Department of Vascular Medicine, Osaka City University Graduate School of Medicine.
Vascular Science Center for Translational Research, Osaka City University Graduate School of Medicine.
J Atheroscler Thromb. 2022 Dec 1;29(12):1835-1848. doi: 10.5551/jat.63311. Epub 2022 Mar 5.
Serum levels of cholesterol absorption and synthesis markers are known to be associated with cardiovascular risk. Individuals with reduced kidney function or chronic kidney disease (CKD) are at an increased risk for cardiovascular disease. Hence, we examined the relationship between estimated glomerular filtration rate (eGFR) and serum markers of cholesterol absorption and synthesis.
The CACHE (Cholesterol Absorption and Cholesterol synthesis in High-risk patiEnts) Consortium, comprised of 13 research groups in Japan possessing data of lathosterol (Latho, synthesis marker) and campesterol (Campe, absorption marker) measured via gas chromatography, compiled the clinical data using the REDCap system. Among the 3597 records, data from 2944 individuals were utilized for five analyses including this CKD analysis.
This study analyzed data from 2200 individuals including 522 hemodialysis patients; 42.3% were female, the median age was 58 years, and the median eGFR was 68.9 mL/min/1.73 m. Latho, Campe, and Campe/Latho ratio were significantly different when compared across CKD stages. When the associations of eGFR with these markers were assessed with multivariable nonlinear regression models, Latho, Campe, and Campe/Latho ratio showed positive, inverse, and inverse associations with eGFR. These associations were significantly modified by sex, the presence/absence of diabetes mellitus, and the presence/absence of statin use.
We showed that individuals with lower eGFR have lower cholesterol synthesis marker levels and higher cholesterol absorption marker levels in this large sample.
已知胆固醇吸收和合成标志物的血清水平与心血管风险相关。肾功能降低或慢性肾脏病(CKD)患者发生心血管疾病的风险增加。因此,我们研究了估算肾小球滤过率(eGFR)与胆固醇吸收和合成的血清标志物之间的关系。
由日本 13 个研究小组组成的 CACHE(胆固醇吸收和高危患者胆固醇合成)联盟,通过气相色谱法测量了羊毛固醇(Latho,合成标志物)和菜油固醇(Campe,吸收标志物),并使用 REDCap 系统对临床数据进行了编译。在 3597 份记录中,对来自 2944 人的数据进行了五项分析,包括这项 CKD 分析。
本研究分析了包括 522 名血液透析患者在内的 2200 名个体的数据;42.3%为女性,中位年龄为 58 岁,中位 eGFR 为 68.9 mL/min/1.73 m。Latho、Campe 和 Campe/Latho 比值在 CKD 分期之间存在显著差异。当使用多变量非线性回归模型评估 eGFR 与这些标志物的相关性时,Latho、Campe 和 Campe/Latho 比值与 eGFR 呈正相关、负相关和负相关。这些相关性被性别、是否存在糖尿病以及是否使用他汀类药物显著修饰。
在这个大样本中,我们发现 eGFR 较低的个体胆固醇合成标志物水平较低,胆固醇吸收标志物水平较高。