Impact of the triglycerides to high-density lipoprotein cholesterol ratio on the incidence and progression of CKD: A longitudinal study in a large Japanese population

Background The impact of the triglycerides to high-density lipoprotein cholesterol (TG:HDL-C) ratio on chronic kidney disease (CKD) is unclear. Study Design Longitudinal cohort study. Setting & Participants 124,700 participants aged 39 to 74 years in the Japanese Specific Health Check and Guidance System, including 50,392 men, 74,308 women, 102,900 without CKD, and 21,800 with CKD. Predictor Quartiles of TG:HDL-C ratio. Outcomes & Measurements Changes in estimated glomerular filtration rate (eGFR) and urinary protein excretion during the 2-year study period. Incident CKD in participants without CKD, and progression of CKD in participants with CKD. Results In the entire study population, higher quartile of TG:HDL-C ratio at baseline was significantly associated with greater decline in eGFR and increase in urinary protein excretion during the 2-year study period, even after adjustment for confounding factors. A higher ratio was associated with higher risk of incident CKD in participants without CKD and higher risk of rapid decline in eGFR and increase in urinary protein excretion in participants with CKD. Higher TG:HDL-C ratio was more strongly associated with decline in eGFR (P for interaction = 0.002) and with incident CKD (P for interaction = 0.05) in participants with diabetes than without diabetes. Limitations Short observation period and single measurement of all variables. Conclusions A higher TG:HDL-C ratio affects the decline in eGFR and incidence and progression of CKD in the Japanese population.