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传统和非传统脂质参数与肾功能下降进展风险之间的相关性:来自中国健康与养老追踪调查(2011 - 2015年)的见解

Correlation between conventional and unconventional lipid parameters with the risk of progression of renal function decline: insights from the China Health and Retirement Longitudinal Study 2011-2015.

作者信息

Xin Yijing, Wang Yimeng, Shu Yuyuan, Liang Hanyang, Yang Yanmin

机构信息

Emergency and Intensive Care Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Ren Fail. 2025 Dec;47(1):2499229. doi: 10.1080/0886022X.2025.2499229. Epub 2025 May 7.

Abstract

BACKGROUND

This study aimed to evaluate the association between conventional and unconventional lipid parameters and the risk of future chronic kidney disease (CKD) and progression of renal function decline.

METHODS

Data from 4,542 participants who were free of CKD at baseline were analyzed using information from the China Health and Retirement Longitudinal Study (2011-2015). The follow-up period was four years. The primary endpoints were incident CKD and rapid progression of renal function decline. The associations between lipid parameters and the risk of CKD and rapid progression of renal function decline were assessed using restricted cubic splines (RCS) and logistic regression analysis.

RESULTS

Logistic regression analysis showed that high-density lipoprotein cholesterol (HDL-C) was negatively associated with CKD risk, while remnant cholesterol (RC) and the atherogenic index of plasma (AIP) were positively associated. Triglycerides (TG), RC, and AIP were positively correlated with rapid renal function decline, whereas low-density lipoprotein cholesterol (LDL-C) and HDL-C were negatively correlated. Among these parameters, AIP was the most strongly associated with CKD [adjusted odds ratio (OR) (95% CI): 2.091 (1.199, 3.649),  = 0.009] and rapid progression of renal function decline [adjusted OR (95% CI): 3.996 (2.632, 6.068),  < 0.001].

CONCLUSION

LDL-C and HDL-C were negatively associated with rapid progression of renal function decline, while TG, RC, and AIP were positively associated with this outcome. Among the lipid parameters examined, AIP was the most strongly associated with CKD and rapid progression of renal function decline.

摘要

背景

本研究旨在评估传统和非传统脂质参数与未来慢性肾脏病(CKD)风险及肾功能下降进展之间的关联。

方法

利用中国健康与养老追踪调查(2011 - 2015年)的信息,对4542名基线时无CKD的参与者的数据进行分析。随访期为四年。主要终点为新发CKD和肾功能快速下降进展。使用受限立方样条(RCS)和逻辑回归分析评估脂质参数与CKD风险及肾功能快速下降进展之间的关联。

结果

逻辑回归分析显示,高密度脂蛋白胆固醇(HDL - C)与CKD风险呈负相关,而残余胆固醇(RC)和血浆致动脉粥样硬化指数(AIP)呈正相关。甘油三酯(TG)、RC和AIP与肾功能快速下降呈正相关,而低密度脂蛋白胆固醇(LDL - C)和HDL - C呈负相关。在这些参数中,AIP与CKD[调整后的优势比(OR)(95%置信区间):2.091(1.199,3.649),P = 0.009]和肾功能快速下降进展[调整后的OR(95%置信区间):3.996(2.632,6.068),P < 0.001]的关联最为密切。

结论

LDL - C和HDL - C与肾功能快速下降进展呈负相关,而TG、RC和AIP与该结果呈正相关。在所检测的脂质参数中,AIP与CKD及肾功能快速下降进展的关联最为密切。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8400/12064124/d6747aa22f99/IRNF_A_2499229_F0001_B.jpg

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