Relationship of High-Density Lipoprotein Cholesterol With Renal Function in Patients Treated With Atorvastatin

被引:1
|
作者
Ong, Kwok Leung [1 ]
Waters, David D. [2 ]
Fayyad, Rana [3 ]
Vogt, Liffert [4 ]
Melamed, Shari [3 ]
DeMicco, David A. [3 ]
Rye, Kerry-Anne [1 ]
Barter, Philip J. [1 ]
机构
[1] Univ New South Wales, Sch Med Sci, Sydney, NSW 2052, Australia
[2] Univ Calif San Francisco, San Francisco Gen Hosp, Div Cardiol, San Francisco, CA USA
[3] Pfizer Inc, New York, NY USA
[4] Univ Amsterdam, Sect Nephrol, Dept Internal Med, Acad Med Ctr, Amsterdam, Netherlands
来源
基金
英国医学研究理事会;
关键词
atorvastatin; epidemiology; estimated glomerular filtration rate; high-density lipoprotein cholesterol; kidney; renal function; KIDNEY-DISEASE; CARDIOVASCULAR-DISEASE; SERUM CREATININE; PROGRESSION; LIPIDS; RISK; PARAOXONASE; DYSFUNCTION; CKD; MEN;
D O I
10.1161/JAHA.117.007387
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BackgroundIt is not known whether the concentration of high-density lipoprotein (HDL) cholesterol is related to renal function in statin-treated patients. We therefore investigated whether HDL cholesterol levels predicted renal function in atorvastatin-treated patients in the TNT (Treating to New Targets) trial. Methods and ResultsA total of 9542 participants were included in this analysis. Renal function was assessed by estimated glomerular filtration rate (eGFR). HDL cholesterol levels at month 3 were used as this is the time point at which on-treatment HDL cholesterol levels became stable. Among 6319 participants with a normal eGFR (60mL/min per 1.73 m(2)) at baseline, higher HDL cholesterol levels at month 3 were significantly associated with lower risk of decline in eGFR (ie, having eGFR <60mL/min per 1.73 m(2)) during follow-up (HR of 1.04, 0.88, 0.85, and 0.77 for HDL cholesterol quintiles 2, 3, 4, and 5, respectively, relative to quintile 1, P for trend=0.006). Among 3223 participants with an eGFR (<60mL/min per 1.73 m(2)) at baseline, higher HDL cholesterol levels at month 3 had less impact on eGFR during follow-up, with statistical significance observed only when analyzing HDL cholesterol levels as a continuous variable (P=0.043), but not as a categorical quintile variable (P for trend=0.27). ConclusionsIn patients treated with atorvastatin, higher HDL cholesterol levels were associated with lower risk of eGFR decline in patients with normal eGFR at baseline. However, further study is needed to establish whether there is any causal relationship between HDLs and renal function. Clinical Trial RegistrationURL: . Unique identifier: NCT00327691.
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页数:7
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