Chen I-Ju, Hsu Le-Tien, Lin Ting-Wei, Chen Jau-Yuan
Department of Family Medicine, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.
Department of Gynecology and Obstetrics, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.
Front Nutr. 2022 Oct 4;9:928910. doi: 10.3389/fnut.2022.928910. eCollection 2022.
Globally, obesity is a major health problem and can markedly increase the risk of various diseases, including type 2 diabetes mellitus, hypertension (HTN), dyslipidemia, and chronic kidney disease (CKD). The association of obesity-related parameters, such as lipid parameters and their ratio, with CKD in clinical settings is not well understood. This study aimed to investigate the association of obesity-related parameters with CKD in the middle-aged and elderly population in Taiwan. This cross-sectional, community-based study recruited 400 participants (141 males and 259 females) aged 50 years or over from a community health promotion project at the Linkou Chang Gung Memorial Hospital (Guishan District, Taoyuan City) in 2014. Each participant completed a questionnaire including personal information and medical history during a face-to-face interview. Laboratory data were obtained from blood and urine sampling. The data were analyzed using -test, chi-square test, Pearson's correlation test, multivariate logistic regression, and receiver operating characteristic (ROC) analysis. A total of 81 participants were identified as having CKD [estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m or urine albumin/creatinine ratio ≥30 mg/g], and their mean triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio was 3.37 ± 2.72. The mean TG/HDL-C ratio of the 319 participants without CKD was 2.35 ± 1.66. After adjusting for age, TG/HDL-C was significantly positively correlated with blood pressure, body mass index, waist circumference, and fasting plasma glucose but not low-density lipoprotein cholesterol. There was a negative correlation between TG/HDL-C and eGFR. Multiple logistic regression model analysis showed that TG/HDL-C was still significantly associated with CKD (OR: 1.17, 95% CI: 1.01-1.36, = 0.04) after adjusting for multiple covariates. The cut-off point of TG/HDL-C as a predictor of CKD was 2.54 with an area under the ROC curve of 0.61 (95% CI: 0.53-0.68). There was a significant positive correlation between TG/HDL-C and several cardiovascular disease risk factors, including obesity indices. The TG/HDL-C ratio was significantly associated with the risk of CKD and demonstrated predictive ability for CKD in the middle-aged and elderly population. Further studies on its application in clinical settings are warranted.
在全球范围内,肥胖是一个主要的健康问题,会显著增加包括2型糖尿病、高血压(HTN)、血脂异常和慢性肾脏病(CKD)等各种疾病的风险。在临床环境中,肥胖相关参数(如血脂参数及其比值)与CKD之间的关联尚未得到充分了解。本研究旨在调查台湾中老年人群中肥胖相关参数与CKD之间的关联。这项基于社区的横断面研究于2014年从林口长庚纪念医院(桃园市龟山区)的一个社区健康促进项目中招募了400名年龄在50岁及以上的参与者(141名男性和259名女性)。每位参与者在面对面访谈中完成了一份包括个人信息和病史的问卷。实验室数据来自血液和尿液样本采集。数据采用t检验、卡方检验、Pearson相关检验、多因素逻辑回归和受试者工作特征(ROC)分析。共有81名参与者被确定患有CKD [估计肾小球滤过率(eGFR)<60 ml/min/1.73 m²或尿白蛋白/肌酐比值≥30 mg/g],他们的平均甘油三酯/高密度脂蛋白胆固醇(TG/HDL-C)比值为3.37±2.72。319名无CKD参与者的平均TG/HDL-C比值为2.35±1.66。在调整年龄后,TG/HDL-C与血压、体重指数、腰围和空腹血糖呈显著正相关,但与低密度脂蛋白胆固醇无关。TG/HDL-C与eGFR呈负相关。多因素逻辑回归模型分析显示,在调整多个协变量后,TG/HDL-C仍与CKD显著相关(OR:1.17,95%CI:1.01-1.36,P = 0.04)。TG/HDL-C作为CKD预测指标的截断点为2.54,ROC曲线下面积为0.61(95%CI:0.53-0.68)。TG/HDL-C与包括肥胖指数在内的几种心血管疾病危险因素之间存在显著正相关。TG/HDL-C比值与CKD风险显著相关,并在中老年人群中显示出对CKD的预测能力。有必要对其在临床环境中的应用进行进一步研究。