Association of Cumulative Remnant Cholesterol with Kidney Function Decline in Chinese Population: A Prospective Cohort Study.

IF 3.2 4区 医学 Q1 UROLOGY & NEPHROLOGY
Kidney Diseases Pub Date : 2025-01-22 eCollection Date: 2025-01-01 DOI:10.1159/000543037
Lei Liu, Changfa Wang, Zhongyang Hu, Pingting Yang, Ying Li, Yufu Zhou, Saiqi Yang, Kui Chen, Shuwen Deng, Xiaoling Zhu, Xuelian Liu, Yaqin Wang
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Abstract

Introduction: There were limited data regarding the association between remnant cholesterol (RC), an emerging novel lipid marker, and chronic kidney disease (CKD). This study aimed to investigate the association of baseline and cumulative exposure of RC (cumRC) with kidney function decline (KFD) risk in the general population of China.

Methods: Using data from the physical examination database in the Third Xiangya Hospital of Central South University (Changsha, China), 22,702 participants (age ≥18 years) without KFD, who underwent 3 consecutive annual health examinations between 2012 and 2015, were included. KFD was recorded during the interval between the third examination and the end of follow-up through 2020.

Results: The cumRC was classified into 4 groups according to these cutoff values: 0.92, 1.33, and 1.99 (mmol/L). During a median follow-up of 3.17 years, 1,085 new KFD events were confirmed. Participants in the highest quartile of cumRC had 43% higher risk of KFD (hazard ratio, 1.43 [95% confidence interval, 1.16-1.77]), compared with the lowest quartile. Similarly, restricted cubic spline analysis showed a significant dose-response relationship between cumRC and the risk of KFD (P nonlinearity = 0.0314). However, baseline RC did not show any typical dose-dependent positive relationship with KFD development. In the discordance analysis, high baseline RC/low baseline low-density lipoprotein cholesterol (LDL-C) or high cumRC/low cumLDL-C were all associated with KFD in adjusted models.

Conclusion: These data suggest a significant association between cumRC and risk of KFD independent of traditional CVD risk factors as well as the LDL-C level. Therefore, consistent RC monitoring should be given to individuals for early KFD prevention, especially in population with normal LDL-C levels who are often overlooked.

中国人群累积残余胆固醇与肾功能下降的关系:一项前瞻性队列研究。
关于残余胆固醇(RC)这一新兴的新型脂质标志物与慢性肾脏疾病(CKD)之间的关系,目前的数据有限。本研究旨在调查中国普通人群中RC (cumRC)的基线和累积暴露与肾功能下降(KFD)风险的关系。方法:使用中南大学湘雅第三医院(中国长沙)体检数据库的数据,纳入2012 - 2015年连续3次年度健康检查的无KFD的22,702名参与者(年龄≥18岁)。在第三次检查至随访结束至2020年期间记录KFD。结果:根据截断值分别为0.92、1.33、1.99 (mmol/L)将cumRC分为4组。在中位3.17年的随访期间,确认了1085例新的KFD事件。与最低四分位数相比,cumRC最高四分位数的参与者患KFD的风险高出43%(风险比为1.43[95%置信区间,1.16-1.77])。同样,限制三次样条分析显示,cumRC与KFD风险之间存在显著的剂量-反应关系(P非线性= 0.0314)。然而,基线RC与KFD的发展没有任何典型的剂量依赖的正相关关系。在不一致分析中,在调整后的模型中,高基线RC/低基线低密度脂蛋白胆固醇(LDL-C)或高cumRC/低cumLDL-C均与KFD相关。结论:这些数据提示cumRC与KFD风险之间存在显著相关性,独立于传统心血管疾病危险因素和LDL-C水平。因此,应该对个体进行持续的RC监测,以早期预防KFD,特别是在LDL-C水平正常且经常被忽视的人群中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Kidney Diseases
Kidney Diseases UROLOGY & NEPHROLOGY-
CiteScore
6.00
自引率
2.70%
发文量
33
审稿时长
27 weeks
期刊介绍: ''Kidney Diseases'' aims to provide a platform for Asian and Western research to further and support communication and exchange of knowledge. Review articles cover the most recent clinical and basic science relevant to the entire field of nephrological disorders, including glomerular diseases, acute and chronic kidney injury, tubulo-interstitial disease, hypertension and metabolism-related disorders, end-stage renal disease, and genetic kidney disease. Special articles are prepared by two authors, one from East and one from West, which compare genetics, epidemiology, diagnosis methods, and treatment options of a disease.
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