Dataset Information

Is There a Nonlinear Relationship between Serum Uric Acid and Lipids in a Hypertensive Population with eGFR ?30?ml/min/1.73?m2? Findings from the China Hypertension Registry Study.

ABSTRACT: Background:Evidence regarding the nonlinear relationship between serum uric acid (SUA) and blood lipids in Chinese population with hypertension is limited. Therefore, the present study aimed to investigate whether there is a nonlinear association between SUA and lipids in Chinese hypertensive population with an estimated glomerular filtration rate (eGFR) ?30?ml/min/1.73?m2. Methods:A total of 13,355 hypertensive participants with eGFR ?30?ml/min/1.73?m2 were selected from the Chinese Hypertension Registry Study. Multivariate linear regression was used to examine the linear relationship between SUA and lipids. Smooth curve fitting (penalized spline method) and threshold saturation effects were used to analyze the nonlinear association between SUA and lipids. Results:In the fully adjusted model, the results showed a positive correlation between SUA and TG (??=?0.15; 95% CI: 0.14, 0.16) and LDL-C (??=?0.06; 95% CI: 0.05, 0.07), respectively. However, the relationship between SUA and HDL-C was nonlinear. The inflection point of SUA was 7.24?mg/dL. On the left side of the inflection point (<7.24?mg/dL), SUA was negatively associated with HDL-C (??=?-0.02; 95% CI -0.02, -0.01). On the right side of the inflection point (?7.24?mg/dL), SUA was not related to HDL-C (??=?0.01; 95% CI -0.01, 0.02). Conclusion:After adjusting for all covariates, SUA was positively associated with TG and LDL-C. The relationship between SUA and HDL-C was nonlinear. The negative correlation between SUA and HDL-C only existed when the SUA was less than 7.24?mg/dL in a hypertensive population with eGFR ?30?ml/min/1.73?m2.

SUBMITTER: Yu Y

PROVIDER: S-EPMC7519986 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Is There a Nonlinear Relationship between Serum Uric Acid and Lipids in a Hypertensive Population with eGFR ≥30 ml/min/1.73 m<sup>2</sup>? Findings from the China Hypertension Registry Study.

Yu Yu Y Huang Xiao X Li Minghui M Ding Congcong C Hu Lihua L Zhong Xiao X Zhou Wei W Wang Tao T Zhu Lingjuan L Bao Huihui H Cheng Xiaoshu X

International journal of endocrinology 20200918

<h4>Background</h4>Evidence regarding the nonlinear relationship between serum uric acid (SUA) and blood lipids in Chinese population with hypertension is limited. Therefore, the present study aimed to investigate whether there is a nonlinear association between SUA and lipids in Chinese hypertensive population with an estimated glomerular filtration rate (eGFR) ≥30 ml/min/1.73 m<sup>2</sup>.<h4>Methods</h4>A total of 13,355 hypertensive participants with eGFR ≥30 ml/min/1.73 m<sup>2</sup> were ...[more]

PMID: 33014048

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Project description:Background and objectivesThe Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) trial demonstrated that the sodium glucose cotransporter 2 (SGLT2) inhibitor canagliflozin reduced the risk of kidney failure and cardiovascular events in participants with type 2 diabetes mellitus and CKD. Little is known about the use of SGLT2 inhibitors in patients with eGFR <30 ml/min per 1.73 m2. The participants in the CREDENCE study had type 2 diabetes mellitus, a urinary albumin-creatinine ratio >300-5000 mg/g, and an eGFR of 30 to <90 ml/min per 1.73 m2 at screening. This post hoc analysis evaluated participants with eGFR <30 ml/min per 1.73 m2 at randomization.Design, setting, participants, & measurementsEffects of eGFR slope through week 130 were analyzed using a piecewise, linear, mixed-effects model. Efficacy was analyzed in the intention-to-treat population, on the basis of Cox proportional hazard models, and safety was analyzed in the on-treatment population. At randomization (an average of 29 days after screening), 174 of 4401 (4%) participants had an eGFR <30 ml/min per 1.73 m2 (mean [SD] eGFR, 26 [3] ml/min per 1.73 m2).ResultsFrom weeks 3 to 130, there was a 66% difference in the mean rate of eGFR decline with canagliflozin versus placebo (mean slopes, -1.30 versus -3.83 ml/min per 1.73 m2 per year; difference, -2.54 ml/min per 1.73 m2 per year; 95% confidence interval [CI], 0.90 to 4.17). Effects of canagliflozin on kidney, cardiovascular, and mortality outcomes were consistent for those with eGFR <30 and ≥30 ml/min per 1.73 m2 (all P interaction >0.20). The estimate for kidney failure in participants with eGFR <30 ml/min per 1.73 m2 (hazard ratio, 0.67; 95% CI, 0.35 to 1.27) was similar to those with eGFR ≥30 ml/min per 1.73 m2 (hazard ratio, 0.70; 95% CI, 0.54 to 0.91; P interaction=0.80). There was no imbalance in the rate of kidney-related adverse events or AKI associated with canagliflozin between participants with eGFR <30 and ≥30 ml/min per 1.73 m2 (all P interaction >0.12).ConclusionsThis post hoc analysis suggests canagliflozin slowed progression of kidney disease, without increasing AKI, even in participants with eGFR <30 ml/min per 1.73 m2.

Dataset Information

Is There a Nonlinear Relationship between Serum Uric Acid and Lipids in a Hypertensive Population with eGFR ?30?ml/min/1.73?m2? Findings from the China Hypertension Registry Study.

Publications

Is There a Nonlinear Relationship between Serum Uric Acid and Lipids in a Hypertensive Population with eGFR ≥30 ml/min/1.73 m<sup>2</sup>? Findings from the China Hypertension Registry Study.

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