Lipid profiles and risk of major adverse cardiovascular events in CKD and diabetes: A nationwide population-based study

被引:19
作者
Lee, Yeonhee [1 ,2 ]
Park, Sehoon [3 ,4 ]
Lee, Soojin [1 ,2 ]
Kim, Yaerim [5 ]
Kang, Min Woo [1 ,2 ]
Cho, Semin [1 ,2 ]
Park, Sanghyun [6 ]
Han, Kyungdo [6 ]
Kim, Yong Chul [1 ,7 ]
Han, Seoung Seok [1 ,7 ]
Lee, Hajeong [1 ,7 ]
Lee, Jung Pyo [2 ,7 ,8 ]
Joo, Kwon Wook [1 ,2 ,7 ]
Lim, Chun Soo [2 ,7 ,8 ]
Kim, Yon Su [3 ,4 ,7 ]
Kim, Dong Ki [3 ,4 ,7 ]
机构
[1] Seoul Natl Univ Hosp, Dept Internal Med, Seoul, South Korea
[2] Seoul Natl Univ, Dept Internal Med, Coll Med, Seoul, South Korea
[3] Seoul Natl Univ, Dept Biomed Sci, Coll Med, Seoul, South Korea
[4] Armed Forces Capital Hosp, Dept Internal Med, Gyeonggi Do, South Korea
[5] Keimyung Univ, Dept Internal Med, Sch Med, Daegu, South Korea
[6] Catholic Univ Korea, Dept Med Stat, Coll Med, Seoul, South Korea
[7] Seoul Natl Univ, Kidney Res Inst, Coll Med, Seoul, South Korea
[8] Seoul Natl Univ, Dept Internal Med, Boramae Med Ctr, Seoul, South Korea
来源
PLOS ONE | 2020年 / 15卷 / 04期
关键词
CHRONIC KIDNEY-DISEASE; DENSITY-LIPOPROTEIN CHOLESTEROL; DIALYSIS PATIENTS; HDL CHOLESTEROL; MORTALITY; ASSOCIATION; METABOLISM; RATIO; DYSFUNCTION; OUTCOMES;
D O I
10.1371/journal.pone.0231328
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
The association of lipid parameters with cardiovascular outcomes and the impact of kidney function on this association have not been thoroughly evaluated in chronic kidney disease (CKD) patients with diabetes. We reviewed the National Health Insurance Database of Korea, containing the data of 10,505,818 subjects who received routine check-ups in 2009. We analyzed the association of lipid profile parameters with major adverse cardiovascular events (MACEs) risk and all-cause mortality in a nationally representative cohort of 51,757 lipid-lowering medication-naive patients who had CKD and diabetes. Advanced CKD patients with eGFR <30 mL/min/1.73 m(2) (n = 10,775) had lower serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c) but higher non-HDL-c levels and triglyceride (TG) to HDL-c ratios. There was a positive linear association between serum LDL-c and MACE risk in both early and advanced CKD patients (P < 0.001 for trend), except for the category of LDL-c 30-49 mg/dL in extremely low LDL-c subgroup analyses. A U-shaped relationship was observed between serum LDL-c and all-cause mortality (the 4th and 8th octile groups; lowest hazard ratio [HR] 0.96, 95% confidence interval [CI] 0.87-1.05 and highest HR 1.14, 95% CI 1.04-1.26, respectively). A similar pattern remained in both early and advanced CKD patients. The TG/HDL-c ratio categories showed a positive linear association for MACE risk in early CKD (P <0.001 for trend), but this correlation disappeared in advanced CKD patients. There was no correlation between the serum TG/HDL-c ratio and all-cause mortality in the study patients. The LDL-c level predicted the risk for MACEs and all-cause mortality in both early and advanced CKD patients with diabetes, although the patterns of the association differed from each other. However, the TG/HDL-c ratio categories could not predict the risk for either MACEs or all-cause mortality in advanced CKD patients with diabetes, except that the TG/HDL-c ratio predicted MACE risk in early CKD patients with diabetes.
