Department of Nephrology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, 200032, Shanghai, China.
Shanghai Medical Center of Kidney Disease, 200032, Shanghai, China.
Lipids Health Dis. 2021 Sep 20;20(1):110. doi: 10.1186/s12944-021-01542-5.
Previous studies show that abnormal lipoprotein metabolism can increase the prevalence of chronic kidney disease (CKD). This study prospectively investigated the association of triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) ratio and renal dysfunction in the Chinese population.
This longitudinal cohort research examined 7,316 participants (age range: 22-93) from the China Health and Retirement Longitudinal Study (CHARLS), including 6,560 individuals with estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m (normal renal function, NRF) group and 756 with eGFR < 60 mL/min/1.73 m (impaired renal function, IRF) group. In NRF group, reduction in renal function was defined as eGFR < 60 mL/min/1.73 m at exit visit and in IRF group, it was defined as decline in eGFR category, average eGFR decline > 5 mL/min/1.73 m per year or > 30 % decrease in eGFR from baseline.
The study results showed that TG/HDL-C ratio was positively associated with the risk of renal function decline in the NRF group (OR 1.30, 95 %CI 1.03-1.65, P = 0.03) and the IRF group (OR 1.90, 95 %CI 1.21-3.23, P = 0.02) when adjusting for age, gender, obesity, diabetes, hypertension, waist circumference, drinking, smoking, history of heart disease and stroke, low-density lipoprotein cholesterol and eGFR category. Analysis of the IRF group indicated that relative to the group of TG/HDL-C < 1.60, the group of TG/HDL-C ≥ 2.97 had an increased risk for the decline of eGFR category (OR 1.89, 95 %CI 1.12-3.21, P = 0.02) and > 30 % decline in eGFR (OR 2.56, 95 %CI 1.05-6.38, P = 0.04).
The high TG/HDL-C ratio was an independent risk factor for declining renal function in the Chinese population.
先前的研究表明，脂蛋白代谢异常会增加慢性肾脏病（CKD）的患病率。本研究前瞻性地调查了甘油三酯与高密度脂蛋白胆固醇（TG/HDL-C）比值与中国人群肾功能障碍的关系。
本纵向队列研究共纳入来自中国健康与养老追踪调查（CHARLS）的 7316 名参与者（年龄范围：22-93 岁），包括肾小球滤过率（eGFR）≥60mL/min/1.73m2 的 6560 名个体（正常肾功能，NRF 组）和 eGFR<60mL/min/1.73m2 的 756 名个体（肾功能受损，IRF 组）。在 NRF 组中，肾功能下降定义为随访时 eGFR<60mL/min/1.73m2，在 IRF 组中，定义为 eGFR 类别下降、平均 eGFR 每年下降>5mL/min/1.73m 或 eGFR 从基线下降>30%。
研究结果表明，在调整年龄、性别、肥胖、糖尿病、高血压、腰围、饮酒、吸烟、心脏病和中风史、低密度脂蛋白胆固醇和 eGFR 类别后，TG/HDL-C 比值与 NRF 组（比值比 [OR] 1.30，95%置信区间 [CI] 1.03-1.65，P=0.03）和 IRF 组（OR 1.90，95%CI 1.21-3.23，P=0.02）肾功能下降风险呈正相关。对 IRF 组的分析表明，与 TG/HDL-C<1.60 组相比，TG/HDL-C≥2.97 组发生 eGFR 类别下降（OR 1.89，95%CI 1.12-3.21，P=0.02）和 eGFR 下降>30%（OR 2.56，95%CI 1.05-6.38，P=0.04）的风险增加。
高 TG/HDL-C 比值是中国人群肾功能下降的独立危险因素。
