Association between chronic kidney disease and new-onset dyslipidemia: The Japan Specific Health Checkups (J-SHC) study. (September 2021)

• Record Type: Journal Article
• Authors: Kosugi, Takaaki; Eriguchi, Masahiro; Yoshida, Hisako; Tasaki, Hikari; Fukata, Fumihiro; Nishimoto, Masatoshi; Matsui, Masaru; Samejima, Ken-ichi; Iseki, Kunitoshi; Fujimoto, Shouichi; Konta, Tsuneo; Moriyama, Toshiki; Yamagata, Kunihiro; Narita, Ichiei; Kasahara, Masato; Shibagaki, Yugo; Kondo, Masahide; Asahi, Koichi; Watanabe, Tsuyoshi; Tsuruya, Kazuhiko
• Is Part Of: Atherosclerosis. Volume 332(2022)
• Page Start: 24
• Page End: 32
• Publication Date: 2021-09
• Subjects: Chronic kidney disease -- Dyslipidemia -- Hypertriglyceridemia -- Hypo-high-density lipoprotein cholesterolemia -- Hyper-low-density lipoprotein cholesterolemia; Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2021.08.004
• Languages: English
• ISSNs: 0021-9150

Abstract

Abstract: Background and aims: Dyslipidemias are common among patients with chronic kidney disease (CKD) and are a major risk factor for cardiovascular disease. This study aimed to investigate the association between early-stage CKD and new-onset dyslipidemia for each lipid profile. Methods: This nationwide longitudinal study included data from the Japan Specific Health Checkups (J-SHC) Study. New-onset dyslipidemia was indicated by hypertriglyceridemia (High-TG; ≥150 mg/dL), hyper-LDL cholesterolemia (High-LDL-C; ≥140 mg/dL), or hypo-HDL chelesterolemia (Low-HDL-C; <40 mg/dL) levels according to the guideline of Japan Atherosclerosis Society, or High-TG/HDL-C ratio (≥3.5) which was a good predictor of atherosclerosis. The incidence of new-onset dyslipidemia was compared between participants with and without CKD. Survival curves were used to analyze the incidence of each dyslipidemia. Results: Of 289, 462 participants with a median follow-up period of 3 years, the incidence of High-TG, High-LDL-C, Low-HDL-C, and High-TG/HDL-C ratios were 64.4/1000 person-years, 83.1/1000 person-years, 14.5/1000 person-years, and 39.6/1000 person-years, respectively. The adjusted hazard ratios (95% confidence intervals) for High-TG, High-LDL-C, Low-HDL-C, and High-TG/HDL-C ratio were 1.09 (1.05–1.13), 0.99 (0.95–1.04), 1.12 (1.05–1.18), and 1.14 (1.09–1.18), respectively, in CKD participants as compared to non-CKD participants. Decreased eGFR and presence of proteinuria were independently associated with higher risks for new-onset of High-TG, Low-HDL-C, and High-TG/HDL-C ratios. Conclusions: CKD was associated with a higher risk of new-onset High-TG, Low-HDL-C, and High-TG/HDL-C ratios, but not High-LDL-C, in the general population. These CKD-specific lipid abnormalities may explain the residual risk for CKD-related cardiovascular disease. Graphical abstract: Image 1 Highlights: Despite adequately lowering LDL-C levels with statins, CVD events occur with unacceptable frequency among CKD patients. This large longitudinal study allowed for the accurate evaluation of new-onset dyslipidemia in early-stage CKD patients. CKD was associated with a higher risk of new-onset High-TG, Low-HDL-C, and High-TG/HDL-C ratio, but not High-LDL-C. The CKD-specific dyslipidemias identified in this study may explain the "residual" risk for CKD-related CVD.