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页数:14
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共 36 条
  • [1] Misleading associations between cholesterol and vascular outcomes in dialysis patients: The need for randomized trials
    Baigent, Colin
    Landray, Martin J.
    Wheeler, David C.
    [J]. SEMINARS IN DIALYSIS, 2007, 20 (06) : 498 - 503
  • [2] Disorders of Lipid Metabolism in Chronic Kidney Disease
    Bulbul, Mustafa C.
    Dagel, Tuncay
    Afsar, Baris
    Ulusu, Nuray N.
    Kuwabara, Masanarini
    Covic, Adrian
    Kanbay, Mehmet
    [J]. BLOOD PURIFICATION, 2018, 46 (02) : 144 - 152
  • [3] Association of Serum Triglyceride to HDL Cholesterol Ratio with All-Cause and Cardiovascular Mortality in Incident Hemodialysis Patients
    Chang, Tae K.
    Streja, Elani
    Soohoo, Melissa
    Kim, Tae Woo
    Rhee, Connie M.
    Kovesdy, Csaba P.
    Kashyap, Moti L.
    Vaziri, Nosratola D.
    Kalantar-Zadeh, Kamyar
    Moradi, Hamid
    [J]. CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2017, 12 (04): : 591 - 602
  • [4] Hyperlipidemia and Long-Term Outcomes in Nondiabetic Chronic Kidney Disease
    Chawla, Varun
    Greene, Tom
    Beck, Gerald J.
    Kusek, John W.
    Collins, Allan J.
    Sarnak, Mark J.
    Menon, Vandana
    [J]. CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2010, 5 (09): : 1582 - 1587
  • [5] Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization
    Go, AS
    Chertow, GM
    Fan, DJ
    McCulloch, CE
    Hsu, CY
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2004, 351 (13) : 1296 - 1305
  • [6] Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Final Report
    Grundy, SM
    Becker, D
    Clark, LT
    Cooper, RS
    Denke, MA
    Howard, WJ
    Hunninghake, DB
    Illingworth, R
    Luepker, RV
    McBride, P
    McKenney, JM
    Pasternak, RC
    Stone, NJ
    Van Horn, L
    Brewer, HB
    Cleeman, JI
    Ernst, ND
    Gordon, D
    Levy, D
    Rifkind, B
    Rossouw, JE
    Savage, P
    Haffner, SM
    Orloff, DG
    Proschan, MA
    Schwartz, JS
    Sempos, CT
    Shero, ST
    Murray, EZ
    Keller, SA
    Jehle, AJ
    [J]. CIRCULATION, 2002, 106 (25) : 3143 - 3421
  • [7] Dyslipidemia in patients with chronic kidney disease
    Hager, Matthew R.
    Narla, Archana D.
    Tannock, Lisa R.
    [J]. REVIEWS IN ENDOCRINE & METABOLIC DISORDERS, 2017, 18 (01) : 29 - 40
  • [8] The validity of a diagnosis of heart failure in a hospital discharge register
    Ingelsson, E
    Ärnlöv, J
    Sundström, J
    Lind, L
    [J]. EUROPEAN JOURNAL OF HEART FAILURE, 2005, 7 (05) : 787 - 791
  • [9] The Development, Evolution, and Modifications of ICD-10 Challenges to the International Comparability of Morbidity Data
    Jette, Nathalie
    Quan, Hude
    Hemmelgarn, Brenda
    Drosler, Saskia
    Maass, Christina
    Moskal, Lori
    Paoin, Wansa
    Sundararajan, Vijaya
    Gao, Song
    Jakob, Robert
    Uestuen, Bedihran
    Ghali, William A.
    [J]. MEDICAL CARE, 2010, 48 (12) : 1105 - 1110
  • [10] New Insights Into Lipid Metabolism in Chronic Kidney Disease
    Kaysen, George A.
    [J]. JOURNAL OF RENAL NUTRITION, 2011, 21 (01) : 120 - 123