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GFR, body mass index, and low high-density lipoprotein concentration in adults with and without CKD.
Am J Kidney Dis. 2007 Oct; 50(4):552-8.AJ

Abstract

BACKGROUND

Low high-density lipoprotein (HDL) cholesterol level is common in patients with chronic kidney disease, but associations between severity of chronic kidney disease, obesity, and HDL level have not been well defined.

STUDY DESIGN

Cross-sectional study.

SETTING & PARTICIPANTS

Within a large integrated health care delivery system, we identified all adult individuals without diabetes who had measured kidney function (estimated glomerular filtration rate [eGFR]), body mass index (BMI), and HDL level, but no substantial proteinuria, confounding medications, or prior renal replacement therapy.

PREDICTORS

The primary predictors for our analyses were eGFR and BMI.

OUTCOMES

Low HDL cholesterol level was the outcome. We performed multivariable logistic regression to investigate whether the relationship between BMI and low HDL level (men, <40 mg/dL; women, <50 mg/dL) varied as a function of eGFR.

RESULTS

Of 380,207 individuals who met cohort entry criteria, there were 26,089 (7%) with chronic kidney disease by eGFR level. Compared with eGFR of 60 mL/min/1.73 m(2) or greater, lower eGFR category (in mL/min/1.73 m(2)) was associated with an increased adjusted odds of low HDL level independent of BMI and other confounders. However, there was a significant interaction between eGFR and BMI (P < 0.001). In separate models stratified by eGFR category (>or=60, 45 to 59, and 30 to 44 mL/min/1.73 m(2)), greater BMI was associated with a graded increased adjusted odds of low HDL level in each eGFR category, but this relationship was attenuated in patients with lower eGFR.

LIMITATIONS

Information for undiagnosed diabetes and proteinuria was unavailable.

CONCLUSIONS

Decreased eGFR is independently associated with greater odds of having a low HDL level. Across a spectrum of eGFR, greater BMI was associated with lower HDL level, but the magnitude of this association was diminished at lower eGFR, suggesting that other factors may also contribute to low HDL levels in patients with advanced chronic kidney disease.

Authors+Show Affiliations

Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA. joan.c.lo@kp.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

17900454

Citation

Lo, Joan C., et al. "GFR, Body Mass Index, and Low High-density Lipoprotein Concentration in Adults With and Without CKD." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 50, no. 4, 2007, pp. 552-8.
Lo JC, Go AS, Chandra M, et al. GFR, body mass index, and low high-density lipoprotein concentration in adults with and without CKD. Am J Kidney Dis. 2007;50(4):552-8.
Lo, J. C., Go, A. S., Chandra, M., Fan, D., & Kaysen, G. A. (2007). GFR, body mass index, and low high-density lipoprotein concentration in adults with and without CKD. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 50(4), 552-8.
Lo JC, et al. GFR, Body Mass Index, and Low High-density Lipoprotein Concentration in Adults With and Without CKD. Am J Kidney Dis. 2007;50(4):552-8. PubMed PMID: 17900454.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - GFR, body mass index, and low high-density lipoprotein concentration in adults with and without CKD. AU - Lo,Joan C, AU - Go,Alan S, AU - Chandra,Malini, AU - Fan,Dongjie, AU - Kaysen,George A, PY - 2007/01/03/received PY - 2007/07/05/accepted PY - 2007/9/29/pubmed PY - 2007/10/16/medline PY - 2007/9/29/entrez SP - 552 EP - 8 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am J Kidney Dis VL - 50 IS - 4 N2 - BACKGROUND: Low high-density lipoprotein (HDL) cholesterol level is common in patients with chronic kidney disease, but associations between severity of chronic kidney disease, obesity, and HDL level have not been well defined. STUDY DESIGN: Cross-sectional study. SETTING & PARTICIPANTS: Within a large integrated health care delivery system, we identified all adult individuals without diabetes who had measured kidney function (estimated glomerular filtration rate [eGFR]), body mass index (BMI), and HDL level, but no substantial proteinuria, confounding medications, or prior renal replacement therapy. PREDICTORS: The primary predictors for our analyses were eGFR and BMI. OUTCOMES: Low HDL cholesterol level was the outcome. We performed multivariable logistic regression to investigate whether the relationship between BMI and low HDL level (men, <40 mg/dL; women, <50 mg/dL) varied as a function of eGFR. RESULTS: Of 380,207 individuals who met cohort entry criteria, there were 26,089 (7%) with chronic kidney disease by eGFR level. Compared with eGFR of 60 mL/min/1.73 m(2) or greater, lower eGFR category (in mL/min/1.73 m(2)) was associated with an increased adjusted odds of low HDL level independent of BMI and other confounders. However, there was a significant interaction between eGFR and BMI (P < 0.001). In separate models stratified by eGFR category (>or=60, 45 to 59, and 30 to 44 mL/min/1.73 m(2)), greater BMI was associated with a graded increased adjusted odds of low HDL level in each eGFR category, but this relationship was attenuated in patients with lower eGFR. LIMITATIONS: Information for undiagnosed diabetes and proteinuria was unavailable. CONCLUSIONS: Decreased eGFR is independently associated with greater odds of having a low HDL level. Across a spectrum of eGFR, greater BMI was associated with lower HDL level, but the magnitude of this association was diminished at lower eGFR, suggesting that other factors may also contribute to low HDL levels in patients with advanced chronic kidney disease. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/17900454/GFR_body_mass_index_and_low_high_density_lipoprotein_concentration_in_adults_with_and_without_CKD_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272-6386(07)01040-2 DB - PRIME DP - Unbound Medicine ER -