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Observational Study
. 2023 Jun 21:14:1189574.
doi: 10.3389/fendo.2023.1189574. eCollection 2023.

Association between remnant cholesterol and chronic kidney disease in Chinese hypertensive patients

Ting Yuan  1   2   3 , Congcong Ding  1   2   3 , Yanyou Xie  1   2   3 , Xinlei Zhou  1   2   3 , Chong Xie  1   2   3 , Tao Wang  2   3   4 , Chao Yu  2   3   4 , Wei Zhou  2   3   4 , Lingjuan Zhu  2   3   4 , Huihui Bao  1   2   3   4 , Xiaoshu Cheng  1   2   3   4
Affiliations
Observational Study

Association between remnant cholesterol and chronic kidney disease in Chinese hypertensive patients

Ting Yuan et al. Front Endocrinol (Lausanne). .

Abstract

Background: Remnant cholesterol (RC) and chronic kidney disease (CKD) have not been definitively linked in individuals with different characteristics. This study aims to investigate the relationship between serum RC level and CKD and examine possible effect modifiers in Chinese patients with hypertension.

Methods: Our study is based on the Chinese H-type Hypertension Project, which is an observational registry study conducted in real-world settings. The outcome was CKD, defined as an estimated glomerular filtration rate of less than 60 ml/min·1.73 m2. Multivariate logistic regression and smooth curve fitting were used to analyze the association between RC and CKD. Subgroup analyses were subsequently conducted to examine the effects of other variables.

Results: The mean age of the 13,024 patients with hypertension at baseline was 63.8 ± 9.4 years, and 46.8% were male. A conspicuous linear positive association was observed between RC level and CKD (per SD increment; odds ratio [OR], 1.15; 95% confidence interval [CI], 1.08-1.23). Compared with the lowest quartile group of RC, the risk of CKD was 53% higher (OR, 1.53; 95% CI, 1.26-1.86) in the highest quartile group. Furthermore, a stronger positive association between RC level and CKD was found among participants with a higher body mass index (BMI <24 vs. ≥24 kg/m2; P-interaction = 0.034) or current non-smokers (smoker vs. non-smoker; P-interaction = 0.024).

Conclusions: Among Chinese adults with hypertension, RC level was positively associated with CKD, particularly in those with a BMI of ≥24 kg/m2 and current non-smokers. These findings may help improve lipid management regimens in patients with hypertension.

Keywords: Chinese hypertensive population; chronic kidney disease; cross-sectional study; lipid metabolism; remnant cholesterol.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Dose-response relationships between RC and the risk of eGFR decline (A) and CKD (B). Adjustment factors included age, sex, BMI, WC, SBP, DBP, TG, smoking status, drinking status, Hcy, diabetes, stroke, coronary heart disease, and antihypertensive drugs at baseline.
Figure 2
Figure 2
The association between RC and CKD in various subgroups. Each subgroup analysis adjusted, if not stratified, for age, sex, BMI, WC, SBP, DBP, TG, smoking status, drinking status, Hcy, diabetes, stroke, coronary heart disease, antihypertensive drugs at baseline.
See this image and copyright information in PMC

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Publication types

Grants and funding

This work was supported by the Cultivation of backup projects for National Science and Technology Awards (20223AEI91007), Jiangxi Science and Technology Innovation Base Plan - Jiangxi Clinical Medical Research Center (20223BCG74012), Science and Technology Innovation Base Construction Project (20221ZDG02010), Jiangxi Science and Technology Innovation Platform Project (20165BCD41005), Jiangxi Provincial Natural Science Foundation (20212ACB206019, 20224BAB206090), Key R&D Projects, Jiangxi (20203BBGL73173), Jiangxi Provincial Health Commission Science and Technology Project (202130440, 202210495, 202310528), Jiangxi Provincial Drug Administration Science and Technology Project (2022JS41), Fund project of the Second Affiliated Hospital of Nanchang University (2016YNQN12034, 2019YNLZ12010, 2021efyA01, 2021YNFY2024).