Serum non-high-density lipoprotein cholesterol and risk of cardiovascular disease in community dwellers with chronic kidney disease: The hisayama study

Tomoko Usui, Masaharu Nagata, Jun Hata, Naoko Mukai, Yoichiro Hirakawa, Daigo Yoshida, Hiro Kishimoto, Takanari Kitazono, Yutaka Kiyohara, Toshiharu Ninomiya

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Abstract

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. 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). 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 non-HDL-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. 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.

Original languageEnglish
Pages (from-to)706-715
Number of pages10
JournalJournal of atherosclerosis and thrombosis
Volume24
Issue number7
DOIs
Publication statusPublished - Jan 1 2017

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Chronic Renal Insufficiency
Cardiovascular Diseases
Coronary Disease
Serum
Confidence Intervals
Hazards
Stroke
Independent Living
lipoprotein cholesterol
Incidence
Kidney Diseases
Glomerular Filtration Rate
Proteinuria
Proportional Hazards Models
Population

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine
  • Biochemistry, medical

Cite this

@article{a0aa41cc744046ec99aa3d409e636c56,
title = "Serum non-high-density lipoprotein cholesterol and risk of cardiovascular disease in community dwellers with chronic kidney disease: The hisayama study",
abstract = "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. 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). 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 non-HDL-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. 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.",
author = "Tomoko Usui and Masaharu Nagata and Jun Hata and Naoko Mukai and Yoichiro Hirakawa and Daigo Yoshida and Hiro Kishimoto and Takanari Kitazono and Yutaka Kiyohara and Toshiharu Ninomiya",
year = "2017",
month = "1",
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doi = "10.5551/jat.37044",
language = "English",
volume = "24",
pages = "706--715",
journal = "Journal of Atherosclerosis and Thrombosis",
issn = "1340-3478",
publisher = "Japan Atherosclerosis Society",
number = "7",

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TY - JOUR

T1 - Serum non-high-density lipoprotein cholesterol and risk of cardiovascular disease in community dwellers with chronic kidney disease

T2 - The hisayama study

AU - Usui, Tomoko

AU - Nagata, Masaharu

AU - Hata, Jun

AU - Mukai, Naoko

AU - Hirakawa, Yoichiro

AU - Yoshida, Daigo

AU - Kishimoto, Hiro

AU - Kitazono, Takanari

AU - Kiyohara, Yutaka

AU - Ninomiya, Toshiharu

PY - 2017/1/1

Y1 - 2017/1/1

N2 - 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. 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). 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 non-HDL-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. 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.

AB - 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. 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). 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 non-HDL-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. 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.

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DO - 10.5551/jat.37044

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