Second Medical College of Wenzhou Medical University, Wenzhou, China.
School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, China.
Ren Fail. 2024 Dec;46(2):2420841. doi: 10.1080/0886022X.2024.2420841. Epub 2024 Nov 3.
Previous studies have revealed an underlying connection between abnormal lipid metabolism and albuminuria. We aim to investigate the causal relationship between lipid metabolism disorders and the risk of albuminuria from both a population and genetic perspective.
A cross-sectional study was conducted by using data from the National Health and Nutrition Examination Survey (NHANES) 2001-2018. Multivariable-adjusted logistic regression, subgroup analysis, interaction tests and restricted cubic spline (RCS) were employed statistically. Mendelian randomization (MR) analysis was performed to validate the causal relationship between exposure and outcome to mitigate confounding factors and reverse causation interference.
After adjusting for confounders, HDL levels (1.03-2.07 nmol/L) were associated with a reduced risk of albuminuria. In contrast, elevated cholesterol levels (>6.2 nmol/L) and triglyceride levels (>2.3 nmol/L) were associated with an increased risk of albuminuria. Serum triglyceride concentration emerged as a potential risk factor for albuminuria. In MR analysis, a reduced risk of albuminuria was associated with serum total HDL level (IVW: OR = 0.91, 95% CI = 0.86-0.97, = 0.002). In contrast, cholesterol esters in medium VLDL (IVW: OR = 1.05, 95% CI = 1.00-1.10, = 0.032), chylomicrons and extremely large VLDL (IVW: OR = 1.08, 95% CI = 1.03-1.14, = 0.003), and triglycerides (IVW: OR = 1.14, 95% CI = 1.09-1.19, < 0.001) were associated with an increased risk of albuminuria.
A causal relationship exists between serum lipid metabolism disorder and albuminuria risk. Further validation of additional blood lipid metabolism biomarkers is imperative for future studies.
先前的研究揭示了异常脂质代谢与白蛋白尿之间存在潜在联系。我们旨在从人群和遗传角度研究脂质代谢紊乱与白蛋白尿风险之间的因果关系。
使用 2001-2018 年国家健康和营养检查调查（NHANES）的数据进行了一项横断面研究。采用多变量调整逻辑回归、亚组分析、交互检验和限制性立方样条（RCS）进行统计学分析。孟德尔随机化（MR）分析用于验证暴露与结局之间的因果关系，以减轻混杂因素和反向因果干扰的影响。
在调整混杂因素后，HDL 水平（1.03-2.07 nmol/L）与降低白蛋白尿风险相关。相反，胆固醇水平升高（>6.2 nmol/L）和甘油三酯水平升高（>2.3 nmol/L）与白蛋白尿风险增加相关。血清甘油三酯浓度是白蛋白尿的一个潜在危险因素。在 MR 分析中，血清总 HDL 水平降低与降低白蛋白尿风险相关（IVW：OR = 0.91，95% CI = 0.86-0.97， = 0.002）。相反，中密度脂蛋白中的胆固醇酯（IVW：OR = 1.05，95% CI = 1.00-1.10， = 0.032）、乳糜微粒和特大 VLDL（IVW：OR = 1.08，95% CI = 1.03-1.14， = 0.003）和甘油三酯（IVW：OR = 1.14，95% CI = 1.09-1.19， < 0.001）与白蛋白尿风险增加相关。
血清脂质代谢紊乱与白蛋白尿风险之间存在因果关系。未来研究需要进一步验证其他血液脂质代谢生物标志物。
