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Abstract: TH-PO864

Metabolic Biomarkers and Risk of CKD: A Prospective Cohort Study

Session Information

Category: CKD (Non-Dialysis)

  • 2201 CKD (Non-Dialysis): Epidemiology‚ Risk Factors‚ and Prevention

Authors

  • Geng, Tingting, Huazhong University of Science and Technology Tongji Medical College, Wuhan, Hubei, China
  • Chen, Junxiang, Huazhong University of Science and Technology Tongji Medical College, Wuhan, Hubei, China
  • Zhou, Yan-Feng, Huazhong University of Science and Technology Tongji Medical College, Wuhan, Hubei, China
  • Liu, Gang, Huazhong University of Science and Technology Tongji Medical College, Wuhan, Hubei, China
  • Pan, An, Huazhong University of Science and Technology Tongji Medical College, Wuhan, Hubei, China
Background

The prospective associations between nuclear magnetic resonance (NMR)-based metabolic biomarkers and chronic kidney disease (CKD) have not been scrutinized, which is crucial for understanding the etiological pathways and paving the way toward novel prevention and treatment strategies of CKD. We aimed to examine the associations of NMR-based metabolic biomarkers with risk of CKD using data from the UK Biobank study.

Methods

A total of 91,534 participants (mean age 55.3 years, 42.8% men) without CKD and lipid-lowering therapy were followed for a median of 11.5 years. NMR spectroscopy was used to quantify 249 metabolic biomarkers, including routine lipids, lipid concentrations and composition within 14 lipoprotein subclasses, as well as other metabolites. Multivariable-adjusted Cox regression models were used to compute the hazard ratios. We also estimated the predictive performance for the 10-year CKD risk using the selected metabolites by the least absolute shrinkage and selection operator (LASSO) regression.

Results

A total of 1846 incident CKD were identified. In general, very-low-density lipoprotein (VLDL) particles were associated with a higher risk of CKD whereas high-density lipoprotein (HDL) particles were associated with a lower risk of CKD. Similar patterns of cholesterol, lipids, and phospholipids in VLDL and HDL with risk of CKD were observed. Triglycerides within all lipoproteins, including all HDL particles were associated with a higher risk of CKD. However, we did not observe significant associations of LDL particles or lipids measures, except for triglycerides and free cholesterol in LDL, with risk of CKD. Adding metabolic biomarkers selected by LASSO, including histidine, isoleucine, albumin, glucose, omega-3 fatty acids to total fatty acids percentage, docosahexaenoic acid to total fatty acids percentage, glycoprotein acetyls, phospholipids to total lipids in very small VLDL percentage, and triglycerides to total lipids in large LDL percentage to the clinical variable-based model improved discrimination (C-statistic from 0.820 to 0.831, P<0.001) for prediction of 10-year CKD incidence.

Conclusion

Circulating lipids, lipoprotein and metabolites were associated with risk of CKD, suggesting that these metabolites may be involved in the pathogenesis of CKD. Selected NMR-based biomarkers could enhance the prediction of CKD.

Funding

  • Government Support – Non-U.S.