Remnant cholesterol, preinflammatory state and chronic kidney disease: association and mediation analyses

Figures & data

Table 1. Baseline information according to quartiles of RC.

RC	All n = 7,696	Q1 (<0.20) n = 1,899	Q2 (0.20-0.36) n = 1,929	Q3 (0.37-0.65) n = 1,955	Q4 (>0.65) n = 1,913	p value for trend
Age, years	51 ± 15	49 ± 15	50 ± 16	51 ± 15	51 ± 14	<0.001
Male sex	3682 (47.84%)	836 (44.02%)	867 (44.95%)	937 (47.93%)	1042 (54.47%)	<0.001
BMI, kg/m^2	23.49 ± 3.51	22.45 ± 3.15	22.85 ± 3.32	23.70 ± 3.51	24.94 ± 3.50	<0.001
Residence						0.002
Urban	2556 (33.21%)	606 (31.91%)	595 (30.84%)	673 (34.42%)	682 (35.65%)
Rural	5140 (66.79%)	1293 (68.09%)	1334 (69.16%)	1282 (65.58%)	1231 (64.35%)
High school and above	1835 (23.84%)	400 (21.06%)	453 (23.48%)	483 (24.71%)	499 (26.08%)	<0.001
Currently smoking	2418 (31.42%)	538 (28.33%)	567 (29.39%)	620 (31.71%)	693 (36.22%)	<0.001
Alcohol consumption	2150 (27.94%)	516 (27.17%)	481 (24.94%)	530 (27.11%)	623 (32.57%)	<0.001
Hypertension	1033 (13.42%)	166 (8.74%)	209 (10.83%)	294 (15.04%)	364 (19.03%)	<0.001
Diabetes	812 (10.55%)	89 (4.69%)	135 (7.00%)	206 (10.54%)	382 (20.00%)	<0.001
Uric acid, μmol/L	313.04 ± 107.54	272.26 ± 78.59	288.99 ± 83.90	310.48 ± 84.62	380.38 ± 138.64	<0.001
BUN, mmol/L	5.46 ± 1.57	5.50 ± 1.59	5.35 ± 1.64	5.33 ± 1.55	5.65 ± 1.50	0.005
eGFR, ml/min^-1/m^-2	79.13 ± 16.96	80.79 ± 16.51	79.45 ± 17.33	78.09 ± 17.23	78.22 ± 16.62	0.002
Fasting blood glucose, mmol/L	5.43 ± 1.51	5.09 ± 0.96	5.24 ± 1.17	5.39 ± 1.41	6.02 ± 2.09	<0.001
HbA1c, %	5.63 ± 0.90	5.49 ± 0.70	5.54 ± 0.77	5.65 ± 0.94	5.83 ± 1.09	<0.001
HDL-C, mmol/L	1.39 ± 0.36	1.59 ± 0.35	1.47 ± 0.34	1.35 ± 0.31	1.15 ± 0.29	<0.001
LDL-C, mmol/L	2.93 ± 0.93	2.97 ± 0.87	2.97 ± 0.91	3.01 ± 0.93	2.76 ± 1.00	<0.001
TG, mmol/L	1.76 ± 1.52	0.88 ± 0.39	1.15 ± 0.56	1.61 ± 0.73	3.42 ± 2.09	<0.001
TC, mmol/L	4.86 ± 1.01	4.67 ± 0.93	4.72 ± 0.96	4.85 ± 0.99	5.20 ± 1.05	<0.001
RC, mmol/L	0.37 (0.20-0.65)	0.11 (0.06-0.16)	0.27 (0.23-0.32)	0.48 (0.42-0.56)	1.01 (0.80-1.43)	<0.001
ApoA, mmol/L	1.14 ± 0.38	1.20 ± 0.39	1.15 ± 0.37	1.13 ± 0.38	1.09 ± 0.38	<0.001
ApoB, mmol/L	0.91 ± 0.27	0.84 ± 0.24	0.87 ± 0.26	0.93 ± 0.27	1.00 ± 0.28	<0.001
Hemoglobin, g/L	141.52 ± 20.39	138.76 ± 20.42	139.55 ± 19.76	141.83 ± 20.64	145.92 ± 19.99	<0.001
WBCs,10^9/L	6.35 ± 2.00	5.98 ± 1.78	6.22 ± 1.94	6.46 ± 1.97	6.74 ± 2.20	<0.001
hs-CRP, mg/L	1.00 (1.00-3.00)	1.00 (0.00-2.00)	1.00 (0.00-2.00)	1.00 (1.00-3.00)	2.00 (1.00-3.00)	<0.001

