Association of hypertriglyceridemic waist phenotype with renal function impairment: a cross-sectional study in a population of Chinese adults

Abstract

Background: Hypertriglyceridemic waist (HTGW) phenotype has been suggested as a risk factor for chronic kidney disease (CKD). However, there is limited evidence on the relationship of triglyceride waist phenotypes with estimated glomerular filtration rate (eGFR) status and severity. Our aim was to explore the associations of triglyceride waist phenotypes with reduced eGFR and various decreased eGFR stages among Chinese adults. Methods: A population-based, cross-sectional study was conducted among Chinese participants aged 20-74 years from June 2016 to December 2017 in Shanghai, China. An eGFR value below 60 mL/min/1.73 m 2 was defined as decreased eGFR. HTGW phenotype was defined as triglyceride (TG) ≥1.7 mmol/L and a waist circumference (WC) of ≥90 cm for men and ≥ 80 cm for women. We examined the association of triglyceride waist phenotypes with decreased eGFR risk using the weighted logistic regression models. Results: A total of 31,296 adults were included in this study. Compared with normal TG level/normal WC (NTNW) phenotype, normal TG level/enlarged WC (NTGW) and elevated TG level/enlarged WC (HTGW) phenotypes were associated with the increased risk of decreased eGFR. Multivariable-adjusted ORs (95% CI) associated with NTGW, elevated TG level/normal WC (HTNW), and HTGW phenotypes were 1.75 (1.41-2.18), 1.29 (0.99-1.68), and 1.99 (1.54-2.58), respectively. These associations between triglyceride waist phenotypes and decreased eGFR risk remained across almost all the subgroups, including sex, age, BMI, T2DM, and hypertension. HTGW phenotype was consistently positively associated with the risk of mildly and moderately decreased eGFR, but not with severely decreased eGFR risk. Conclusions: HTGW was consistently associated with the increased risk of decreased eGFR and various decreased eGFR stages, except for severely decreased eGFR. Further prospective studies are warranted to confirm our findings and to investigate the underlying biological mechanisms.

The association between hypertriglyceridemic-waist phenotype and chronic kidney disease: a cohort study and meta-analysis

“…The current finding on the increased risk of CKD among HTGW individuals were consistent with several previous studies 15 , 16 , 18 , 20 , 21 , 23 . For example, a cross-sectional study conducted in China showed that participants with HTGW phenotype were more likely to have CKD (OR 2.09, 95% CI 1.26 to 3.45) 15 .…”

“…In terms of the associations between NTGW and HTNW groups with CKD risk, only the NTGW phenotype showed a significantly elevated CKD risk compared to participants with NTNW in our present study. The results were similar to a cross-sectional study of 31,296 adults aged 20–74 years in China 16 . Nevertheless, inconsistent findings were also observed 17 , 19 .…”

“…In contrast, another prospective analysis found that HTGW was not significantly associated with CKD, regardless of the sex 19 . A cross-sectional study further demonstrated that HTGW was linked to mildly and moderately reduced eGFR (eGFR between 30 and 89 mL/min/1.73 m 2 ), but not severely reduced eGFR (eGFR between 15 and 29 mL/min/1.73 m 2 ) 16 .…”

The hypertriglyceridemic waist phenotype is associated with fatty liver and glycometabolic profiles in overweight and obese adults: a cross-sectional study

“…The concept of the hypertriglyceridemic waist phenotype was first proposed by Lemieux et al based on the evidence that high TG or WC alone were inadequate to identify the metabolic triad 9 . This phenotype has been widely accepted in risk assessment or prediction of high visceral fat 25 , diabetes 26 , hypertension 27 , metabolic syndrome 28 , atherosclerosis 29 , cardiovascular diseases 30 , and renal dysfunction 31 . All these results support that the hypertriglyceridemic waist phenotype is a cost-effective screening tool that can be used in clinical practice and is an efficient and effective phenotype that can be used for health management.…”

Early-Life Exposure to Famine and Risk of Metabolic Associated Fatty Liver Disease in Chinese Adults

“…In each committee or village, residents aged 20-74 years were invited into the cohort. The study design and sampling methods have been described in detail elsewhere [17,18].…”