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Tsuruya K.,Kyushu University | Yoshida H.,Kyushu University | Nagata M.,Kyushu University | Kitazono T.,Kyushu University | And 10 more authors.
Atherosclerosis | Year: 2014

Objectives: To investigate the relationship between triglycerides to high-density lipoprotein cholesterol ratio (TG/HDL-C) and chronic kidney disease (CKD). Methods: We used data from 216,007 Japanese adults who participated in a nationwide health checkup program. Men (n=88,516) and women (n=127,491) were grouped into quartiles based on their TG/HDL-C levels (<1.26, 1.26-1.98, 1.99-3.18, and >3.18 in men; <0.96, 0.96-1.44, 1.45-2.22, and >2.22 in women). We cross-sectionally assessed the association of TG/HDL-C levels with CKD [defined as an estimated glomerular filtration rate (eGFR) of <60mL/min/1.73m2 (low eGFR) and/or proteinuria (defined as urinary protein ≥1+ on dipstick testing)], low eGFR, and proteinuria. Results: The prevalence of CKD, low eGFR, and proteinuria increased significantly with elevating quartiles of TG/HDL-C in both genders (all P for trend <0.001). Participants in the highest quartile of TG/HDL-C had a significantly greater risk of CKD than those in the lowest quartile after adjustment for the relevant confounding factors (odds ratio: 1.57, 95% confidence interval: 1.49-1.65 in men; 1.41, 1.34-1.48 in women, respectively). Furthermore, there were significant associations with low eGFR and proteinuria. In stratified analysis, the risk of CKD increased linearly with greater TG/HDL-C levels in participants with and without hypertension, diabetes, and obesity. Moreover, higher TG/HDL-C levels were relevant for CKD, especially in participants with hypertension and diabetes (P for interaction <0.001, respectively). Conclusions: An elevated TG/HDL-C is associated with the risk of CKD in the Japanese population. © 2014 Elsevier Ireland Ltd.

Sato Y.,University of Miyazaki | Fujimoto S.,University of Miyazaki | Konta T.,Yamagata University | Iseki K.,Steering Communications for the Examination of the Positioning of CKD in Specific Health Check and Guidance | And 8 more authors.
Clinical and Experimental Nephrology | Year: 2014

Background: There is little data on the association between body mass index (BMI) and proteinuria. Methods: This was a cross-sectional cohort study assessing the association between BMI and proteinuria in a large Japanese population. Using a nationwide health check-up database of 212,251 Japanese aged >20 years with no pre-existing cardiovascular diseases (185,183 men, median age 66 years; 127,068 women, median age 65 years), we examined the association between BMI and proteinuria (≥1+ on dipstick). Results: Subjects were divided into 11 subgroups by BMI grading in 1 kg/m2 intervals from 18.5-27.5 kg/m2. A BMI of approximately 22 ± 0.5 kg/m2 was considered optimal for Japanese; therefore, this subgroup was set as a reference when logistic analysis was applied. Age, waist circumference, height, weight, smoking and drinking habits, use of medications such as antihypertensive, antidiabetic, or antihyperlipidemic, as well as proteinuria, estimated glomerular filtration rate (eGFR), chemistry data, and blood pressure levels were significantly different between subgroups in both genders. The odds ratio for proteinuria showed a U-shape in men and women, even after adjustment for significant covariates such as age, waist circumference, systolic blood pressure, eGFR, fasting plasma glucose, triglyceride, low-density lipoprotein, antihypertensive use, antidiabetic use, antihyperlipidemic use, and lifestyle factors (smoking and drinking). Gender differences were also prominent - a BMI <20.4 kg/m2 was significantly associated with proteinuria in men compared to a BMI <18.4 kg/m2 in women. On the other hand, a BMI ≥ 25.5 kg/m2 was also significantly associated with proteinuria in men compared to a BMI ≥ 22.5 kg/m2 in women. Conclusions: We found that BMI levels were associated with proteinuria in a U-shaped manner and showed marked gender differences. Health guidance should not only focus on higher BMI subjects, but also on thin subjects, in terms of the prevention of chronic kidney disease. © 2013 Japanese Society of Nephrology.

Sato Y.,University of Miyazaki | Yano Y.,University of Miyazaki | Fujimoto S.,University of Miyazaki | Konta T.,Yamagata University | And 9 more authors.
Nephrology Dialysis Transplantation | Year: 2012

BackgroundThere is little data on the assessment of prediabetes with proteinuria.MethodsThis is a cross-sectional cohort study assessing prediabetes with proteinuria in a large Japanese population. Using a nationwide health checkup database of 228 778 Japanese aged <20 years (median 66 years; 39.3 were men; none had pre-existing cardiovascular disease), we examined the association between prediabetes and proteinuria (<1 on dipstick) separately in prediabetes subjects diagnosed with the new hemoglobin A1c (HbA1c) criterion only (PD-A1c), the impaired fasting plasma glucose only (PD-IFG) and fulfilling both criteria (PD-Both).ResultsAccording to the American Diabetes Association's (ADA's) criterion of 5.7-6.4 HbA1c and/or 100-125 mg/dL fasting plasma glucose, 43.8 of the subjects were judged as having prediabetes. Prediabetes subjects were divided into subclasses of PD-A1c (53.7), PD-IFG (21.7) and PD-Both (24.5), respectively. Therefore, 21.7 of prediabetes subjects were missed using the new HbA1c criterion only. Compared with subjects with normal glucose tolerance (as a reference), the odds ratio (OR) [95 confidence interval (95 CI)] for the increased risk of proteinuria (<1) in diabetes itself was 2.191 (2.081-2.307) and in whole prediabetes was 1.093 (1.046-1.142); when prediabetes was subdivided, the OR for proteinuria in PD-IFG was 1.217 (1.140-1.300) and that in PD-Both was 1.249 (1.174-1.329), but that in PD-A1c was not significant, even after adjustment for significant covariates, such as age, sex, body mass index, systolic blood pressure, antihypertensive medication, eGFR, lifestyle and lipid profile.ConclusionsPrediabetes is a significant risk factor for proteinuria compared with completely normal glucose level, and subjects with prediabetes defined using IFG are at significantly higher risk for proteinuria than those defined by HbA1c only. © 2012 The Author.

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