Diabetic kidney damage linked to ratio of non-HDL-C to HDL-C: Study

A new study published in the PLOS ONE journal found that diabetic kidney disease (DKD) is linked to the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (HDL-C). Diabetes is a common endocrine condition marked by high blood glucose levels. It is mostly caused by beta-cell failure in the pancreas and the ensuing lack of insulin. Diabetic kidney disease, a serious consequence that affects 30% to 40% of people with diabetes, has increased in tandem with the growth in the prevalence of diabetes.

DKD presents a serious global threat to public health as it is linked to increased mortality and is a major cause of end-stage renal disease (ESRD). The urine albumin to creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) are now the main indicators for diagnosing DKD in renal structure and function. Because it lowers oxidative stress and promotes anti-apoptotic effects, high-density lipoprotein cholesterol (HDL-C) is well known for its preventive function in cardiovascular diseases (CVD).

This study makes the assumption that lipid metabolism abnormalities affect the progression of DKD, which leads to a link between Non-High-Density Lipoprotein Cholesterol to High-Density Lipoprotein Cholesterol Ratio (NHHR) and DKD. This study attempts to offer a fresh viewpoint for the sophisticated identification and diagnosis of DKD using NHANES data from 1999 to 2020.

The strict inclusion and exclusion criteria were used to choose the participants. To look into the connection between NHHR and DKD, this research utilized smooth curve fitting, multivariate logistic regression, and single-factor analysis. A total of 8,329 diabetic participants were enrolled in this study who were divided into groups with and without renal impairment.

There was a notable variation in NHHR across these groups. The study discovered a favorable correlation between NHHR and the prevalence of DKD after controlling for possible variables. In particular, the prevalence of DKD increased by 6% with every unit increase in NHHR, and this relationship held true for all stratified NHHR levels.

According to threshold effect analysis, there was an inflection point at an NHHR of 1.75. Where the prevalence of DKD increased by 7% for every unit rise in NHHR, beyond this. Subgroup analysis validated that these results were robust. Overall, the results show that the prevalence of DKD and NHHR are positively correlated. To clarify the causal association and offer further proof for the early diagnosis and prediction of DKD, future randomized controlled studies are crucial.

Reference:

Zhang, L., Fan, D., Zhu, T., Geng, L., Gan, L., Ou, S., & Yin, D. (2024). The ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol is associated with diabetic kidney disease: A cross-sectional study. In M. Khorasani (Ed.), PLOS ONE (Vol. 19, Issue 11, p. e0311620). Public Library of Science (PLoS). https://doi.org/10.1371/journal.pone.0311620