Estimate of reduced glomerular filtration rate by triglyceride-glucose index: insights from a general Chinese population

Abstract Background We aimed to investigate the accuracy of different equations in evaluating estimated glomerular filtration rate (eGFR) in a Chinese population with different BMI levels. Methods A total of 837 Chinese patients were enrolled, and the eGFRs were calculated by three Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, three full-age spectrum (FAS) equations and two Modification of Diet in Renal Disease (MDRD) equations. Results of measured GFR (mGFR) by the 99Tcm-diathylenetriamine pentaacetic acid (99Tcm-DTPA) renal dynamic imaging method were the reference standards. According to BMI distribution, the patients were divided into three intervals: below 25th(BMIP25), 25th to 75th(BMIP25–75) and over 75th percentiles (BMIP75). Results The medium BMI of the three BMI intervals were 20.9, 24.8 and 28.9 kg/m2, respectively. All deviations from mGFR (eGFR) were correlated with BMI (p < 0.05). The percentage of cases in which eGFR was within mGFR ±30% (P30) was used to represent the accuracy of each equation. Overall, eGFRFAS_Cr_CysC and eGFREPI_Cr_2009 performed similarly, showing the best agreement with mGFR among the eight equations in Bland-Altman analysis (biases: 4.1 and − 4.2 mL/min/1.73m2, respectively). In BMIP25 interval, eGFRFAS_Cr got − 0.7 of the biases with 74.2% of P30, the kappa value was 0.422 in classification of CKD stages and the AUC60 was 0.928 in predicting renal insufficiency, and eGFREPI_Cr_2009 got 2.3 of the biases with 71.8% of P30, the kappa value was 0.418 in classification of CKD stages and the AUC60 was 0.920 in predicting renal insufficiency. In BMIP25–75 interval, the bias of eGFRFAS_Cr_CysC was 4.0 with 85.0% of P30, the kappa value was 0.501 and the AUC60 was 0.941, and eGFRFAS_Cr_CysC showed balanced recognition ability of each stage of CKD (62.3, 63.7, 68.0, 71.4 and 83.3% respectively). In BMIP75 interval, the bias of eGFREPI_Cr_CysC_2012 was 3.8 with 78.9% of P30, the kappa value was 0.484 the AUC60 was 0.919, and eGFREPI_Cr_CysC_2012 equation showed balanced and accurate recognition ability of each stage (60.5, 60.0, 71.4, 57.1 and 100% respectively). In BMIP75 interval, the bias of eGFRFAS_Cr_CysC was − 1.8 with 78.5% of P30, the kappa value was 0.485, the AUC60 was 0.922. However, the recognition ability of each stage of eGFRFAS_Cr_CysC eq. (71.1, 61.2, 70.0, 42.9 and 50.0% respectively) was not as good as GFREPI_Cr_CysC_2012 equation. Conclusion For a Chinese population, we tend to recommend choosing eGFRFAS_Cr and eGFREPI_Cr_2009 when BMI was around 20.9, eGFRFAS_Cr_CysC when BMI was near 24.8, and eGFREPI_Cr_CysC_2012 when BMI was about 28.9.

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Associations of Serum Lipids and Lipoproteins with the Estimated Glomerular Filtration Rate in the Adult Chinese Population: A Cross-sectional Study

10.21203/rs.3.rs-24670/v1 ◽

2020 ◽

Author(s):

Xiaomu Kong ◽

Zhaojun Yang ◽

Bo Zhang ◽

Liping Yu ◽

Haiqing Zhu ◽

...

