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Association between high-density lipoprotein cholesterol and renal function in elderly hypertension: a cross-sectional study in Chinese population.

Zhang YP, Lu MG, Duan DD, Liu YL, Liu M, Li Y, Kuang ZM, Lu Y, Liu X, Li XH, Yuan H - Medicine (Baltimore) (2015)

Bottom Line: Bonferroni correction was performed for multiple comparisons.Analysis of covariance was used to control for confounding factors.The significance of difference between 3 groups and more was determined by chi-square test for categorical variables.

View Article: PubMed Central - PubMed

Affiliation: From the Pediatric Heart Center (YP Zhang, YL Liu), Department of Hypertension (ZM Kuang), Beijing Anzhen Hospital, Capital Medical University, Beijing, China; School of Community and Health Sciences (MG Lu), Laboratory of Cardiovascular Phenomics, the Department of Pharmacology (DD Duan), University of Nevada School of Medicine, Reno, NV, USA; Department of Geriatrics, the First Hospital, Peking University, Beijing (M Liu); Center of Clinical Pharmacology, the Third Xiang-Ya Hospital (Y Li, Y Lu, X Liu, H Yuan), and Department of Pharmacology, School of Pharmaceutical Sciences (XH Li), Central South University, Changsha, China.

ABSTRACT
Few studies have yet investigated the possible association between high-density lipoprotein cholesterol (HDL-C) and kidney function in elderly patients with primary hypertension. Accordingly, the aim of the present study was to evaluate the relationship between HDL-C and kidney function in elderly hypertension. A total of 14,644 elderly hypertensive subjects were enrolled in our cross-sectional study. The patients were categorized based on serum HDL-C level and glomerular filtration rate (GFR) value, respectively. One-way analysis of variance was used to compare the parameters among different groups. Bonferroni correction was performed for multiple comparisons. Analysis of covariance was used to control for confounding factors. The significance of difference between 3 groups and more was determined by chi-square test for categorical variables. Serum creatinine and uric acid were negatively related to HDL-C level, whereas GFR was positively related to HDL-C level in elderly hypertensive patients according to tertiles of HDL-C and tertiles of HDL-C/total cholesterol ratio (all P for trends <0.05). The male elderly hypertensive patients showed stronger relationship between HDL-C and renal function than the female elderly hypertensive subjects. Low HDL-C was associated with renal insufficiency and proteinuria in the hypertensive elderly (P < 0.05). The elderly "renal-hyperfiltrator" appeared to have lower HDL-C level, compared with the "normal renal-filtrator" (P < 0.05). There was an inverse "V" shape between HDL-C and GFR by GFR strata. Our results point out that there is an association of low HDL-C level with impaired kidney function in elderly hypertensive patients. Glomerular hyperfiltration may also affect HDL-C level and sex might be an influential factor for the association of HDL-C with kidney function in elderly hypertension.

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GFRMDRD, GFRCKD-EPI, Scr, and UA levels according to tertiles of HDL-C. Range 1, 2, and 3 of HDL-C in increasing tertiles were <1, 1–2, >2 mmol/L, respectively. The vertical bars represent 95% confidence interval for mean. All P for trends <0.05. CKD-EPI = chronic kidney disease epidemiology collaboration, GFR = glomerular filtration rate, HDL-C = high-density lipoprotein cholesterol, MDRD = simplified modification of diet in renal disease, Scr = Serum creatinine, UA = uric acid. n = 2241 for tertile 1, 11783 for tertile 2, and 620 for tertile 3.
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Figure 1: GFRMDRD, GFRCKD-EPI, Scr, and UA levels according to tertiles of HDL-C. Range 1, 2, and 3 of HDL-C in increasing tertiles were <1, 1–2, >2 mmol/L, respectively. The vertical bars represent 95% confidence interval for mean. All P for trends <0.05. CKD-EPI = chronic kidney disease epidemiology collaboration, GFR = glomerular filtration rate, HDL-C = high-density lipoprotein cholesterol, MDRD = simplified modification of diet in renal disease, Scr = Serum creatinine, UA = uric acid. n = 2241 for tertile 1, 11783 for tertile 2, and 620 for tertile 3.

Mentions: The parameters of 3 groups according to tertiles of serum HDL-C level were demonstrated in Table 2. The subjects were younger in tertile 1 and tertile 2 than that in tertile 3. The females had higher HDL-C level, whereas males had lower HDL-C level. As HDL-C level elevated from tertile 1 to tertile 3, TC level increased, but TG and BMI levels decreased. The LDL-C level was highest in tertile 2 and lowest in tertile 1. Compared with tertile 2 and tertile 3, tertile 1 had higher glucose level. The systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP) were not different among 3 groups. The GFR, Scr, and UA values among 3 groups were presented in Figure 1. The Scr and UA levels were highest in tertile 1 and lowest in tertile 3, whereas the GFRMDRD and GFRCKD-EPI values were lowest in tertile 1 and highest in tertile 3. There was no difference in BUN level among 3 groups (P = 0.06, data not shown). The prevalence of renal insufficiency and proteinuria prevalence were lower in tertile 2 and tertile 3, compared with that in tertile 1 (P < 0.05, Figures 2A and 3A). Since sex was an influential factor for lipid and kidney function, we further categorized tertiles of HDL-C into female and male groups. We performed ANCOVA using age, BMI, TC, TG, LDL-C, and glucose concentration as confounding factors to explore the effect of HDL-C on kidney function (data shown in Table 3). As HDL-C level increased from tertile 1 to tertile 3, Scr and UA levels decreased while GFR value increased for male subjects. There was no difference in BUN, Scr and GFR values for female subjects among tertiles of HDL-C.


