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血脂参数与慢性肾脏病风险的关联:一项基于中国南方人群的纵向研究。

Association of Lipid Parameters with the Risk of Chronic Kidney Disease: A Longitudinal Study Based on Populations in Southern China.

作者信息

Wang Xin, Chen Haishan, Shao Xiaofei, Xiong Chongxiang, Hong Guobao, Chen Jianhui, Li Xiaolin, You Xu, Gao Peichun, Chen Yunying, Zou Ziliang, Ning Jing, Xiao Hua, Zou Hequn, Wei Lixin

机构信息

Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou 510630, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2020 Mar 4;13:663-670. doi: 10.2147/DMSO.S229362. eCollection 2020.

Abstract

OBJECTIVE

To investigate which plasma lipid parameters are useful for detecting chronic kidney disease (CKD) in a Chinese population without known CKD or renal impairment.

METHODS

This was a prospective study. In southern Chinese cities from 2012 to 2013, a total of 1037 subjects aged ≥ 18 years old received a survey. Logistic regression and multiple linear regression analyses were performed. The lipid parameters studied included total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), non-high-density lipoprotein cholesterol (nHDL-C), TG/HDL-C ratio, TC/HDL-C ratio and nHDL-C/HDL-C ratio.

RESULTS

After adjusting for confounding factors, the fourth percentile of logTG/HDL-C was observed to be an independent risk factor for CKD (OR = 2.453, P < 0.001), and the highest quantile of the logTG/HDL-C ratio was associated with a higher prevalence of CKD (P < 0.05). This risk was reduced when the model was adjusted with Insulin resistance (IR) (OR = 2.034, P < 0.05). In the group of women, glucose metabolism disorders, high uric acid, and obesity, this risk was increased. Multiple regression models showed that log TG and nonHDL-C/HDL-C were negatively correlated with eGFR (P < 0.05), while log TG and TC were positively correlated with logACR (P < 0.05). The area under the curve (ROC) of lgTG/HDL was 0.623 (p < 0.001).

CONCLUSION

The serum logTG/HDL-C ratio is the only suitable predictor of CKD, and IR may be the mechanism. This risk needs to be controlled in a specific population. Log TG and nonHDL-C/HDL-C were negatively correlated with eGFR, while log TG and TC were positively correlated with logACR.

摘要

目的

探讨哪些血脂参数有助于在中国无已知慢性肾脏病(CKD)或肾功能损害的人群中检测CKD。

方法

这是一项前瞻性研究。2012年至2013年期间,在中国南方城市对1037名年龄≥18岁的受试者进行了调查。进行了逻辑回归和多元线性回归分析。研究的血脂参数包括总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、非高密度脂蛋白胆固醇(nHDL-C)、TG/HDL-C比值、TC/HDL-C比值和nHDL-C/HDL-C比值。

结果

在调整混杂因素后,发现logTG/HDL-C的第四个百分位数是CKD的独立危险因素(OR = 2.453,P < 0.001),且logTG/HDL-C比值的最高分位数与CKD的较高患病率相关(P < 0.05)。当模型用胰岛素抵抗(IR)进行调整时,这种风险降低(OR = 2.034,P < 0.05)。在女性、糖代谢紊乱、高尿酸和肥胖组中,这种风险增加。多元回归模型显示,log TG和非HDL-C/HDL-C与估算肾小球滤过率(eGFR)呈负相关(P < 0.05),而log TG和TC与log尿白蛋白肌酐比值(logACR)呈正相关(P < 0.05)。lgTG/HDL的曲线下面积(ROC)为0.623(p < 0.001)。

结论

血清logTG/HDL-C比值是CKD唯一合适的预测指标,IR可能是其机制。在特定人群中需要控制这种风险。log TG和非HDL-C/HDL-C与eGFR呈负相关,而log TG和TC与logACR呈正相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/efd0/7061434/707340903972/DMSO-13-663-g0001.jpg

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