a Department of Cardiology , The First Hospital of China Medical University , Shenyang , Liaoning , People's Republic of China.
Ann Med. 2018 May;50(3):249-259. doi: 10.1080/07853890.2018.1445277. Epub 2018 Feb 28.
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.
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 m.
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.
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.
尽管目前人们对非传统脂质谱对心血管疾病的不利影响很感兴趣,但有关其与 H 型高血压人群肾小球滤过率(GFR)降低之间关系的信息尚未得到系统阐明。
分析基于 3259 名 H 型高血压患者的横断面研究,这些患者接受了生化、人体测量和血压值评估。如果估计的 GFR <60ml/min/1.73m,则认为存在 GFR 降低。
逐步多元回归分析表明,非传统脂质参数仍然是估计 GFR 的独立决定因素(均 p<0.001)。在多变量模型中,我们观察到 TC/HDL-C、TG/HDL-C、LDL-C/HDL-C 比值和非 HDL-C 水平每增加一个 SD,GFR 降低的风险分别增加 50%、51%、31%和 24%。TC/HDL-C、TG/HDL-C 和 LDL-C/HDL-C 比值的最高四分位数与 GFR 降低的几率(置信区间)分别为 5.50(2.50 至 12.09)、6.63(2.58 至 17.05)和 2.22(1.15 至 4.29)。
非传统脂质谱的相对独立贡献,如 TC/HDL-C、TG/HDL-C、LDL-C/HDL-C 比值和非 HDL-C 所示,与 GFR 降低有关,这为脂蛋白介导的肾脏损伤提供了研究证据,这为应用降低慢性肾脏病负担的临床和公共卫生建议树立了重要榜样。关键信息:非传统脂质谱与心血管疾病的发生有关,但没有一项专门针对 H 型高血压人群中非传统脂质谱对降低 GFR 风险影响的研究。本研究的一个重点是 TC/HDL-C、TG/HDL-C、LDL-C/HDL-C 比值和非 HDL-C 的内在价值,这些值综合了致动脉粥样硬化和抗动脉粥样硬化脂质分子,以预测 H 型高血压人群中 GFR 降低的风险,并深入了解随后的心脏-脑血管事件的病理生理学。在一项针对中国 H 型高血压成年人的大型研究中,TC/HDL-C、TG/HDL-C、LDL-C/HDL-C 比值和非 HDL-C 等非传统脂质谱的相对独立贡献,与 GFR 降低有关,这为脂蛋白介导的肾脏损伤提供了研究证据,为应用降低慢性肾脏病负担的临床和公共卫生建议树立了重要榜样。