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Predictive value of triglyceride/high-density lipoprotein cholesterol for major clinical outcomes in advanced chronic kidney disease: a nationwide population-based study.


ABSTRACT:

Background

Dyslipidemia is an essential parameter in the prediction of cardiovascular disease (CVD). We aimed to explore whether lipid profiles could predict major outcomes in patients with advanced chronic kidney disease (CKD).

Methods

We retrospectively reviewed the National Health Insurance Service database for people who received nationwide health screening in 2009. All subjects exposed to a lipid-lowering agent before screening were excluded. The population was divided into control, early [estimated glomerular filtration rate (eGFR) 45-59 mL/min/1.73 m2] and advanced (eGFR <45 mL/min/1.73 m2) CKD groups. The hazard ratios (HRs) of outcomes were calculated using multivariate Cox regression models.

Results

A total of 3 634 873 participants were included in this study, with 404 298 (11.1%) and 66 805 (1.8%) having early and advanced CKD, respectively. For all populations, levels of triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) showed a linear association with major cardiovascular and cerebrovascular events (MACCEs) and all-cause mortality, while low-density lipoprotein cholesterol (LDL-C) showed a different pattern of association with MACCEs (linear association) from all-cause mortality (U-shaped association). The significance between the levels of LDL-C and outcomes was attenuated in the advanced CKD group. For TG/HDL-C, although the significance was decreased, the linear patterns with both MACCEs and all-cause mortality were maintained in the advanced CKD group.

Conclusions

The pattern and significance of lipid profiles were different according to the grade of kidney function. TG/HDL-C should be additionally considered as a predictive marker for CVD and mortality along with LDL-C in patients with CKD.

SUBMITTER: Kim Y 

PROVIDER: S-EPMC8323149 | biostudies-literature | 2021 Aug

REPOSITORIES: biostudies-literature

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Publications

Predictive value of triglyceride/high-density lipoprotein cholesterol for major clinical outcomes in advanced chronic kidney disease: a nationwide population-based study.

Kim Yaerim Y   Lee Soojin S   Lee Yeonhee Y   Kang Min Woo MW   Park Sehoon S   Park Sanghyun S   Han Kyungdo K   Paek Jin Hyuk JH   Park Woo Yeong WY   Jin Kyubok K   Han Seugyeup S   Han Seung Seok SS   Lee Hajeong H   Lee Jung Pyo JP   Joo Kwon Wook KW   Lim Chun Soo CS   Kim Yon Su YS   Kim Dong Ki DK  

Clinical kidney journal 20201225 8


<h4>Background</h4>Dyslipidemia is an essential parameter in the prediction of cardiovascular disease (CVD). We aimed to explore whether lipid profiles could predict major outcomes in patients with advanced chronic kidney disease (CKD).<h4>Methods</h4>We retrospectively reviewed the National Health Insurance Service database for people who received nationwide health screening in 2009. All subjects exposed to a lipid-lowering agent before screening were excluded. The population was divided into c  ...[more]

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