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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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Inverse “V” shape between GFR and HDL-C. Range 1, 2, 3, 4, 5, and 6 of GFRMDRD in increasing sextiles of GFRMDRD were <30, 30–60, 60–90, 90–120, 120–140, >140 mL/min/1.73m2, respectively. Range 1, 2, 3, 4, and 5 of GFRCKD-EPI in increasing quintiles of GFRCKD-EPI were <30, 30–60, 60–90, 90–120, >120 mL/min/1.73m2, respectively. 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. n = 79 for sextile 1, 807 for sextile 2, 7166 for sextile 3, 5831 for sextile 4, 602 for sextile 5, and 159 for sextile 6 according to GFRMDRD, n = 90 for quintile1, 1073 for quintile 2, 8763 for quintile 3, 4629 for quintile 4, and 89 for quintile 5 according to GFRCKD-EPI.
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Figure 5: Inverse “V” shape between GFR and HDL-C. Range 1, 2, 3, 4, 5, and 6 of GFRMDRD in increasing sextiles of GFRMDRD were <30, 30–60, 60–90, 90–120, 120–140, >140 mL/min/1.73m2, respectively. Range 1, 2, 3, 4, and 5 of GFRCKD-EPI in increasing quintiles of GFRCKD-EPI were <30, 30–60, 60–90, 90–120, >120 mL/min/1.73m2, respectively. 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. n = 79 for sextile 1, 807 for sextile 2, 7166 for sextile 3, 5831 for sextile 4, 602 for sextile 5, and 159 for sextile 6 according to GFRMDRD, n = 90 for quintile1, 1073 for quintile 2, 8763 for quintile 3, 4629 for quintile 4, and 89 for quintile 5 according to GFRCKD-EPI.

Mentions: According to MDRD formula, GFR increased from sextile 1 to sextile 5 (all P for the trends < 0.05, Figure 5) and then eGFR decreased from sextile 5 to sextile 6 (P < 0.05, Figure 5). The GFRCKD-EPI increased from quintile 1 to quintile 4 (all P for the trends <0.05, Figure 5) and then GFRCKD-EPI decreased from quintile 4 to quintile 5 (P < 0.05, Figure 5). The inverse “V” shape was observed between GFR and HDL-C (Figure 5). Either MDRD formula or CKD-EPI equation was used to calculate GFR.


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)

Inverse “V” shape between GFR and HDL-C. Range 1, 2, 3, 4, 5, and 6 of GFRMDRD in increasing sextiles of GFRMDRD were <30, 30–60, 60–90, 90–120, 120–140, >140 mL/min/1.73m2, respectively. Range 1, 2, 3, 4, and 5 of GFRCKD-EPI in increasing quintiles of GFRCKD-EPI were <30, 30–60, 60–90, 90–120, >120 mL/min/1.73m2, respectively. 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. n = 79 for sextile 1, 807 for sextile 2, 7166 for sextile 3, 5831 for sextile 4, 602 for sextile 5, and 159 for sextile 6 according to GFRMDRD, n = 90 for quintile1, 1073 for quintile 2, 8763 for quintile 3, 4629 for quintile 4, and 89 for quintile 5 according to GFRCKD-EPI.
© Copyright Policy - open-access
Related In: Results  -  Collection

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Show All Figures
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Figure 5: Inverse “V” shape between GFR and HDL-C. Range 1, 2, 3, 4, 5, and 6 of GFRMDRD in increasing sextiles of GFRMDRD were <30, 30–60, 60–90, 90–120, 120–140, >140 mL/min/1.73m2, respectively. Range 1, 2, 3, 4, and 5 of GFRCKD-EPI in increasing quintiles of GFRCKD-EPI were <30, 30–60, 60–90, 90–120, >120 mL/min/1.73m2, respectively. 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. n = 79 for sextile 1, 807 for sextile 2, 7166 for sextile 3, 5831 for sextile 4, 602 for sextile 5, and 159 for sextile 6 according to GFRMDRD, n = 90 for quintile1, 1073 for quintile 2, 8763 for quintile 3, 4629 for quintile 4, and 89 for quintile 5 according to GFRCKD-EPI.
Mentions: According to MDRD formula, GFR increased from sextile 1 to sextile 5 (all P for the trends < 0.05, Figure 5) and then eGFR decreased from sextile 5 to sextile 6 (P < 0.05, Figure 5). The GFRCKD-EPI increased from quintile 1 to quintile 4 (all P for the trends <0.05, Figure 5) and then GFRCKD-EPI decreased from quintile 4 to quintile 5 (P < 0.05, Figure 5). The inverse “V” shape was observed between GFR and HDL-C (Figure 5). Either MDRD formula or CKD-EPI equation was used to calculate GFR.

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