Association Between Renal Dysfunction and Low HDL Cholesterol Among the Elderly in China
Aijun You, Yaxin Li, Brian Tomlinson, Longfei Yue, Kaijie Zhao, Huimin Fan, Zhongmin Liu, Yuzhen Zhang, Liang Zheng
Abstract
Objective: Chronic kidney disease (CKD) and cardiovascular disease (CVD) have a high morbidity and mortality among the elderly. Low levels of high-density lipoprotein cholesterol (HDL-C), a traditional risk marker for CVD, are common in CKD patients. Little is known about the association of low HDL-C with renal dysfunction in the community dwelling population. Methods: This was a population-based cross-sectional study included 4,753 participants enrolled in a prospective study, the Shanghai Elderly Cardiovascular Health (SHECH) study. Estimated glomerular filtration rate (eGFR), calculated by the Chinese Modification of Diet in Renal Disease (C-MDRD equation), was used to assess renal dysfunction. Associations between renal dysfunction and low HDL-C were evaluated using multiple logistic regression models and restricted cubic splines. Results: Of 4,649 individuals who met inclusion criteria, 620 (13.34%) had low HDL-C at <40 mg/dl. In the fully adjusted model, lower eGFR of <60 ml/min/1.73 m 2 (OR, 2.03; 95% CI, 1.21–3.43) and marginal eGFR of 60 to 90 ml/min/1.73 m 2 (OR, 1.26; 95% CI, 1.01–1.58) were significantly associated with low HDL-C, compared with normal eGFR of ≥90 ml/min/1.73 m 2 . Moreover, consistent findings were obtained in subsidiary analyses using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Fully adjusted cubic spline models indicated a significant dose-response relationship between eGFR and low HDL-C ( P for non-linearity, 0.356). Conclusion: In this general elderly population, renal dysfunction was independently and significantly associated with low HDL-C, and the prevalence of low HDL-C increased with decreasing eGFR, such that even slight changes in renal function may be associated with altered lipid levels.