LDL-C/apoB and HDL-C/apoA-1 ratios predict incident chronic kidney disease in a large apparently healthy cohort

Abstract

Background and aims: The objective of this study was to evaluate the ability of lipid variables to predict the development of chronic kidney disease (CKD). We investigated the longitudinal association between lipid profiles and incident CKD in a large apparently healthy cohort.

Methods: A retrospective longitudinal analysis of 10,288 subjects who had participated in comprehensive health check-ups at least four times over a 7-year period was conducted. The risk of incident CKD associated with lipid variables was analyzed using adjusted hazard ratio (HR) for CKD per 1 standard deviation (SD) increase in lipid level. The development of CKD was defined as estimated glomerular filtration rate <60 ml/min/1.73 m(2).

Results: Over a mean follow-up of 56.5 ± 14.3 months, 356 (3.5%) subjects developed CKD. The multivariate adjusted HRs for incident CKD per 1 SD increase in baseline lipid level were 1.29 (95% confidence interval [CI], 1.17-1.41) for triglycerides (TG), 0.77 (0.68-0.88) for high-density lipoprotein cholesterol (HDL-C), 1.22 (1.12-1.32) for the TG/HDL-C ratio, 0.82 (0.73-0.92) for the low-density lipoprotein cholesterol/apolipoprotein B (LDL-C/apoB) ratio, and 0.74 (0.66-0.83) for the HDL-C/apoA-1 ratio. No longitudinal association was found between incident CKD and baseline total cholesterol, LDL-C, non-HDL-C, the LDL-C/HDL-C ratio, apoB, apoA-I, or the apoB/apoA-I ratio.

Conclusions: The LDL-C/apoB and HDL-C/apoA-1 ratios as well as TG and HDL-C concentrations independently predicted an increased risk for developing CKD. Our findings suggest that particle size of HDLs and LDLs may contribute to the development of CKD.

Keywords: Apolipoprotein; Chronic kidney disease; Dyslipidemia; Estimated glomerular filtration rate; Low-density lipoprotein cholesterol; Triglycerides to high-density lipoprotein cholesterol ratio.