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Abstract: PO1827

Association Between Kidney Function and Lipid Levels in Older Adults

Session Information

Category: Hypertension and CVD

  • 1403 Hypertension and CVD: Mechanisms

Authors

  • Srivastava, Shreya, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Coresh, Josef, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Rebholz, Casey, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Grams, Morgan, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Matsushita, Kunihiro, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Martin, Seth Shay, Johns Hopkins Medicine, Baltimore, Maryland, United States
  • Shin, Jung-Im, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States
Background

The associations between kidney function and lipid levels in older adults have not been well characterized. Moreover, it is unknown whether residual atherosclerotic cardiovascular disease (ASCVD) risk after statin use differs by lipid levels other than total cholesterol (TC) or low-density lipoprotein cholesterol (LDL-C), such as triglyceride (TG).

Methods

We conducted a cross-sectional study of older adults (≥65 years) using visit 5 data (2011-2013) of the Atherosclerosis Risk in Communities study. Multivariable linear and logistic regression was used to examine the eGFR-lipid level associations, stratified by statin use. Among statin users without ASCVD who had LDL-C levels <100 mg/dl, we predicted 10-year ASCVD risk after statin use by TG levels (<150 mg/dl vs. ≥150 mg/dl) across eGFR groups.

Results

The mean age of the study population (n=4965) was 75 (SD 5) years, 58% were female, and 22% were Black. The mean eGFR was 63 (SD 18) ml/min/1.73 m2 and 52% were on a statin. In both statin users and non-users, there were no associations between eGFR and total TC or LDL-C. Low eGFR was associated with low high-density lipoprotein cholesterol (HDL-C) and high TG (Figure). Among statin non-users, eGFR <45 (vs. ≥60) was independently associated with low HDL-C (<50 mg/dl) (prevalence=59% vs. 34%, odds ratio=1.86; 95% CI, 1.38-2.51) and high TG (≥150 mg/dl) (31% vs. 20%, 1.54; 1.13-2.09). The results were similar among statin users. Among statins users with LDL-C <100 mg/dl, the prevalence of high predicted ASCVD risk (risk ≥20%) was greater among those with vs. without high TG across all eGFR categories (eGFR ≥60, 66% vs. 59%; 45-59, 78% vs. 73%; eGFR <45, 90% vs. 79%).

Conclusion

We found that low eGFR was associated with low HDL-C and high TG levels, regardless of statin use. Among statin users who achieved adequate LDL-C control, ASCVD risk was still higher among those with high TG compared to those without high TG.

Adjusted associations between eGFR and lipid levels in older adults

Funding

  • NIDDK Support