Serum Non-High-Density Lipoprotein Cholesterol and Risk of Cardiovascular Disease in Community Dwellers with Chronic Kidney Disease: the Hisayama Study

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  • Usui Tomoko
    Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
  • Nagata Masaharu
    Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
  • Hata Jun
    Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
  • Mukai Naoko
    Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
  • Hirakawa Yoichiro
    Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
  • Yoshida Daigo
    Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
  • Kishimoto Hiro
    Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University
  • Kitazono Takanari
    Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University
  • Kiyohara Yutaka
    Hisayama Research Institute for Lifestyle Diseases
  • Ninomiya Toshiharu
    Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University

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Abstract

<p>Aim: It is not clear whether elevated serum non-high-density lipoprotein cholesterol (non-HDL-C) levels are a risk factor for cardiovascular disease (CVD) in subjects with chronic kidney disease (CKD) in the general population.</p><p>Methods: A total of 2,630 community-dwelling Japanese subjects (1,107 men and 1,523 women) without history of CVD and aged ≥40 years were prospectively followed up for an average of 19 years, and the association between serum non-HDL-C levels and the incidence of type-specific CVD was estimated using a Cox proportional hazards model. CKD was defined as estimated glomerular filtration rate ＜60 mL/min/1.73 m2 or proteinuria (≥1＋ on dipstick).</p><p>Results: At baseline, 357 subjects had CKD. During the follow up, 186 coronary heart disease (CHD) and 277 stroke events occurred. The age- and sex-adjusted incidence of CHD was significantly higher in subjects with higher non-HDL-C levels, both in those with and without CKD. In the CKD group, the risk of CHD was significantly higher in those with non-HDL-C levels of 150– 189 mg/dL [adjusted hazard ratio (HR), 2.23; 95% confidence interval (CI), 1.04–4.77] and those with levels ≥190 mg/dL (adjusted HR, 3.20; 95% CI, 1.46–7.03) than in those with levels ＜150 mg/dL. In the non-CKD group, the risk of CHD was significantly higher only in those with nonHDL-C levels ≥190 mg/dL (adjusted HR, 2.12; 95% CI, 1.33–3.38). However, no such association was observed for the risk of stroke.</p><p>Conclusions: Our findings suggest that higher serum non-HDL-C levels are associated with greater risk of CHD in subjects with and without CKD and that this association is greater in subjects with CKD than in those without CKD.</p>

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