study lends support to discordant associations of lipid parameters with albuminuria and renal function. TG to HDL-C ratio is a better marker than other routine lipid measures for identifying renal insufficiency and should be given more consideration in the clinical practice.
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Affiliation(s)
- Kan Sun
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
| | - Diaozhu Lin
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
| | - Feng Li
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
| | - Chulin Huang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
| | - Yiqin Qi
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
| | - Shengneng Xue
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
| | - Juying Tang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
| | - Chuan Yang
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
| | - Yan Li
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
| | - Meng Ren
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China.
| | - Li Yan
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China.
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Relationship between TG/HDL-C ratio and metabolic syndrome risk factors with chronic kidney disease in healthy adult population. Clin Nutr 2015; 34:874-80. [DOI: 10.1016/j.clnu.2014.09.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2014] [Revised: 09/07/2014] [Accepted: 09/13/2014] [Indexed: 11/17/2022]
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Thyroid function modifies the association between ratio of triglyceride to high-density lipoprotein cholesterol and renal function: a multicenter cross-sectional study. Sci Rep 2015; 5:11052. [PMID: 26179571 PMCID: PMC4503948 DOI: 10.1038/srep11052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 05/11/2015] [Indexed: 11/08/2022] Open
Abstract
Hypothyroidism was confirmed to be associated with both dyslipidemia and renal dysfunction. However, the impact of thyroid function on the relationship between serum lipid levels and renal function has never been given sufficient attention. In this large-scale multicenter cross-sectional study, the ratio of triglyceride to high-density lipoprotein cholesterol (TG/HDL) and the prevalence of hypothyroidism in CKD subjects were significantly higher than those in non-CKD ones (P < 0.001). After adjustment for potential confounding factors, TG/HDL was shown to be significantly associated with serum Cr levels (β = 0.551; 95%CI, 0.394–0.708), and eGFR (β = −0.481; 95%CI, −0.731–−0.230). The risk for CKD was significantly increased as TG/HDL ratio was elevated (adjusted odds ratio = 1.20; 95%CI, 1.11–1.27). These significant associations were found among subjects with euthyroidism and hypothyroidism rather than hyperthyroidism. Furthermore, the associations between TG/HDL and Cr or CKD status were significantly greater in hypothyroidism than those in euthyroidism (P < 0.05). These results suggested that elevated TG/HDL ratio was associated with renal dysfunction; it exhibited a significantly stronger association with Cr and CKD in hypothyroidism than in euthyroidism. Therefore, more attention should be paid on lipid profile to prevent or delay the occurrence and progression of renal dysfunction, especially for those with hypothyroidism.
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Tsuruya K, Yoshida H, Nagata M, Kitazono T, Iseki K, Iseki C, Fujimoto S, Konta T, Moriyama T, Yamagata K, Narita I, Kimura K, Kondo M, Asahi K, Kurahashi I, Ohashi Y, Watanabe T. Impact of the Triglycerides to High-Density Lipoprotein Cholesterol Ratio on the Incidence and Progression of CKD: A Longitudinal Study in a Large Japanese Population. Am J Kidney Dis 2015; 66:972-83. [PMID: 26145254 DOI: 10.1053/j.ajkd.2015.05.011] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 05/05/2015] [Indexed: 11/11/2022]
Abstract
BACKGROUND The impact of the triglycerides to high-density lipoprotein cholesterol (TG:HDL-C) ratio on chronic kidney disease (CKD) is unclear. STUDY DESIGN Longitudinal cohort study. SETTING & PARTICIPANTS 124,700 participants aged 39 to 74 years in the Japanese Specific Health Check and Guidance System, including 50,392 men, 74,308 women, 102,900 without CKD, and 21,800 with CKD. PREDICTOR Quartiles of TG:HDL-C ratio. OUTCOMES & MEASUREMENTS Changes in estimated glomerular filtration rate (eGFR) and urinary protein excretion during the 2-year study period. Incident CKD in participants without CKD, and progression of CKD in participants with CKD. RESULTS In the entire study population, higher quartile of TG:HDL-C ratio at baseline was significantly associated with greater decline in eGFR and increase in urinary protein excretion during the 2-year study period, even after adjustment for confounding factors. A higher ratio was associated with higher risk of incident CKD in participants without CKD and higher risk of rapid decline in eGFR and increase in urinary protein excretion in participants with CKD. Higher TG:HDL-C ratio was more strongly associated with decline in eGFR (P for interaction = 0.002) and with incident CKD (P for interaction = 0.05) in participants with diabetes than without diabetes. LIMITATIONS Short observation period and single measurement of all variables. CONCLUSIONS A higher TG:HDL-C ratio affects the decline in eGFR and incidence and progression of CKD in the Japanese population.
