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 Nephrology, Nara Medical University, Kashihara, Nara, Japan.
Clin Exp Nephrol. 2021 Apr;25(4):385-393. doi: 10.1007/s10157-020-02000-9. Epub 2021 Jan 4.
Patients with chronic kidney disease (CKD) have a higher risk of atherosclerotic cardiovascular disease (ASCVD). Dyslipidemia has been established as a risk factor for ASCVD. In the present study, we aimed to determine the prevalence of dyslipidemia at each stage of CKD.
We conducted a cross-sectional study among 4476 patients registered in the Fukuoka Kidney Disease Registry Study, a Japanese prospective cohort study in patients with non-dialysis-dependent CKD. Outcomes were the prevalence of hyper-low-density lipoprotein (LDL) cholesterolemia, hyper-non-high-density lipoprotein (non-HDL) cholesterolemia, hypertriglyceridemia, and hypo-high-density lipoprotein (hypo-HDL) cholesterolemia at each stage of CKD. We analyzed the relationships between CKD stage and the prevalence of dyslipidemia using logistic regression models.
Patients in the advanced stages of CKD were more likely to have hypertriglyceridemia [OR 2.16 (95% CI 1.03-4.56), OR 2.24 (95% CI 1.04-4.84), OR 2.62 (95% CI 1.19-5.78), and OR 2.47 (95% CI 1.04-5.88) for CKD stages G3a, G3b, G4, and G5, respectively] and hypo-HDL-cholesterolemia [OR 2.66 (95% CI 1.21-5.82), OR 3.10 (95% CI 1.38-6.95), OR 2.86 (95% CI 1.25-6.53), and OR 3.30 (95% CI 1.35-8.10) for CKD stages G3a, G3b, G4, and G5, respectively] as compared with patients in CKD stage G1. The prevalence of hyper-LDL-cholesterolemia and hyper-non-HDL-cholesterolemia was not related to CKD stage.
Patients with advanced CKD stages are more likely to have hypertriglyceridemia and hypo-HDL-cholesterolemia than those in early stages. This type of lipid profile may represent a risk factor for ASCVD in patients with CKD.
慢性肾脏病(CKD)患者发生动脉粥样硬化性心血管疾病(ASCVD)的风险较高。血脂异常已被确定为 ASCVD 的一个危险因素。本研究旨在确定 CKD 各阶段血脂异常的患病率。
我们对 4476 例在非透析依赖型 CKD 日本前瞻性队列研究——福冈肾脏病登记研究中登记的患者进行了横断面研究。结局为 CKD 各阶段低密脂蛋白(LDL)胆固醇血症、非高密度脂蛋白(non-HDL)胆固醇血症、高甘油三酯血症和低高密度脂蛋白(HDL)胆固醇血症的患病率。我们使用逻辑回归模型分析了 CKD 分期与血脂异常患病率之间的关系。
CKD 晚期患者更易发生高甘油三酯血症[CKD 3a、3b、4 和 5 期的比值比(OR)分别为 2.16(95%可信区间[CI] 1.03-4.56)、2.24(95%CI 1.04-4.84)、2.62(95%CI 1.19-5.78)和 2.47(95%CI 1.04-5.88)]和低 HDL-胆固醇血症[CKD 3a、3b、4 和 5 期的 OR 分别为 2.66(95%CI 1.21-5.82)、3.10(95%CI 1.38-6.95)、2.86(95%CI 1.25-6.53)和 3.30(95%CI 1.35-8.10)],与 CKD 1 期患者相比。高 LDL-胆固醇血症和高 non-HDL-胆固醇血症的患病率与 CKD 分期无关。
与早期 CKD 患者相比,晚期 CKD 患者更易发生高甘油三酯血症和低 HDL-胆固醇血症。这种血脂谱可能代表 CKD 患者发生 ASCVD 的一个危险因素。