Abstract
BackgroundAlthough renal insufficiency and dyslipidemia are known to be closely associated, the effect of kidney function on the size and clinical value of high-density lipoprotein (HDL) particles remains largely unknown, especially in patients with coronary heart disease.MethodsA total of 419 coronary heart disease patients and 105 non-coronary heart disease patients were included. HDL particle size, represented by HDL-C/apoA-I, was compared between groups stratified by estimated glomerular filtration rate (eGFR) and Gensini scores using standard Student’s t test and one-way ANOVA. Pearson’s correlation test was performed to analyze the association between eGFR and HDL-C/apoA-I in patients with coronary heart disease. The relationship between HDL particle size and the occurrence of coronary heart disease was explored using Univariate logistic regression analysis.ResultsIn patients with coronary heart disease, between-group analysis revealed that HDL-C/apoA-I increased as eGFR declined, and significance appeared as eGFR declined to under 60 ml/min·1.73 m2 (P < 0.001), and Pearson's correlation test also confirmed an inverse correlation between eGFR and HDL-C/apoA-I levels in coronary heart disease patients. When stratified by Gensini scores, in coronary heart disease patients with eGFR ≥ 90 mL/(min·1.73 m2), those with higher Gensini scores had smaller HDL-C/apoA-I. However, with or without kidney insufficiency, smaller HDL-C/apoA-I was associated with a higher occurrence of coronary heart disease (P < 0.05).ConclusionWith the presence of renal insufficiency, HDL-C/apoA1 was higher in patients with coronary heart disease. Lower HDL-C/apoA1 was still associated with a higher occurrence of coronary heart disease, but the original association between lower HDL-C/apoA1 and more severe coronary artery stenosis was lost in patients with renal insufficiency.
Highlights
Renal insufficiency and dyslipidemia are known to be closely associated, the effect of kidney function on the size and clinical value of high-density lipoprotein (HDL) particles remains largely unknown, especially in patients with coronary heart disease
BMI, Body mass index; BP, Blood Pressure levels were shown to increase in coronary heart disease patients (0.31 ± 0.01 vs. 0.25 ± 0.02, P = 0.001)
Lipid profiles and gensini scores in patients with coronary heart disease, stratified by estimated glomerular filtration rate (eGFR) As shown in Table 2, in patients with coronary heart disease, 227 patients had decreased eGFR. Both high-density lipoprotein cholesterol (HDL-C)/apolipoprotein A-I (apoA-I) levels and HDL-C levels were notably higher in patients with kidney insufficiency (0.83 ± 0.13 and 0.87 ± 0.11, P = 0.005 and0.93 ± 0.02 and 0.98 ± 0.02, P = 0.024).patients were grouped by chronic kidney disease categories, and between-group analysis revealed that HDL-C/ apoA-I increased as eGFR declined, and significance was presented in patients with moderately reduced kidney function, as shown in Table 3 and Fig. 1
Summary
Renal insufficiency and dyslipidemia are known to be closely associated, the effect of kidney function on the size and clinical value of high-density lipoprotein (HDL) particles remains largely unknown, especially in patients with coronary heart disease. High-density lipoprotein (HDL) has been acknowledged as a protective factor for cardiovascular disease, as there is unequivocal evidence of the inverse association between the HDL-C level and the occurrence and mortality of cardiovascular disease [1]. In recent years, several clinical trials aiming to increase plasma high-density lipoprotein cholesterol (HDL-C). Mature HDL particles are generally considered to be anti-inflammatory and cardiovascular protective, and recently, studies have reported decreased amounts of larger HDL particles in patients with end stage kidney disease (ESRD) [6]
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