Department of Nephrology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan 450052, China.
Chin Med J (Engl). 2013 Apr;126(7):1207-12.
Dyslipidemia, a well-known risk factor for cardiovascular disease, is common in patients with kidney disease. Recent studies discerned that dyslipidemias play a critical role in renal damage progression in renal diseases, but the association between dyslipidemias and chronic kidney disease (CKD) in the general population remains unknown. Thus, we assessed whether the growing prevalence of dyslipidemia could increase the risk of CKD.
A total of 4779 middle-aged and elderly participants participated in this study. Dyslipidemias were defined by the 2007 Guidelines in Chinese Adults. Incident CKD was defined as albuminuria and/or reduced estimated glomerular filtration rate (eGFR, < 60 ml×min(-1)×1.73 m(-2)). Regression analysis was used to evaluate the association between dyslipidemia and albuminuria/reduced eGFR.
Participants with hypercholesterolemia exhibited a greater prevalence of albuminuria and reduced eGFR (10.0% vs. 6.1%, P = 0.001; 4.0% vs. 2.4%, P = 0.028, respectively). Both hypercholesterolemia and low high density lipoprotein cholesterol (HDL-C) were independently associated with albuminuria (odds ratio (OR) 1.49; 95% confidence interval (CI) 1.08 - 2.07 and OR 1.53; 95%CI 1.13 - 2.09, respectively). The multivariable adjusted OR of reduced eGFR in participants with hypercholesterolemia was 1.65 (95%CI 1.03 - 2.65). As the number of dyslipidemia components increased, so did the OR of CKD: 0.87 (95%CI 0.65 - 1.15), 1.29 (95%CI, 0.83 - 2.01), and 7.87 (95%CI, 3.75 - 16.50) for albuminuria, and 0.38 (95%CI 0.21 - 0.69), 1.92 (95%CI 1.14 - 3.25), and 5.85 (95%CI 2.36 - 14.51) for reduced eGFR, respectively.
Our findings indicate that dyslipidemias increase the risk of CKD in the middle-aged and elderly Chinese population. Hypercholesterolemia plays an important role in reducing total eGFR. Both low HDL-C and hypercholesterolemia are associated with an increased risk for albuminuria.
血脂异常是心血管疾病的一个众所周知的危险因素，在肾病患者中很常见。最近的研究表明，血脂异常在肾脏疾病的肾损伤进展中起着关键作用，但血脂异常与普通人群中慢性肾脏病（CKD）之间的关系尚不清楚。因此，我们评估了血脂异常患病率的增加是否会增加 CKD 的风险。
共有 4779 名中老年参与者参加了这项研究。血脂异常按照中国成年人 2007 年指南定义。新发 CKD 定义为蛋白尿和/或估算肾小球滤过率（eGFR，<60 ml×min(-1)×1.73 m(-2)）降低。回归分析用于评估血脂异常与蛋白尿/降低 eGFR 之间的关系。
高胆固醇血症患者蛋白尿和降低 eGFR 的患病率更高（10.0% vs. 6.1%，P = 0.001；4.0% vs. 2.4%，P = 0.028）。高胆固醇血症和低高密度脂蛋白胆固醇（HDL-C）均与蛋白尿独立相关（比值比（OR）1.49；95%置信区间（CI）1.08-2.07 和 OR 1.53；95%CI 1.13-2.09）。高胆固醇血症患者 eGFR 降低的多变量调整 OR 为 1.65（95%CI 1.03-2.65）。随着血脂异常成分数量的增加，CKD 的 OR 也随之增加：0.87（95%CI 0.65-1.15）、1.29（95%CI，0.83-2.01）和 7.87（95%CI，3.75-16.50）用于蛋白尿，0.38（95%CI 0.21-0.69）、1.92（95%CI 1.14-3.25）和 5.85（95%CI 2.36-14.51）用于降低 eGFR。
我们的研究结果表明，血脂异常增加了中国中老年人群 CKD 的风险。高胆固醇血症在降低总 eGFR 方面起着重要作用。低 HDL-C 和高胆固醇血症均与蛋白尿风险增加有关。
