Kidney Week

Abstract: TH-PO251

Association of Triglycerides to High-Density Lipoprotein Cholesterol Ratio With Incident Cardiovascular Disease but Not ESKD Among Patients With Biopsy-Proven Diabetic Nephropathy

Session Information

• Diabetic Kidney Disease: Clinical - I
  November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diabetic Kidney Disease

• 602 Diabetic Kidney Disease: Clinical

Authors

• Uemura, Takayuki, Nara Medical University, Kashihara, Nara, Japan

Takayuki Uemura,

• Nishimoto, Masatoshi, Nara Medical University, Kashihara, Nara, Japan

Masatoshi Nishimoto,

• Eriguchi, Masahiro, Nara Medical University, Kashihara, Nara, Japan

Masahiro Eriguchi,

• Tamaki, Hiroyuki, Nara Medical University, Kashihara, Nara, Japan

Hiroyuki Tamaki,

• Tasaki, Hikari, Nara Medical University, Kashihara, Nara, Japan

Hikari Tasaki,

• Furuyama, Riri, Nara Medical University, Kashihara, Nara, Japan

Riri Furuyama,

• Fukata, Fumihiro, Nara Medical University, Kashihara, Nara, Japan

Fumihiro Fukata,

• Kosugi, Takaaki, Nara Medical University, Kashihara, Nara, Japan

Takaaki Kosugi,

• Morimoto, Katsuhiko, Nara Prefecture Seiwa Medical Center, Ikoma, Nara, Japan

Katsuhiko Morimoto,

• Matsui, Masaru, Nara Prefecture General Medical Center, Nara, Nara, Japan

Masaru Matsui,

• Samejima, Ken-ichi, Nara Medical University, Kashihara, Nara, Japan

Ken-ichi Samejima,

• Tsuruya, Kazuhiko, Nara Medical University, Kashihara, Nara, Japan

Kazuhiko Tsuruya,

Background

Increased triglycerides (TG) and decreased high-density lipoprotein cholesterol (HDL-C) are dyslipidemias characteristic of diabetes. Here, we aimed to examine the associations of TG/HDL-C ratio with subsequent cardiovascular disease (CVD) and kidney outcomes among patients with diabetic nephropathy.

Methods

A retrospective observational study consists of patients with biopsy proven diabetic nephropathy between June 1981 and December 2014. Patients complicated with other kidney diseases were excluded. Exposure of interest was TG/HDL-C ratio measured at the time of kidney biopsy. The outcome variables were kidney histological findings, incident CVD and end-stage kidney disease (ESKD). The association between TG/HDL-C ratio and histological findings was examined using logistic regression models. The association of TG/HDL-C ratio with incident CVD and ESKD was examined using Cox proportional hazard models.

Results

A total of 353 subjects were divided into quartiles based on TG/HDL-C ratio: Quartile 1 (reference), <1.96; Quartile 2, 1.96−3.10; Quartile 3, 3.11−4.55; and Quartile 4, ≥4.56. TG/HDL-C ratio was not a predictor of any histological findings in the fully adjusted model. During median follow-up periods of 6.2 and 7.3 years, 152 and 90 subjects developed incident CVD and ESKD, respectively. Higher TG/HDL-C ratio was independently associated with a higher incidence of CVD even after adjustments for potential confounders (hazard ratio (HR) [95% confidence interval (CI)] for Quartile 3 vs. reference; 1.73 [1.08−2.79] and Quartile 4 vs. reference; 1.86 [1.10−3.17]). Although there was a weak association between TG/HDL-C ratio and incident ESKD in the univariable model, the association was not significant in the fully adjusted model.

Conclusion

Among patients with biopsy-proven diabetic nephropathy, higher TG/HDL-C ratio was independently associated with a higher incidence of CVD. The effect of TG/HDL-C ratio on kidney dysfunction would be inconclusive, and further studies are now warranted.