Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Ren Fail. 2021 Dec;43(1):32-39. doi: 10.1080/0886022X.2020.1853569.
This study explored whether lipid disorders or an elevated atherogenic index of plasma (AIP, a risk factor for cardiovascular diseases) could predict major kidney function decline.
We conducted a retrospective 7-year cohort study of 3712 Chinese adults followed up between 2010 and 2017. Major kidney function decline was defined as ≥ 30% reduction in the estimated glomerular filtration rate (eGFR) from baseline. Multivariable logistic regression models were used to evaluate the relationship between lipid profiles and major kidney function decline. Smoking habits, waist circumference, and physical activity were not assessed.
During the 7-year follow-up, 1.70% ( = 63) of the participants developed major kidney function decline. After adjustment for potential confounders, the odds ratios (ORs) for developing eGFR decline with per standard deviation increase were 1.23 [95% confidence interval (CI): 1.06-1.43] for triglyceride and 2.55 (95% CI: 1.01-6.42) for AIP in all participants. Furthermore, in the stratified analysis, we found sex-related differences; triglyceride and AIP were only independently associated with the risk of eGFR decline in men (OR, 1.27, 95% CI: 1.08-1.48; OR, 3.98, 95% CI: 1.22-12.99, respectively). When the participants were divided into groups according to the baseline lipid status, association was observed only between abnormal AIP and eGFR decline (all values < 0.05).
Our findings suggest that a higher serum triglyceride level or an elevated AIP increases the risk of major kidney function decline in Chinese men with normal kidney function. Thus, assessment of AIP may help identify the risk of eGFR decline.
本研究旨在探讨脂质异常或血浆致动脉粥样硬化指数（AIP，心血管疾病的危险因素）升高是否可预测主要肾功能下降。
我们进行了一项回顾性的 7 年队列研究，纳入了 2010 年至 2017 年间随访的 3712 名中国成年人。主要肾功能下降定义为肾小球滤过率（eGFR）基线值下降≥30%。采用多变量逻辑回归模型评估血脂谱与主要肾功能下降之间的关系。未评估吸烟习惯、腰围和身体活动。
在 7 年的随访期间，1.70%（n=63）的参与者出现了主要肾功能下降。在调整了潜在混杂因素后，与 eGFR 下降相关的比值比（OR）分别为 1.23（95%置信区间 [CI]：1.06-1.43）和 2.55（95% CI：1.01-6.42），每标准偏差升高甘油三酯和 AIP。此外，在分层分析中，我们发现了性别相关的差异；甘油三酯和 AIP 仅与男性 eGFR 下降的风险独立相关（OR，1.27，95% CI：1.08-1.48；OR，3.98，95% CI：1.22-12.99）。当根据基线血脂状况将参与者分为不同组别时，仅发现异常 AIP 与 eGFR 下降之间存在关联（所有 P 值均<0.05）。
我们的研究结果表明，血清甘油三酯水平升高或 AIP 升高与肾功能正常的中国男性主要肾功能下降的风险增加相关。因此，评估 AIP 可能有助于识别 eGFR 下降的风险。