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Affiliation(s)
- Kazuhiko Tsuruya
- Department of Integrated Therapy for Chronic Kidney Disease, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Steering Committee for "Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup," Fukushima, Japan.
| | - Hisako Yoshida
- Department of Integrated Therapy for Chronic Kidney Disease, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masaharu Nagata
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kunitoshi Iseki
- Steering Committee for "Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup," Fukushima, Japan
| | - Chiho Iseki
- Dialysis Unit, University Hospital of the Ryukyus, Okinawa, Japan
| | - Shouichi Fujimoto
- Steering Committee for "Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup," Fukushima, Japan
| | - Tsuneo Konta
- Steering Committee for "Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup," Fukushima, Japan
| | - Toshiki Moriyama
- Steering Committee for "Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup," Fukushima, Japan
| | - Kunihiro Yamagata
- Steering Committee for "Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup," Fukushima, Japan
| | - Ichiei Narita
- Steering Committee for "Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup," Fukushima, Japan
| | - Kenjiro Kimura
- Steering Committee for "Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup," Fukushima, Japan
| | - Masahide Kondo
- Steering Committee for "Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup," Fukushima, Japan
| | - Koichi Asahi
- Steering Committee for "Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup," Fukushima, Japan
| | | | - Yasuo Ohashi
- Department of Integrated Science and Engineering for Sustainable Society, Chuo University, Tokyo, Japan
| | - Tsuyoshi Watanabe
- Steering Committee for "Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup," Fukushima, Japan
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21
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Zuo PY, Chen XL, Liu YW, Zhang R, He XX, Liu CY. Non-HDL-cholesterol to HDL-cholesterol ratio as an independent risk factor for the development of chronic kidney disease. Nutr Metab Cardiovasc Dis 2015; 25:582-587. [PMID: 25921842 DOI: 10.1016/j.numecd.2015.03.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 02/10/2015] [Accepted: 03/05/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Dyslipidemia contributes to the development and progression of renal disease. The objective of this study was to investigate whether an elevated non-HDL-cholesterol to HDL-cholesterol ratio (NonHDLc/HDLc) predicts new-onset chronic kidney disease (CKD). METHODS AND RESULTS We followed 1891 Chinese adults with normal or near-normal kidney function at baseline who participated in an annual health checkup program for the occurrence of new-onset CKD [defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m(2) (low eGFR) and/or proteinuria (defined as urinary protein ≥1 + on dipstick testing)] or low eGFR. Cox proportional hazards models were used to examine the independent relationship between the plasma NonHDLc/HDLc ratio and new-onset CKD. During a median follow-up period of 2.8 years, 3% (n = 57) of participants developed new-onset CKD. Compared with patients in the lowest tertile, patients with NonHDLc/HDLc ratios in the highest tertile had a 1.45-fold higher risk of new-onset CKD (hazard ratio [HR], 2.45; 95% confidence interval [95% CI], 1.07 to 5.61; P = 0.035) after adjustment for potential confounders. There was a marginally significant association with low eGFR (tertile 3 versus tertile 1: HR, 2.94; 95% CI, 0.98 to 8.82; P = 0.054). CONCLUSIONS NonHDLc/HDLc ratio is an independent risk factor for the development of CKD. Assessment of NonHDLc/HDLc ratio may help identify high risk groups with chronic kidney disease.
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Affiliation(s)
- P Y Zuo
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - X L Chen
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Y W Liu
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - R Zhang
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - X X He
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - C Y Liu
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China.