Association between high-density lipoprotein cholesterol and renal function in elderly hypertension: a cross-sectional study in Chinese population.

Zhang YP, Lu MG, Duan DD, Liu YL, Liu M, Li Y, Kuang ZM, Lu Y, Liu X, Li XH, Yuan H - Medicine (Baltimore) (2015)

GFRMDRD, GFRCKD-EPI, Scr, and UA levels according to tertiles of HDL-C. Range 1, 2, and 3 of HDL-C in increasing tertiles were <1, 1–2, >2 mmol/L, respectively. The vertical bars represent 95% confidence interval for mean. All P for trends <0.05. CKD-EPI = chronic kidney disease epidemiology collaboration, GFR = glomerular filtration rate, HDL-C = high-density lipoprotein cholesterol, MDRD = simplified modification of diet in renal disease, Scr = Serum creatinine, UA = uric acid. n = 2241 for tertile 1, 11783 for tertile 2, and 620 for tertile 3.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554054&req=5

Figure 1: GFRMDRD, GFRCKD-EPI, Scr, and UA levels according to tertiles of HDL-C. Range 1, 2, and 3 of HDL-C in increasing tertiles were <1, 1–2, >2 mmol/L, respectively. The vertical bars represent 95% confidence interval for mean. All P for trends <0.05. CKD-EPI = chronic kidney disease epidemiology collaboration, GFR = glomerular filtration rate, HDL-C = high-density lipoprotein cholesterol, MDRD = simplified modification of diet in renal disease, Scr = Serum creatinine, UA = uric acid. n = 2241 for tertile 1, 11783 for tertile 2, and 620 for tertile 3.
Mentions: The parameters of 3 groups according to tertiles of serum HDL-C level were demonstrated in Table 2. The subjects were younger in tertile 1 and tertile 2 than that in tertile 3. The females had higher HDL-C level, whereas males had lower HDL-C level. As HDL-C level elevated from tertile 1 to tertile 3, TC level increased, but TG and BMI levels decreased. The LDL-C level was highest in tertile 2 and lowest in tertile 1. Compared with tertile 2 and tertile 3, tertile 1 had higher glucose level. The systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP) were not different among 3 groups. The GFR, Scr, and UA values among 3 groups were presented in Figure 1. The Scr and UA levels were highest in tertile 1 and lowest in tertile 3, whereas the GFRMDRD and GFRCKD-EPI values were lowest in tertile 1 and highest in tertile 3. There was no difference in BUN level among 3 groups (P = 0.06, data not shown). The prevalence of renal insufficiency and proteinuria prevalence were lower in tertile 2 and tertile 3, compared with that in tertile 1 (P < 0.05, Figures 2A and 3A). Since sex was an influential factor for lipid and kidney function, we further categorized tertiles of HDL-C into female and male groups. We performed ANCOVA using age, BMI, TC, TG, LDL-C, and glucose concentration as confounding factors to explore the effect of HDL-C on kidney function (data shown in Table 3). As HDL-C level increased from tertile 1 to tertile 3, Scr and UA levels decreased while GFR value increased for male subjects. There was no difference in BUN, Scr and GFR values for female subjects among tertiles of HDL-C.

Bottom Line: Bonferroni correction was performed for multiple comparisons.Analysis of covariance was used to control for confounding factors.The significance of difference between 3 groups and more was determined by chi-square test for categorical variables.

View Article: PubMed Central - PubMed

Affiliation: From the Pediatric Heart Center (YP Zhang, YL Liu), Department of Hypertension (ZM Kuang), Beijing Anzhen Hospital, Capital Medical University, Beijing, China; School of Community and Health Sciences (MG Lu), Laboratory of Cardiovascular Phenomics, the Department of Pharmacology (DD Duan), University of Nevada School of Medicine, Reno, NV, USA; Department of Geriatrics, the First Hospital, Peking University, Beijing (M Liu); Center of Clinical Pharmacology, the Third Xiang-Ya Hospital (Y Li, Y Lu, X Liu, H Yuan), and Department of Pharmacology, School of Pharmaceutical Sciences (XH Li), Central South University, Changsha, China.

ABSTRACT
Few studies have yet investigated the possible association between high-density lipoprotein cholesterol (HDL-C) and kidney function in elderly patients with primary hypertension. Accordingly, the aim of the present study was to evaluate the relationship between HDL-C and kidney function in elderly hypertension. A total of 14,644 elderly hypertensive subjects were enrolled in our cross-sectional study. The patients were categorized based on serum HDL-C level and glomerular filtration rate (GFR) value, respectively. One-way analysis of variance was used to compare the parameters among different groups. Bonferroni correction was performed for multiple comparisons. Analysis of covariance was used to control for confounding factors. The significance of difference between 3 groups and more was determined by chi-square test for categorical variables. Serum creatinine and uric acid were negatively related to HDL-C level, whereas GFR was positively related to HDL-C level in elderly hypertensive patients according to tertiles of HDL-C and tertiles of HDL-C/total cholesterol ratio (all P for trends <0.05). The male elderly hypertensive patients showed stronger relationship between HDL-C and renal function than the female elderly hypertensive subjects. Low HDL-C was associated with renal insufficiency and proteinuria in the hypertensive elderly (P < 0.05). The elderly "renal-hyperfiltrator" appeared to have lower HDL-C level, compared with the "normal renal-filtrator" (P < 0.05). There was an inverse "V" shape between HDL-C and GFR by GFR strata. Our results point out that there is an association of low HDL-C level with impaired kidney function in elderly hypertensive patients. Glomerular hyperfiltration may also affect HDL-C level and sex might be an influential factor for the association of HDL-C with kidney function in elderly hypertension.

Show MeSH
Related in: MedlinePlus