Department of Geriatric Medicine, Nanchang First Hospital, Jiangxi, Nanchang, China.
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangdong, Guangzhou, China.
Ren Fail. 2024 Dec;46(2):2361094. doi: 10.1080/0886022X.2024.2361094. Epub 2024 Jun 10.
Blood lipid management is a key approach in the prevention of chronic kidney disease (CKD). Remnant cholesterol (RC) plays an important role in the development of multiple diseases chronic inflammation. The aim of our study was to determine the relationship between RC and CKD and explore the role of inflammation in this relationship. The 7696 subjects from the Chinese Health and Nutrition Survey were divided into four subgroups according to the quartile of RC. The estimated glomerular filtration rate was calculated using the CKD Epidemiology Collaboration equation. Fasting RC was calculated as total cholesterol minus low-density lipoprotein cholesterol and high-density lipoprotein cholesterol. Logistic regression analysis was employed to evaluate the relationships between RC and CKD. Mediation analysis was undertaken to identify potential mediators of high-sensitivity C-reactive protein (hs-CRP) and white blood cells (WBCs). Of all participants, the mean age was 51 years, and the male accounted for 47.8%. The multivariable-adjusted odds ratios (95% CIs) for the highest versus lowest quartile of remnant cholesterol were 1.40 (1.10-1.78, for trend = 0.006) for CKD. RC and preinflammatory markers have combined effect on CKD. The preinflammatory state, presented by increased hs-CRP or WBCs, partially mediated the association between RC and CKD with proportion of 10.14% ( = 0.002) and 11.65% ( = 0.012), respectively. In conclusion, this study suggested a positive relationship between RC and CKD, which was partially mediated by preinflammatory state. These findings highlight the importance of RC and inflammation in renal dysfunction.IMPACT STATEMENT Dyslipidemia plays an important role in the development of chronic kidney disease (CKD). Remnant cholesterol (RC), as a triglyceride-rich particle, can contribute to target organ damage, primarily through inflammatory pathways. However, the relationship between RC and CKD in the community-dwelling population, particularly the role of inflammation, is not yet fully understood. This study shows that RC was significantly associated with CKD. RC and preinflammatory status exhibit a combined effect on CKD. Preinflammatory state, presented by increased high-sensitivity C-reactive protein or white blood cells, partially mediated the association between RC and CKD. The study provides us with a better understanding of the role of RC and inflammation in kidney dysfunction and raises the awareness of RC in the management of CKD.
血脂管理是预防慢性肾脏病（CKD）的关键方法。残粒胆固醇（RC）在多种疾病的发展中起着重要作用，包括慢性炎症。我们的研究旨在确定 RC 与 CKD 之间的关系，并探讨炎症在此关系中的作用。根据 RC 的四分位数，将来自中国健康与营养调查的 7696 名受试者分为四组。使用 CKD 流行病学合作方程计算肾小球滤过率。空腹 RC 计算为总胆固醇减去低密度脂蛋白胆固醇和高密度脂蛋白胆固醇。采用 logistic 回归分析评估 RC 与 CKD 之间的关系。进行中介分析以确定高敏 C 反应蛋白（hs-CRP）和白细胞（WBC）的潜在介导物。在所有参与者中，平均年龄为 51 岁，男性占 47.8%。RC 最高四分位数与最低四分位数相比，多变量调整后的比值比（95%可信区间）为 1.40（1.10-1.78，趋势=0.006）。RC 和前炎症标志物对 CKD 有共同作用。以 hs-CRP 或 WBC 增加为表现的前炎症状态部分介导了 RC 与 CKD 之间的关联，其比例分别为 10.14%（=0.002）和 11.65%（=0.012）。总之，本研究表明 RC 与 CKD 之间存在正相关关系，部分通过前炎症状态介导。这些发现强调了 RC 和炎症在肾功能障碍中的重要性。
