Association of Chronic Kidney Disease and Diabetes with Triglyceridesto-HDL Cholesterol Ratio for a Japanese Population: The Nagasaki Islands Study

Abstract

Objective and background Although a previous study of ours found that diabetes combined with high serum Triglycerides to High-Density Lipoprotein cholesterol (TG-HDL) ratios constitutes a risk factor for atherosclerosis, the association, in terms of TGHDL ratio, between diabetes and Chronic Kidney Disease (CKD), which is also known to be an independent risk factor for atherosclerosis, has not been clarified yet. Methods We conducted a cross-sectional study of 3,069 Japanese (1,153 men and 1,916 women) aged 60-89 years who underwent a general health check. We investigated the associations between CKD and diabetes for all subjects, who were divided into tertiles according to TG-HDL level. Diabetes was defined as HbA1c ≥ 6.5% (reference: the National Glycohemoglobin Standardization Program), and/or initiation of glucose-lowering medication or insulin therapy. CKD was defined as GFR<60mL/min/1.73 m2. Results Of the 246 diabetes participants identified in this study, 102 had high and 74 low TG-HDL diabetes. Even though total diabetes showed no significant association with CKD, high TG-HDL diabetes showed a significant positive association and low TG-HDL diabetes a significant inverse association. Adjusted odds ratios (ORs) of classical cardiovascular risk factors for CKD were 0.92 (0.70-1.23) for total diabetes, 1.52 (1.01-2.29) for high TG-HDL diabetes, and 0.55 (0.31- 0.97) for low TG-HDL diabetes. Conclusion High but not low TG-HDL diabetes constitutes a significant risk for CKD, suggesting that diabetes categorized by TG-HDL ratio is clinically relevant for estimating the risk of CKD.