Abstract: SA-PO1093
Inflammation Alters Relationship Between High-Density Lipoprotein Cholesterol and Risk of CKD: Results from UK Biobank Study
Session Information
- CKD Epidemiology, Risk Factors, Prevention - III
November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Jung, Hui-Yun, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
- Han, Seung Hyeok, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
Background
Under inflammatory condition, the functional changes of high-density lipoprotein-cholesterol (HDL-C) can transition from a protective role to a proatherosclerotic direction. We aimed to investigate whether inflammation could modify the relationship between HDL-C and risk of incident chronic kidney disease (CKD).
Methods
We conducted an observational study in 342,204 European adults, aged 38 to 73 years, who were free of CKD at recruitment between Mar 13, 2006, and Oct 1, 2010, from the UK Biobank study. The main exposure was HDL-C level. The presence of inflammation was defined when high sensitivity C-reactive protein (hs-CRP) level was above the median (>1.31 mg/L). The primary outcome was incident CKD.
Results
During a follow-up period of 3,983,553 person-years (median, 11.9 years), the primary outcome occurred in 13,950 (4.1%) participants. Overall, a higher HDL-C level was associated with a decreased risk of incident CKD in multivariable Cox analysis after adjustment of confounders. There was a significant interaction between HDL-C and the presence of inflammation on the risk of incident CKD (P-for-interaction=0.019). In patients without inflammation, the protective association of a higher HDL level remained similar. The hazard ratios (HRs) (95% CIs) for HDL-C of <30, 30-39, 50-59, 60-69, 70-79, ≥80 mg/dL were 1.20 (0.93-1.56), 1.13 (1.03-1.24), 0.92 (0.85-1.00), 0.88 (0.80-0.96), 0.85 (0.75-0.95), 0.73 (0.64-0.85), respectively, compared with HDL-C of 40-49 mg/dL. However, this association was attenuated in patients with inflammation, particularly for HDL-C ≥80 mg/dL. Notably, a lower HDL level was associated with a higher risk of CKD in all patients with a stronger increased risk observed in patients with inflammation.
Conclusion
A higher HDL-C level is associated with decreased risk of incident CKD, but this association was weak under inflammatory condition. These findings suggests that inflammation may modify the relationship between HDL-C and the development of CKD.