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22
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Streja E, Kovesdy CP, Streja DA, Moradi H, Kalantar-Zadeh K, Kashyap ML. Niacin and Progression of CKD. Am J Kidney Dis 2015; 65:785-98. [DOI: 10.1053/j.ajkd.2014.11.033] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 11/19/2014] [Indexed: 12/17/2022]
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23
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Zhang L, Yuan Z, Chen W, Chen S, Liu X, Liang Y, Shao X, Zou H. Serum lipid profiles, lipid ratios and Chronic Kidney Disease in a Chinese population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:7622-35. [PMID: 25075881 PMCID: PMC4143822 DOI: 10.3390/ijerph110807622] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 07/08/2014] [Accepted: 07/10/2014] [Indexed: 11/23/2022]
Abstract
AIM To examine the association of serum lipids, lipid ratios with Chronic Kidney Disease (CKD) in a Chinese population. METHODS Data were drawn from a cross-sectional survey in China. CKD was defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m(2) or albuminuria-to-creatinine ratio (ACR) > 30 mg/g. Multivariable logistic regressions and multivariate regression models were used. Serum lipids and lipid ratios included total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), TG/HDL-C ratio, TC/HDL-C ratio and LDL-C/HDL-C ratio. RESULTS In men, only logarithm-transformed (log) TG was associated with CKD. The odds ratio (every SD increment) was 1.39 (95% CI 1.03-1.87, P = 0.03). In women, none of the serum lipids and lipid ratios was associated with CKD. Using multivariate regression models, it was shown that log TG and log TG/HDL-C were negatively correlated with eGFR (P < 0.05) in men and LDL-C and log LDL-C/HDL-C ratio were correlated with ACR in men. In female subjects, serum TC, log TG, log TG/HDL-C and log TC/HDL-C were negatively correlated with eGFR (P < 0.05). All of serum lipid profiles and lipid related ratio were not correlated with ACR in women. CONCLUSION Serum TG is the only suitable predictor for CKD in men. However, in women, none of serum lipids and lipid ratio can be used as a predictor for CKD. Log TG and log TG/HDL-C are negatively correlated with eGFR in both genders.
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Affiliation(s)
- Liying Zhang
- Department of Nephrology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China.
| | - Zhiyong Yuan
- Wanzai Hospital of Xiangzhou district, Zhuhai 519000, China.
| | - Wu Chen
- Qianjin health service center of Tianhe district, Guangzhou 510000, China.
| | - Shanying Chen
- Department of Nephrology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China.
| | - Xinyu Liu
- Department of Nephrology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China.
| | - Yan Liang
- Department of Nephrology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China.
| | - Xiaofei Shao
- Department of Nephrology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China.
| | - Hequn Zou
- Department of Nephrology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China.
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24
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Tsuruya K, Yoshida H, Nagata M, Kitazono T, Hirakata H, Iseki K, Moriyama T, Yamagata K, Yoshida H, Fujimoto S, Asahi K, Kurahashi I, Ohashi Y, Watanabe T. Association of the triglycerides to high-density lipoprotein cholesterol ratio with the risk of chronic kidney disease: analysis in a large Japanese population. Atherosclerosis 2014; 233:260-7. [PMID: 24529154 DOI: 10.1016/j.atherosclerosis.2013.12.037] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 11/18/2013] [Accepted: 12/04/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To investigate the relationship between triglycerides to high-density lipoprotein cholesterol ratio (TG/HDL-C) and chronic kidney disease (CKD). METHODS We used data from 216,007 Japanese adults who participated in a nationwide health checkup program. Men (n = 88,516) and women (n = 127,491) were grouped into quartiles based on their TG/HDL-C levels (<1.26, 1.26-1.98, 1.99-3.18, and >3.18 in men; <0.96, 0.96-1.44, 1.45-2.22, and >2.22 in women). We cross-sectionally assessed the association of TG/HDL-C levels with CKD [defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m(2) (low eGFR) and/or proteinuria (defined as urinary protein ≥ 1+ on dipstick testing)], low eGFR, and proteinuria. RESULTS The prevalence of CKD, low eGFR, and proteinuria increased significantly with elevating quartiles of TG/HDL-C in both genders (all P for trend <0.001). Participants in the highest quartile of TG/HDL-C had a significantly greater risk of CKD than those in the lowest quartile after adjustment for the relevant confounding factors (odds ratio: 1.57, 95% confidence interval: 1.49-1.65 in men; 1.41, 1.34-1.48 in women, respectively). Furthermore, there were significant associations with low eGFR and proteinuria. In stratified analysis, the risk of CKD increased linearly with greater TG/HDL-C levels in participants with and without hypertension, diabetes, and obesity. Moreover, higher TG/HDL-C levels were relevant for CKD, especially in participants with hypertension and diabetes (P for interaction <0.001, respectively). CONCLUSIONS An elevated TG/HDL-C is associated with the risk of CKD in the Japanese population.
