Suh Sang Heon, Oh Tae Ryom, Choi Hong Sang, Kim Chang Seong, Bae Eun Hui, Oh Kook-Hwan, Han Seung Hyeok, Ma Seong Kwon, Kim Soo Wan
Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hospital, Gwangju, South Korea.
Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.
Front Nutr. 2022 Nov 24;9:1037618. doi: 10.3389/fnut.2022.1037618. eCollection 2022.
To investigate whether high serum triglycerides (TG) level is associated with adverse renal outcomes in patients with non-dialysis chronic kidney disease (CKD), a total of 2,158 subjects from a prospective cohort study (Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease) were divided into the quartile by serum TG level. The primary outcomes were composite renal events, which is defined as a composite of decline of kidney function (the first occurrence of > 50% decline of estimated glomerular filtration rate or doubling of serum creatinine from the baseline) or onset of end-stage renal disease (initiation of dialysis or kidney transplantation). During the median follow-up of 6.940 years, the cumulative incidence of composite renal event was significantly differed by serum TG level in Kaplan-Meier curve analysis (P < 0.001, by Log-rank test). Cox regression analysis demonstrated that, compared to that of the 1st quartile, the risk of composite renal event was significantly higher in the 4th quartile (adjusted hazard ratio 1.433, 95% confidence interval 1.046 to 1.964). The association between high serum TG level and adverse renal outcome remained consistent in the cause-specific hazard model. Subgroup analyses revealed that the association is modified by age, estimated glomerular filtration rate, and spot urine albumin-to-creatinine ratio. In conclusion, high serum TG level is independently associated with adverse renal outcomes in patients with non-dialysis CKD. Interventional studies are warranted to determine whether lowering serum TG levels may alter the natural course of CKD.
为了研究高血清甘油三酯（TG）水平是否与非透析慢性肾脏病（CKD）患者的不良肾脏结局相关，一项前瞻性队列研究（韩国慢性肾脏病患者结局队列研究）中的2158名受试者按血清TG水平分为四分位数。主要结局是复合肾脏事件，定义为肾功能下降（估计肾小球滤过率首次下降>50%或血清肌酐较基线水平翻倍）或终末期肾病（开始透析或肾移植）的复合情况。在6.940年的中位随访期内，Kaplan-Meier曲线分析显示，复合肾脏事件的累积发生率因血清TG水平而异（对数秩检验，P<0.001）。Cox回归分析表明，与第一四分位数相比，第四四分位数中复合肾脏事件的风险显著更高（调整后风险比1.433，95%置信区间1.046至1.964）。在病因特异性风险模型中，高血清TG水平与不良肾脏结局之间的关联仍然一致。亚组分析显示，这种关联因年龄、估计肾小球滤过率和随机尿白蛋白与肌酐比值而改变。总之，高血清TG水平与非透析CKD患者的不良肾脏结局独立相关。有必要进行干预性研究以确定降低血清TG水平是否可能改变CKD的自然病程。