The mean ± SD, median (Q1-Q3), or n (%) was calculated after filling in missing data.

BMI: body mass index; BUN: blood urea nitrogen; eGFR: estimated glomerular filtrate rate; HbA1c: hemoglobin A1c; HDL-C: high-density lipoprotein cholesterol; LDL-C: low-density lipoprotein cholesterol; TGs: triglycerides; TC: total cholesterol; RC: remnant cholesterol; Apo-A: apolipoprotein A; Apo-B: apolipoprotein B; WBCs: white blood cells; hs-CRP: high-sensitivity C-reactive protein.

Figure 1. Associations of RC with hs-CRP (a) and WBCs (b). Models adjusted for age and sex. Red curves are GAM functions with 95% confidence intervals in dotted line. Data outside 1% of the population was not included because the wide confidence intervals.

RC: remnant cholesterol; WBCs: white blood cells; hs-CRP: high-sensitivity C-reactive protein

Table 2. ORs (95% CIs) For CKD in different quartiles of RC.

	RC				Each 1 quartile increase in RC	P for trend
	Q1 (<0.20)	Q2 (0.20-0.36)	Q3 (0.37-0.65)	Q4 (>0.65)
Median RC	0.11	0.27	0.48	1.01	-	-
Model 1	Ref.	1.34 (1.10–1.65)	1.46 (1.19–1.78)	1.37 (1.12–1.68)	1.10 (1.03–1.17)	0.002
Model 2	Ref.	1.32 (1.06–1.66)	1.45 (1.16–1.81)	1.54 (1.22–1.94)	1.14 (1.06–1.23)	<0.001
Model 3	Ref.	1.32 (1.05–1.66)	1.44 (1.15–1.80)	1.53 (1.21–1.93)	1.14 (1.06–1.23)	<0.001
Model 4	Ref.	1.30 (1.04–1.64)	1.37 (1.09–1.72)	1.40 (1.10–1.78)	1.11 (1.03–1.19)	0.006

Data are shown as the OR (95% CI), which was evaluated using logistic regression models.

Model 1: unadjusted;.

Model 2: adjusted for age, sex and BMI;.

Model 3: further adjusted for education, residence, smoking, and alcohol consumption;.

Model 4: further adjusted for hypertension and diabetes.

RC: remnant cholesterol; Q: quantile.

Figure 2. Combined effects of remnant cholesterol, hs-CRP and WBCs on CKD. a. Combined effects of RC and hs-CRP; b. Combined effects of RC and WBCs; c. Odds ratios of the combined effects. Model adjusted for age, sex and BMI, education, residence, smoking, and alcohol consumption, hypertension and diabetes.

RC: remnant cholesterol; CKD: chronic kidney disease; WBCs: white blood cells; hs-CRP: high-sensitivity C-reactive protein

Figure 3. Mediation analysis of the preinflammatory state on the association between RC and CKD. a. unadjusted; b. adjusted for age, sex, BMI, education, residence, smoking, alcohol consumption, hypertension and diabetes.

RC: remnant cholesterol; CKD: chronic kidney disease; hs-CRP: high-sensitivity C-reactive protein; WBCs: white blood cells

Data availability statement

The data in this study are available at: https://www.cpc.unc.edu/projects/china.