Zhang Xue, Hu Haofei, He Lishu, Huang Xia, Zhang Zhichao, Tu Lirong, Zhang Heping, Liu Feiyuan, Liu Xiaohui, He Yongcheng
Department of Nephrology, Affiliated Hospital of North Sichuan Medical College, No.1 Maoyuan South Rd, Nanchong, 637000, Sichuan Province, China.
Department of Nephrology, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong Province, China.
Sci Rep. 2024 Dec 28;14(1):30960. doi: 10.1038/s41598-024-82084-5.
The evidence for the association between the triglyceride (TG) to high-density lipoprotein cholesterol (HDL-c) ratio and the risk of developing microalbuminuria is still limited in the Chinese population. Therefore, our research will endeavor to explore the relationship between the two. The cross-sectional survey enrolled 32,877 general population from eight regional centers in China. If the urinary albumin-creatinine ratio (UACR) ≥ 30 mg/g, it was considered microalbuminuria. The dependent variable in the study was microalbuminuria, while the independent variable was the TG/HDL-c ratio. A binary logistic regression model was utilized to examine the independent association between the likelihood of microalbuminuria and the TG/HDL-c ratio. A generalized additive model (GAM) and spline smoothing were employed to investigate non-linear relationships between these two variables. To confirm the findings and pinpoint important turning points, subgroup and threshold effect tests were performed. The average age of the study participants was 57.67 ± 9.29 years, with 22,052 (67%) females and 10,825 (33%) males. The ratio of TG/HDL-c had a median value of 1.06, while the UACR had a median value of 9.92 mg/g. The prevalence of microalbuminuria was 14.4%. Following covariate adjustment, the prevalence of microalbuminuria and the TG/HDL-c ratio showed a significant positive connection (OR = 1.17,95% CI 1.13-1.21). Interestingly, we discovered a non-linear relationship between the occurrence of microalbuminuria and the TG/HDL-c ratio. At a TG/HDL-c ratio of 0.911, we detected an inflection point, with ORs of 1.12 (95% CI: 1.08, 1.17) on the right side of the point and 1.89 (95% CI: 1.51, 2.36) on the left. Subgroup analyses further validated the results. Our research revealed a positive and non-linear connection between the TG/HDL-c ratio and the prevalence of microalbumin in Chinese individuals. The connection was especially robust when the TG/HDL-c ratio was below 0.911. Reducing TG or raising HDL-c levels in order to lower the TG/HDL-c ratio may significantly mitigate the risk of microalbuminuria.
在中国人群中，甘油三酯（TG）与高密度脂蛋白胆固醇（HDL-c）的比值和发生微量白蛋白尿风险之间关联的证据仍然有限。因此，我们的研究将致力于探索两者之间的关系。这项横断面调查纳入了来自中国八个区域中心的32877名普通人群。如果尿白蛋白肌酐比值（UACR）≥30mg/g，则被视为微量白蛋白尿。研究中的因变量是微量白蛋白尿，自变量是TG/HDL-c比值。采用二元逻辑回归模型来检验微量白蛋白尿可能性与TG/HDL-c比值之间的独立关联。使用广义相加模型（GAM）和样条平滑来研究这两个变量之间的非线性关系。为了证实研究结果并找出重要转折点，进行了亚组分析和阈值效应检验。研究参与者的平均年龄为57.67±9.29岁，其中女性22052名（67%），男性10825名（33%）。TG/HDL-c比值的中位数为1.06，而UACR的中位数为9.92mg/g。微量白蛋白尿的患病率为14.4%。在进行协变量调整后，微量白蛋白尿的患病率与TG/HDL-c比值呈现出显著的正相关（OR=1.17，95%CI 1.13 - 1.21）。有趣的是，我们发现微量白蛋白尿的发生与TG/HDL-c比值之间存在非线性关系。在TG/HDL-c比值为0.911时，我们检测到一个拐点，该点右侧的OR值为1.12（95%CI：1.08，1.17），左侧为1.89（95%CI：1.51，2.36）。亚组分析进一步验证了结果。我们的研究揭示了中国人群中TG/HDL-c比值与微量白蛋白患病率之间存在正相关且非线性关系。当TG/HDL-c比值低于0.911时，这种关系尤为显著。降低TG或提高HDL-c水平以降低TG/HDL-c比值可能会显著降低微量白蛋白尿的风险。