Keyword(s):

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Chinese Population ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

Adult Population ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Effective Control ◽

Lipids And Lipoproteins

Abstract Background: Dyslipidemia has a critical impact on renal dysfunction, but the exact types of lipids and lipoproteins that influence the estimated glomerular filtration rate (eGFR) are under investigation. Observations from an adult Chinese population ≥20 years old are lacking. The present study is to investigate the associations of total cholesterol (TC), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C), and low-density lipoprotein-cholesterol (LDL-C) with eGFR, and the risks for a mildly and a moderately/severely reduced eGFR. Methods: A total of 16,206 participants from a national representative adult population (20 years of age or older) in China were included. All calculations were weighted based on the Chinese population data and the sampling scheme. Results: Upon stratifying the population based on lipids or lipoprotein categories, we observed a significantly lower mean eGFR as well as a higher estimated prevalence of impaired eGFR among Chinese adults with TG levels in the ranges of 1.7 mmol/L≤ TG <2.3 mmol/L [mean eGFR: 110.99 mL/min per 1.73 m 2 , P =0.0000; prevalence of mildly eGFR impairment: 30.92%, P =0.0000; prevalence of moderately/severely eGFR impairment: 2.01%, P =0.1842] and ≥2.3 mmol/L [111.62 mL/min per 1.73 m 2 , P =0.0000; 27.92%, P =0.0000; 2.81%, P =0.0174], compared to those among individuals with normal TG [122.03 mL/min per 1.73 m 2 ; 19.96%; 1.20%]. Also, a higher prevalence of mildly impaired eGFR was observed with 3.4 mmol/L≤ LDL-C <4.1 mmol/L (27.93%) compared with LDL-C <3.4 mmol/L (22.61%, P =0.0092). An elevated TG was proven to be an independent risk factor for decreased eGFR [β(SE) -0.0238(0.0039), P =0.0000], and each per mmol/L increase in TG was associated with the 1.19-fold and 1.31-fold increased risks for mildly impaired eGFR and moderately/severely impaired eGFR, respectively ( P =0.0000, 0.0001). A decreased HDL-C also showed a negative contribution to eGFR [-0.0883(0.0176), P =0.0000]. In contrast, increased TC was associated with increased eGFR [0.0314(0.0060), P =0.0000] and a reduction in the risk for mildly impaired eGFR by 0.91-fold ( P =0.0302). Increased LDL-C also contributed to an elevated eGFR [0.0251(0.0070), P =0.0004]. Conclusion: A decreased eGFR could be attributed independently to an elevated TG or reduced HDL-C. It emphasizes the importance of effective control of TG and HDL-C for preserving eGFR.

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Combined Effects of Dyslipidemia and High Adiposity on the Estimated Glomerular Filtration Rate in a Middle-Aged Chinese Population

Diabetes Metabolic Syndrome and Obesity Targets and Therapy ◽

10.2147/dmso.s337190 ◽

2021 ◽

Vol Volume 14 ◽

pp. 4513-4522

Author(s):

Xichang Wang ◽

Haoyu Wang ◽

Jiashu Li ◽

Xiaotong Gao ◽

Yutong Han ◽

...

Keyword(s):

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Chinese Population ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

Combined Effects ◽

Middle Aged

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Cardiovascular metabolic risk factors and glomerular filtration rate: a rural Chinese population study

Lipids in Health and Disease ◽

10.1186/s12944-016-0346-9 ◽

2016 ◽

Vol 15 (1) ◽

Cited By ~ 4

Author(s):

Wei Zheng ◽

Geng Qian ◽

Wenjun Hao ◽

Xiaodong Geng ◽

Quan Hong ◽

...

Keyword(s):

Risk Factors ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Population Study ◽

Chinese Population ◽

Filtration Rate ◽

Metabolic Risk Factors ◽

Metabolic Risk

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Usefulness of estimated pulse wave velocity for identifying prevalent coronary heart disease: findings from a general Chinese population

BMC Cardiovascular Disorders ◽

10.1186/s12872-022-02456-5 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Xiao-Wu He ◽

Jieun Park ◽

Wen-Sheng Huang ◽

Li-Hua Leng ◽

Yan Yu ◽

...

