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Association of triglycerides to high-density lipoprotein cholesterol ratio with incident cardiovascular disease but not end-stage kidney disease among patients with biopsy-proven diabetic nephropathy

Hypertension Research volume 46, pages 1423–1432 (2023)Cite this article

Abstract

Increased triglycerides (TG) and decreased high-density lipoprotein cholesterol (HDL-C) are dyslipidemias characteristic of diabetes. Here, we aimed to examine associations of TG/HDL-C ratio with cardiovascular disease (CVD) and kidney dysfunction among patients with diabetic nephropathy. This retrospective observational study consists of patients with biopsy-proven diabetic nephropathy at Nara Medical University Hospital. Exposure of interest was TG/HDL-C ratio measured at kidney biopsy. Outcome variables were kidney histological findings, incident CVD and end-stage kidney disease (ESKD). Multivariable logistic regression models and Cox proportional hazard models were used to examined these associations. 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 fully adjusted models. During median follow-up periods of 6.2 and 7.3 years, 152 and 90 subjects developed CVD and ESKD, respectively. Higher TG/HDL-C ratio was independently associated with higher incidences of CVD even after adjustments for potential confounders (hazard ratio [95% confidence interval] 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 ESKD in the univariable model, the association was not significant in fully adjusted models. In conclusion, among patients with biopsy-proven diabetic nephropathy, higher TG/HDL-C ratio was independently associated with higher incidences of CVD but not with kidney outcomes, suggesting different impact of TG/HDL-C ratio on cardiorenal outcomes.

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Funding

This work was supported by grants from the Japan Society for the Promotion of Science (Grant-in-Aid for Scientific Research 18K15984) to KS.

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Authors and Affiliations

  1. Department of Nephrology, Nara Medical University, Nara, Japan

    Takayuki Uemura, Masatoshi Nishimoto, Masahiro Eriguchi, Hiroyuki Tamaki, Hikari Tasaki, Riri Furuyama, Fumihiro Fukata, Takaaki Kosugi, Masaru Matsui, Ken-ichi Samejima & Kazuhiko Tsuruya

  2. Department of Nephrology, Nara Prefecture Seiwa Medical Center, Nara, Japan

    Katsuhiko Morimoto

  3. Department of Nephrology, Nara Prefecture General Medical Center, Nara, Japan

    Masaru Matsui

Authors
  1. Takayuki Uemura
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Contributions

Research idea and study design: TU, MN, ME, and KT; data acquisition: MN, ME, KM, and KS; and supervision or mentorship: ME, MN, HTam, HTas, RF, FF, TK, KM, MM, KS, and KT. All authors provided intellectual content of critical importance to the work described and approved the final version of the manuscript.

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Correspondence to Masahiro Eriguchi.

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Uemura, T., Nishimoto, M., Eriguchi, M. et al. Association of triglycerides to high-density lipoprotein cholesterol ratio with incident cardiovascular disease but not end-stage kidney disease among patients with biopsy-proven diabetic nephropathy. Hypertens Res 46, 1423–1432 (2023). https://doi.org/10.1038/s41440-023-01197-y

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