#6365 ASSOCIATION OF TRADITIONAL AND NON-TRADITIONAL LIPID ABNORMALITIES WITH RENAL FUNCTION: A SURVEY IN A RURAL POPULATION OF BANGLADESH

Abstract

Abstract Background and Aims The traditional and non-traditional lipid have been recognized to be involved in various atherosclerotic disease process. Several studies showed that, there is relation with renal function and dyslipidemia. Early detection of these modifiable risk factors and initiation of treatment may prevent or retard the progression of renal disease. Aim of this study was to evaluate the association of the traditional and non-traditional lipid abnormalities with renal function. Methods This cross sectional study was carried out in a rural area of Bangladesh. Renal function was evaluated by estimation of enzymatic creatinine, eGFR (CKD-EPI) and spot ACR. Total cholesterol (TC), triglyceride (TG), LDL and HDL was measured as traditional lipids and Apo-A1, APO-B, Lipo (a) as non-traditional lipids. Traditional dyslipidemia (TDLP) and non-traditional dyslipidemia (nTDLP) means abnormality in any of their components. Other tests include urine microscopy, Hb%, FBS, HbA1c, serum albumin and uric acid as additional risk marker. Results Total 201 patients were included for analysis. The mean age was 41± 13 years and male/female ratio 48:52. Around 48% were overweight. Among these 20% were hypertensive, 14% diabetic, nephropathy in13% and rest 53% had no known chronic disease. The mean value of creatinine was 0.8±0.2 mg%; eGFR was 94±23 ml/min/1.73m2, ACR was 9.70 (median), TG 182±104 mg/dl, TC 96 ±47 mg/dl; LDL 121 ± 39 mg/dl and HDL 38±6. The value of Apo-Al was 1.3 g/l (0.2-13.9), Apo-B 1.04 g/l (0.2-2.6) and Lipoprotein (a) was 17.3mg/dl (1.1-81.8). Mean value of FBS was 6.2 ±2.3 mmol/l, HbA1c 6.1 ±1.5%, Hb% 13.5 ± 1.6 g% and albumin was 4.8 ±0.5 mg%. When measured the TDLP was present in 81% and normal traditional lipids present in 19%. Similarly as a whole 50% had nTDLP and non-traditional lipids were normal in other half. Around 16% were free from both TDLP and nTDLP. The eGFR was lower in – TG >150 group than in < 150 (90 ± 24 vs. 98 ± 21 mg%, p<0.02); TC >200 than <200 (91 ± 23 vs. 100 ± 22 mg%, p<0.001); LDL >100 and < 100 (91± 23 vs. 100 ± 22 mg%, p<0.015) but no difference for components of nTDLP. The ACR was higher (> 30 mg/g) in 76% vs 24% (p<0.001) when TG is > 150 and < 150 mg%; 60% vs. 40% (p<0.05) when TC is > 200 and < 200mg%; and 81% vs. 19% (p<0.04) when LDL > 100 and < 100mg%. No such difference for renal functional parameters for non-traditional lipid components. In this study, eGFR had significant negative correlation with TC (r = -0.34 & p<0.001), TG (r = -0.24 & p<0.001), LDL (r = -0.25 & p<0.001) and only ACR had positive correlation with TG (r = 0.17 & p = 0.012). The nTDL wasn't associated with altered eGFR or ACR. Conclusion In this study it was observed that traditional lipid components were altered in 81% whereas non-traditional lipids were altered in 50% rural subjects. Only the traditional dyslipidemia was associated with lower eGFR and higher ACR.