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Coronary Heart Disease ◽

Glomerular Filtration Rate ◽

Chinese Population ◽

Aortic Stiffness ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

Pulse Wave ◽

General Chinese Population

Abstract Background Aortic stiffness and coronary heart disease (CHD) share a similar spectrum of risk factors; previous studies have identified the association between aortic stiffness and CHD. Recent studies have demonstrated estimated pulse wave velocity (ePWV) as a simple and easy-acquired indicator of aortic stiffness. Our work aims to evaluate the association between ePWV and the prevalence of CHD and assess the value of ePWV for the identification of prevalent CHD. Methods The current cross-sectional work included 7012 subjects from rural areas of southeastern China between September 2020 and February 2021. ePWV was calculated from age and mean blood pressure by specific algorithm. Results The prevalence of CHD in our population was 3.58% (251 patients among 7012 subjects). After adjusting for age, sex, education, income and exercise level, current smoking and drinking status, body mass index, waist circumference, fasting plasma glucose, total cholesterol, high density lipoprotein, estimated glomerular filtration rate and cerebrovascular diseases, each standard deviation increment of ePWV would produce an additional 37.8% risk of prevalent CHD. Moreover, after dividing ePWV into quartiles, the 4th quartile of ePWV showed a significant risk of prevalent CHD (OR (95% CI): 3.567 (1.963–6.479)) when compared with the 1st quartile. Additionally, the subgroup analysis showed the association between ePWV and prevalent CHD was robust to several common risk factors of CHD, including age, sex, body mass index, hypertension, diabetes and reduced estimated glomerular filtration rate. Finally, the area under curve (AUC) displayed an improvement when adding ePWV into common CHD risk factors (0.705 vs. 0.718. P = 0.044). Consistently, net reclassification index (0.436, 95% CI: 0.301–0.571, P < 0.001) and integrated discrimination index (0.004, 95% CI: 0.001–0.006, P = 0.002) demonstrated the value of ePWV to optimize the identification of prevalent CHD in the general population. Conclusion The present analysis implicates the robust association between ePWV, a simple, rapid, and practical marker of aortic stiffness, and prevalent CHD in the general Chinese population. More importantly, the results suggest the value of ePWV as a potential marker to improve the identification of prevalent CHD.

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Association between estimated glomerular filtration rate, ankle-brachial index, and recurrent ischemic stroke in a Chinese population of ischemic stroke patients

VASA ◽

10.1024/0301-1526/a000266 ◽

2013 ◽

Vol 42 (3) ◽

pp. 177-183 ◽

Cited By ~ 2

Author(s):

Yong L. Wang ◽

Heng Ma ◽

Jun Yang ◽

Jue Li ◽

Xiaochen Hao ◽

...

Keyword(s):

Ischemic Stroke ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Chinese Population ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

Ankle Brachial Index ◽

Stroke Patients ◽

Study Results

Background: Very few studies have examined combined association of estimated glomerular filtration rate (eGFR) and ankle-brachial index (ABI) on recurrent ischemic stroke in patients with ischemic stroke in Chinese populations. Patients and methods: A Chinese population of 1219 ischemic stroke patients was followed up in this six-year prospective study. Results: 1080 ischemic stroke patients with complete follow-up data were included in the statistical analysis. A total of 245 ischemic stroke patients (22.7 %) had recurrent ischemic stroke during follow-up. The Incidence of recurrent ischemic stroke was significantly increased with decreasing eGFR levels and that of patients with eGFR < 30 ml/min/1.73m2 was the highest. Hazard ratio (HR) of eGFR < 30 ml/min/1.73m2 to recurrent ischemic stroke was 2.633 (95 % CI: 1.653 - 4.194) compared with that of eGFR ≥ 60 ml/min/1.73m2 after adjusting for other potential confounders using Cox regression analysis. Incidence of recurrent ischemic stroke was significantly increased with simultaneously decreasing eGFR and ABI. The highest percentage (71.4 %) of patients with eGFR < 30 ml/min/1.73m2 and ABI ≤ 0.4 simultaneously had recurrent ischemic stroke during follow-up. HR of eGFR < 30 ml/min/1.73m2 and ABI ≤ 0.4 simultaneously with recurrent ischemic stroke was 9.415 (95 % CI: 3.479 - 25.483) compared with that of eGFR ≥ 60 ml/min/1.73m2 and ABI > 1.0 to ≤ 1.4 respectively Conclusions: Low ABI and low eGFR together had synergistic effects on increasing recurrent ischemic stroke of ischemic stroke patients during a long-term follow-up.

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