Association of baseline and cumulative remnant cholesterol with incidence of diabetic nephropathy: A longitudinal cohort study

Zhiyuan Wu; Siqi Yu; Qian Zhu; Zhiwei Li; Haiping Zhang; Xiaoping Kang; Zongkai Xu; Xinlei Miao; Xiangtong Liu; Xia Li; Jingbo Zhang; Wei Wang; Lixin Tao; Xiuhua Guo

doi:10.1016/j.diabres.2022.110079

Association of baseline and cumulative remnant cholesterol with incidence of diabetic nephropathy: A longitudinal cohort study

Diabetes Res Clin Pract. 2022 Sep:191:110079. doi: 10.1016/j.diabres.2022.110079. Epub 2022 Sep 11.

Authors

Zhiyuan Wu¹, Siqi Yu², Qian Zhu³, Zhiwei Li⁴, Haiping Zhang⁴, Xiaoping Kang⁵, Zongkai Xu⁴, Xinlei Miao⁴, Xiangtong Liu⁴, Xia Li⁶, Jingbo Zhang⁷, Wei Wang⁸, Lixin Tao⁹, Xiuhua Guo¹⁰

Affiliations

¹ Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China; Centre for Precision Health, Edith Cowan University, Perth, Australia. Electronic address: wuxiaozhi@ccmu.edu.cn.
² Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China. Electronic address: ysq@mail.ccmu.edu.cn.
³ Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China. Electronic address: zhuqian45@mail.ccmu.edu.cn.
⁴ Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.
⁵ Beijing Xiaotangshan Hospital, Beijing, China.
⁶ Department of Mathematics and Statistics, La Trobe University, Melbourne, Australia. Electronic address: x.li2@latrobe.edu.au.
⁷ Beijing Physical Examination Center, Beijing, China.
⁸ Centre for Precision Health, Edith Cowan University, Perth, Australia. Electronic address: wei.wang@ecu.edu.au.
⁹ Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China. Electronic address: taolixin@ccmu.edu.cn.
¹⁰ Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China; Centre for Precision Health, Edith Cowan University, Perth, Australia. Electronic address: statguo@ccmu.edu.cn.

PMID: 36099974
DOI: 10.1016/j.diabres.2022.110079

Abstract

Aims: To evaluate the longitudinal association of remnant cholesterol with the incidence of diabetic nephropathy using a Chinese diabetes cohort.

Methods: We included 4237 individuals with type 2 diabetes during 2013-2014 from Beijing Health Management Cohort. Remnant cholesterol was defined by Martin-Hopkins equation. Diabetic nephropathy was confirmed by urine albumin/creatinine ratio and estimated glomerular filtration rate. We calculated the hazard ratio (HR) and 95% confidence interval (CI) for incident diabetic nephropathy using adjusted Cox proportional hazards regression.

Results: The median [IQR] age was 55 [48, 64] years, and 3 256 (76.8 %) were men. During follow-up, 248 (5.9 %) participants developed diabetic nephropathy. One-SD increase of baseline and average cumulative remnant cholesterol were significantly associated with an increased risk of diabetic nephropathy, and the adjusted HRs were 1.208 (95 % CI: 1.098-1.329) and 1.216 (95 % CI: 1.102-1.341), respectively. Individuals in the highest tertile of baseline and average cumulative remnant cholesterol had a 82.3 % and 87.6 % excess risk of diabetic nephropathy, compared with those in the lowest.

Conclusion: Remnant cholesterol is independently associated with incident diabetic nephropathy in type 2 diabetes.

Keywords: Cohort study; Diabetic nephropathy; Lipid profile; Remnant cholesterol; Type 2 diabetes.

MeSH terms

Albumins
Cholesterol
Cohort Studies
Creatinine
Diabetes Mellitus, Type 2* / complications
Diabetes Mellitus, Type 2* / epidemiology
Diabetic Nephropathies* / etiology
Female
Humans
Incidence
Longitudinal Studies
Male
Middle Aged
Risk Factors

Substances

Albumins
Cholesterol
Creatinine