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三酰甘油与高密度脂蛋白胆固醇比值与慢性肾脏病风险的关系:一项在大型日本人群中的分析。

Association of the triglycerides to high-density lipoprotein cholesterol ratio with the risk of chronic kidney disease: analysis in a large Japanese population.

机构信息

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.

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.

出版信息

Atherosclerosis. 2014 Mar;233(1):260-7. doi: 10.1016/j.atherosclerosis.2013.12.037. Epub 2014 Jan 18.

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.

摘要

目的

探讨甘油三酯与高密度脂蛋白胆固醇比值(TG/HDL-C)与慢性肾脏病(CKD)的关系。

方法

我们使用了 216007 名日本成年人参加全国健康体检计划的数据。根据 TG/HDL-C 水平,男性(n=88516)和女性(n=127491)分为四组(男性:<1.26、1.26-1.98、1.99-3.18 和 >3.18;女性:<0.96、0.96-1.44、1.45-2.22 和 >2.22)。我们横断面评估了 TG/HDL-C 水平与 CKD[定义为肾小球滤过率(eGFR)<60mL/min/1.73m²(低 eGFR)和/或蛋白尿(尿蛋白≥1+试纸检测)]、低 eGFR 和蛋白尿的关系。

结果

在两性中,随着 TG/HDL-C 四分位升高,CKD、低 eGFR 和蛋白尿的患病率显著增加(所有趋势 P 值均<0.001)。在调整了相关混杂因素后,TG/HDL-C 最高四分位的参与者发生 CKD 的风险明显高于最低四分位的参与者(男性:比值比:1.57,95%置信区间:1.49-1.65;女性:1.41,1.34-1.48)。此外,与低 eGFR 和蛋白尿也存在显著关联。在分层分析中,在有和没有高血压、糖尿病和肥胖的参与者中,CKD 的风险与更高的 TG/HDL-C 水平呈线性相关。此外,更高的 TG/HDL-C 水平与 CKD 相关,尤其是在有高血压和糖尿病的参与者中(交互作用 P 值均<0.001)。

结论

在日本人群中,升高的 TG/HDL-C 与 CKD 风险相关。

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