Zhang Ping, Liu Yu-Hong, Xiong Wen-Yan, Fan Yi-Bing, Zhu Xiao-Lin, Zhou Kun, Li Hui
Nanchang First Hospital, Nanchang, China.
The Collaboration Unit for State Key Laboratory of Infectious Disease Prevention and Control, Jiangxi Provincial Health Commission Key Laboratory of Pathogenic Diagnosis and Genomics of Emerging Infectious Diseases, Nanchang Center for Disease Control and Prevention, Nanchang, China.
Hormones (Athens). 2025 Apr 18. doi: 10.1007/s42000-025-00651-5.
Chronic kidney disease (CKD) is creating an ever heavier global health burden with population ageing. This study aimed to examine the longitudinal associations of remnant cholesterol (RC) with CKD morbidity in a large high-risk population (type 2 diabetes and hypertension).
A total of 11,881 participants who participated in annual health examinations from 2021 to 2023 were included in our analysis. The Cox proportional hazards model was performed to analyze the associations of baseline RC, cumulative RC, and variability of RC with CKD morbidity. The cross-lagged panel analysis was used to examine the temporal relationship between RC and renal function.
The results of the multivariable-adjusted models showed that higher baseline, cumulative RC, and variability of RC were related to higher risks of developing CKD, the adjusted HR (95% CI) comparing tertile 3 with tertile 1 were 1.26 (95% CI 1.10-1.45), 1.33 (95% CI 1.16-1.52), 1.36 (95% CI 1.20-1.55), respectively. Stratified analysis found that gender did not change these associations. Compared with individuals in the low cumulative and variability RC group, those in the high cumulative and variability RC group had a 1.62 times higher risk of CKD (95% CI: 1.34-1.96). The cross-lagged panel analysis showed that the increase in RC levels may precede the decrease in eGFR.
High baseline level, cumulative exposure to RC, and variability of RC are associated with increased CKD risk. Therefore, monitoring RC-related parameters is crucial to delay the occurrence and development of CKD in high-risk populations.
随着人口老龄化，慢性肾脏病（CKD）给全球健康带来的负担日益加重。本研究旨在探讨在一个大型高危人群（2型糖尿病和高血压患者）中，残余胆固醇（RC）与CKD发病之间的纵向关联。
我们纳入了2021年至2023年参加年度健康检查的11881名参与者。采用Cox比例风险模型分析基线RC、累积RC和RC变异性与CKD发病之间的关联。采用交叉滞后面板分析来研究RC与肾功能之间的时间关系。
多变量调整模型的结果显示，较高的基线、累积RC以及RC变异性与发生CKD的较高风险相关，与第1三分位数相比，第3三分位数的调整后HR（95%CI）分别为1.26（95%CI 1.10 - 1.45）、1.33（95%CI 1.16 - 1.52）、1.36（95%CI 1.20 - 1.55）。分层分析发现，性别并未改变这些关联。与低累积和低变异性RC组的个体相比，高累积和高变异性RC组的个体发生CKD的风险高1.62倍（95%CI：1.34 - 1.96）。交叉滞后面板分析表明，RC水平的升高可能先于估算肾小球滤过率（eGFR）的降低。
高基线水平、RC的累积暴露以及RC变异性与CKD风险增加相关。因此，监测与RC相关的参数对于延缓高危人群中CKD的发生和发展至关重要。