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Affiliation(s)
- Kazuhiko Tsuruya
- Department of Integrated Therapy for Chronic Kidney Disease, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan; Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Hisako Yoshida
- Department of Integrated Therapy for Chronic Kidney Disease, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Masaharu Nagata
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Hideki Hirakata
- Division of Nephrology and Dialysis Center, Japanese Red Cross Fukuoka Hospital, 3-1-1 Okusu, Minami-ku, Fukuoka 815-8555, Japan.
| | - Kunitoshi Iseki
- Steering Committee for the Examination of the Positioning of CKD in Specific Health Check and Guidance, 3-28-8 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
| | - Toshiki Moriyama
- Steering Committee for the Examination of the Positioning of CKD in Specific Health Check and Guidance, 3-28-8 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
| | - Kunihiro Yamagata
- Steering Committee for the Examination of the Positioning of CKD in Specific Health Check and Guidance, 3-28-8 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
| | - Hideaki Yoshida
- Steering Committee for the Examination of the Positioning of CKD in Specific Health Check and Guidance, 3-28-8 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
| | - Shouichi Fujimoto
- Steering Committee for the Examination of the Positioning of CKD in Specific Health Check and Guidance, 3-28-8 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
| | - Koichi Asahi
- Steering Committee for the Examination of the Positioning of CKD in Specific Health Check and Guidance, 3-28-8 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
| | - Issei Kurahashi
- Department of Planning, Information, and Management, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
| | - Yasuo Ohashi
- Department of Biostatistics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
| | - Tsuyoshi Watanabe
- Steering Committee for the Examination of the Positioning of CKD in Specific Health Check and Guidance, 3-28-8 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
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25
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Kim JY, Kang HT, Lee HR, Lee YJ, Shim JY. Comparison of lipid-related ratios for prediction of chronic kidney disease stage 3 or more in Korean adults. J Korean Med Sci 2012; 27:1524-9. [PMID: 23255852 PMCID: PMC3524432 DOI: 10.3346/jkms.2012.27.12.1524] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 10/11/2012] [Indexed: 12/04/2022] Open
Abstract
Dyslipidemia is implicated in increased cardiovascular risk associated with chronic kidney disease (CKD) and in the progression of renal damage. This study compared 4 different lipid-related ratios (total cholesterol [TC]/high-density lipoprotein cholesterol [HDL-C], triglyceride [TG]/HDL-C, calculated low-density lipoprotein cholesterol [c-LDL-C]/HDL-C, and non-HDL-C/HDL-C ratio) for prediction of CKD stage 3 or more to investigate the association between them. This cross-sectional study included 8,650 adults who participated in the 2007-2008 Korean National Health and Nutrition Examination Survey. The overall prevalence of CKD stage 3 or more was 6.4%. For TG/HDL-C, the prevalence with CKD stage 3 or more increased with increasing quartile group in both sexes (P value for trend = 0.046 in men, 0.002 in women) while other lipid-related ratios showed increasing prevalence only in women. In comparison with the lowest quartile of the lipid-related ratios, only the fourth quartile of TG/HDL-C was associated with the prevalence of CKD stage 3 or more in both sexes after adjustment for multiple covariates (odds ratio [OR] for TG/HDL-C-Q(4), 1.82; 95% CI [confidence interval], 1.09-3.03 in men, OR 2.45; 95% CI, 1.52-3.95 in women). In conclusion, TG/HDL-C is the only lipid-related ratio that is independently associated with CKD stage 3 or more in both sexes of Koreans.
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Affiliation(s)
- Ji-Young Kim
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hee-Taik Kang
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hye-Ree Lee
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yong-Jae Lee
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Jae-Yong Shim
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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