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RESEARCH PRODUCT

The role of plasma triglyceride/high-density lipoprotein cholesterol ratio to predict cardiovascular outcomes in chronic kidney disease.

Mahmut Ilker YilmazMahmut GokCem HaymanaTayfun EyiletenManfredi RizzoYusuf OguzHakki CetinkayaMutlu SaglamAlper SonmezMurat KaramanHilmi Umut UnalAbdulgaffar VuralPeter P. Toth

subject

AdultMalemedicine.medical_specialtyFlow mediated dilatationTriglyceride to HDL-cholesterol ratioEndocrinology Diabetes and MetabolismAsymmetric dimethyl arginineClinical BiochemistryRenal functionClinical nutritionArginineGastroenterologychemistry.chemical_compoundEndocrinologyInsulin resistanceHigh-density lipoproteinInternal medicineChronic kidney diseasemedicineHumansLongitudinal StudiesRenal Insufficiency ChronicSerum AlbuminTriglyceridesAgedRetrospective StudiesBiochemistry medicalbiologybusiness.industryCholesterolResearchBiochemistry (medical)C-reactive proteinCholesterol HDLMiddle Agedmedicine.diseaseEndocrinologyC-Reactive ProteinchemistryCardiovascular DiseasesParathyroid Hormonebiology.proteinlipids (amino acids peptides and proteins)FemalebusinessBiomarkersKidney diseaseLipidologyGlomerular Filtration Rate

description

Background Cardiovascular disease (CVD) risk is substantially increased in subjects with chronic kidney disease (CKD). The Triglycerides (TG) to High-Density Lipoprotein Cholesterol (HDL-C) ratio is an indirect measure of insulin resistance and an independent predictor of cardiovascular risk. No study to date has been performed to evaluate whether the TG/HDL-C ratio predicts CVD risk in patients with CKD. Methods A total of 197 patients (age 53 ± 12 years) with CKD Stages 1 to 5, were enrolled in this longitudinal, observational, retrospective study. TG/HDL-C ratio, HOMA-IR indexes, serum asymmetric dimethyl arginine (ADMA), high sensitivity C-reactive protein (CRP), parathyroid hormone (PTH), calcium, phosphorous, estimated glomerular filtration rate (eGFR), and albumin levels were measured. Flow mediated vasodilatation (FMD) of the brachial artery was assessed by using high-resolution ultrasonography. Results A total of 11 cardiovascular (CV) deaths and 43 nonfatal CV events were registered in a mean follow-up period of 30 (range 9 to 35) months. Subjects with TG/HDL-C ratios above the median values (>3.29) had significantly higher plasma ADMA, PTH, and phosphorous levels (p = 0.04, p = 0.02, p = 0.01 respectively) and lower eGFR and FMD values (p = 0.03, p < 0.001 respectively). The TG/HDL-C ratio was an independent determinant of FMD (β = −0.25 p = 0.02) along with TG, HDL-C, hsCRP, serum albumin, phosphate levels, systolic blood pressure, PTH, eGFR and the presence of diabetes mellitus. The TG/HDL-C ratio was also a significant independent determinant of cardiovascular outcomes [HR: 1.36 (1.11-1.67) (p = 0.003)] along with plasma ADMA levels [HR: 1.31 (1.13-1.52) (p < 0.001)] and a history of diabetes mellitus [HR: 4.82 (2.80-8.37) (p < 0.001)]. Conclusion This study demonstrates that the elevated TG/HDL-C ratio predicts poor CVD outcome in subjects with CKD. Being a simple, inexpensive, and reproducible marker of CVD risk, the TG/HDL-C ratio may emerge as a novel and reliable indicator among the many well-established markers of CVD risk in CKD. Systematic review registration Clinical trial registration number and date: NCT02113462 / 10-04-2014.

yearjournalcountryeditionlanguage
2015-04-16Lipids in health and disease
10.1186/s12944-015-0031-4https://pubmed.ncbi.nlm.nih.gov/25885289