Mei Xiyue, Wang Yue, Sun Ruizhao, Dong Yanqing, Li Zuolin, Xu Shengchun, Tang Rining, Liu Hong
Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China; Institute of Nephrology, Nanjing Lishui People's Hospital, Nanjing, China.
Institute of Nephrology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Nutr Metab Cardiovasc Dis. 2025 May;35(5):103852. doi: 10.1016/j.numecd.2025.103852. Epub 2025 Jan 4.
Remnant cholesterol (RC) is a risk factor for coronary heart disease (CHD). This study aimed to investigate the association between RC, CHD, and the severity of coronary artery stenosis in patients with stage 3-5 chronic kidney disease (CKD).
We conducted a retrospective study of non-dialysis patients diagnosed with stage 3-5 CKD and suspected CHD who underwent coronary angiography (CAG) at our center between August 2015 and December 2017. CAG was used to diagnose CHD, and the Gensini score was used to quantify the severity of coronary artery stenosis. Of 870 patients included in this study, 659 were diagnosed with CHD. There was no significant difference in the RC concentration between the CHD and non-CHD groups (P = 0.129). Multivariate logistic regression analysis demonstrated that RC was ssociated with CHD (OR 2.733, 95 % CI 1.094-6.825; P = 0.031). Further analysis of the CHD group showed that the Gensini score for severe coronary artery stenosis in the third tertile of the RC concentration (44 [20-86]) was higher than that in the first tertile (36 [15-68]; P = 0.046). After adjusting for potential confounders, the RC level was independently associated with severe coronary artery stenosis (tertile 2 vs. tertile 1: adjusted OR 3.659, 95 % CI 1.231-10.878; P = 0.020; and tertile 3 vs. tertile 1: adjusted OR 5.597, 95 % CI 1.835-17.070; P = 0.002).
Higher RC levels were independently associated with CHD and severe coronary artery stenosis among non-dialysis patients with stage 3-5 CKD.
残余胆固醇（RC）是冠心病（CHD）的一个危险因素。本研究旨在调查3 - 5期慢性肾脏病（CKD）患者中RC、CHD及冠状动脉狭窄严重程度之间的关联。
我们对2015年8月至2017年12月期间在本中心接受冠状动脉造影（CAG）的3 - 5期CKD且疑似CHD的非透析患者进行了一项回顾性研究。CAG用于诊断CHD，Gensini评分用于量化冠状动脉狭窄的严重程度。本研究纳入的870例患者中，659例被诊断为CHD。CHD组与非CHD组的RC浓度无显著差异（P = 0.129）。多因素逻辑回归分析表明，RC与CHD相关（OR 2.733，95%CI 1.094 - 6.825；P = 0.031）。对CHD组的进一步分析显示，RC浓度第三分位数（44[20 - 86]）时严重冠状动脉狭窄的Gensini评分高于第一分位数（36[15 - 68]；P = 0.046）。在调整潜在混杂因素后，RC水平与严重冠状动脉狭窄独立相关（第二分位数与第一分位数比较：调整后OR 3.659，95%CI 1.231 - 10.878；P = 0.020；第三分位数与第一分位数比较：调整后OR 5.597，95%CI 1.835 - 17.070；P = 0.002）。
在3 - 5期CKD非透析患者中，较高的RC水平与CHD及严重冠状动脉狭窄独立相关。
