Lee Sung-Ho, Kim Do Hoon, Kim Yang-Hyun, Roh Yong Kyun, Ju Sang Yhun, Nam Hyo-Yun, Nam Ga-Eun, Choi Jun-Seok, Lee Jong-Eun, Sang Jung-Eun, Han Kyungdo, Park Yong-Gyu
From the Department of Family Medicine, Korea University, College of Medicine, Seoul (S-HL, DHK, Y-HK, H-YN, G-EN, J-SC, J-EL, J-ES); Department of Family Medicine, Hallym University, College of Medicine, Chunchon (YKR); Department of Family Medicine, Catholic University (SYJ); and Department of Biostatistics, The Catholic University of Korea, College of Medicine, Seoul (KDH, Y-GP), Republic of Korea.
Medicine (Baltimore). 2016 Apr;95(16):e3224. doi: 10.1097/MD.0000000000003224.
This study aimed to estimate the relationship between various lipid abnormalities and albuminuria in hypertensive Korean adults. Data obtained from the Korea National Health and Nutrition Examination Survey in 2011 to 2012 were analyzed. The study included 2330 hypertensive participants. Total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels were measured. Dyslipidemia parameters were defined as high TG ≥200 mg/dL, low HDL-C as HDL-C <40 mg/dL, high TC/HDL-C as TC/HDL-C ratio ≥4, high TG/HDL-C as TG/HDL-C ratio ≥3.8, and high LDL-C/HDL-C as LDL-C/HDL-C ratio ≥2.5. Albuminuria was defined as a urine albumin to creatinine ratio (ACR) ≥30 mg/g. Women with albuminuria showed significantly higher levels of TG, TC/HDL-C, and TG/HDL-C and a lower level of HDL-C than women without albuminuria (all P < 0.05). LogTG, TC/HDL-C, and logTG/HDL-C were positively correlated with ACR in both men and women; however, HDL-C was negatively correlated with ACR in women and non-HDL-C was positively correlated with ACR in men. In men, there was no association between ACR and lipid parameters. However, in women, higher values for logTG, TC/HDL-C, and logTG/HDL-C were associated with an increased odds ratio (OR) for albuminuria (OR [95% confidence interval]: 1.53 [1.06-2.21], 1.21 [1.02-1.45], and 1.78 [1.21-2.63], respectively) and HDL-C with a decreased OR for albuminuria (0.78 [0.67-0.92]) after adjusting for all covariates. LogTG, TC/HDL-C, and logTG/HDL-C were associated with an increased prevalence of albuminuria in hypertensive women. Screening and treatment for dyslipidemia may be necessary for hypertensive women to address potential albuminuria.
本研究旨在评估韩国高血压成年患者中各种脂质异常与蛋白尿之间的关系。对2011年至2012年韩国国家健康与营养检查调查所获数据进行分析。该研究纳入了2330名高血压参与者。测量了总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）和低密度脂蛋白胆固醇（LDL-C）水平。血脂异常参数定义为高TG≥200mg/dL、低HDL-C为HDL-C<40mg/dL、高TC/HDL-C为TC/HDL-C比值≥4、高TG/HDL-C为TG/HDL-C比值≥3.8、高LDL-C/HDL-C为LDL-C/HDL-C比值≥2.5。蛋白尿定义为尿白蛋白与肌酐比值（ACR）≥30mg/g。有蛋白尿的女性与无蛋白尿的女性相比，TG、TC/HDL-C和TG/HDL-C水平显著更高，而HDL-C水平更低（所有P<0.05）。LogTG、TC/HDL-C和logTG/HDL-C在男性和女性中均与ACR呈正相关；然而，HDL-C在女性中与ACR呈负相关，非HDL-C在男性中与ACR呈正相关。在男性中，ACR与脂质参数之间无关联。然而，在女性中，调整所有协变量后，logTG、TC/HDL-C和logTG/HDL-C的较高值与蛋白尿的比值比（OR）增加相关（OR[95%置信区间]：分别为1.53[1.06 - 2.21]、1.21[1.02 - 1.45]和1.78[1.21 - 2.63]），而HDL-C与蛋白尿的OR降低相关（0.78[0.67 - 0.92]）。LogTG、TC/HDL-C和logTG/HDL-C与高血压女性蛋白尿患病率增加相关。对于高血压女性，可能有必要进行血脂异常的筛查和治疗以应对潜在的蛋白尿。
