U-Shaped Relationship Between Proteinuria and High-Density Lipoprotein Cholesterol: Results of Cross-Sectional and Six Years Cohort Studies (KITCHEN-10)

Manami Igata; Kei Nakajima

doi:10.14740/jocmr4762

U-Shaped Relationship Between Proteinuria and High-Density Lipoprotein Cholesterol: Results of Cross-Sectional and Six Years Cohort Studies (KITCHEN-10)

J Clin Med Res. 2022 Aug;14(8):300-308. doi: 10.14740/jocmr4762. Epub 2022 Aug 27.

Authors

Manami Igata¹, Kei Nakajima^{1

2

3}

Affiliations

¹ School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka 238-8522, Japan.
² Saitama Medical Center, Department of Endocrinology and Diabetes, Saitama Medical University, Kawagoe 350-8550, Japan.
³ Food and Nutrition, Faculty of Human Sciences and Design, Japan Women's University, Bunkyo-ku, Tokyo 112-8681, Japan.

Abstract

Background: Although a very high level of high-density lipoprotein cholesterol (HDL-C) may be a potential cardiovascular disease risk factor, the detail and underlying mechanism remain unclear. Therefore, we examined the associations of serum HDL-C with the incidence of proteinuria, a predictor for cardiovascular disease, in a community-based study.

Methods: We investigated clinical parameters, including serum HDL-C and proteinuria, among 1,191,409 people aged 40 - 74 years who underwent a health checkup in a cross-sectional study. In the cohort study, the incidence of proteinuria after 6 years was investigated in 451,987 participants without proteinuria at baseline, who were simultaneously enrolled in the cross-sectional study.

Results: The prevalence of proteinuria showed a U-shaped relationship with 10 HDL-C categories, with a minimum of 60 - 89 mg/dL in the cross-sectional study. Logistic regression analysis showed similar U-shaped relationships between odds ratios for proteinuria and HDL-C categories, with a minimum of 70 - 79 mg/dL. The associations between very high HDL-C (≥ 90 mg/dL) and proteinuria were strengthened after adjustment for body mass index (BMI). In the cohort study, a crude L-shaped relationship was observed between the incidence of proteinuria and baseline HDL-C, which turned into U-shaped relationship after adjustment for baseline BMI and HDL-C after 6 years.

Conclusions: Low and very high levels of HDL-C may be associated with the incidence of proteinuria, and BMI may be a potent contributing factor to the underlying mechanism.

Keywords: Big data; Body mass index; Extremely high HDL-C; High-density lipoprotein cholesterol; Low-density lipoprotein cholesterol; Proteinuria.