Journal of Atherosclerosis and Thrombosis
Online ISSN : 1880-3873
Print ISSN : 1340-3478
ISSN-L : 1340-3478
Original Article
Serum Non-High-Density Lipoprotein Cholesterol and Risk of Cardiovascular Disease in Community Dwellers with Chronic Kidney Disease: the Hisayama Study
Tomoko UsuiMasaharu NagataJun HataNaoko MukaiYoichiro HirakawaDaigo YoshidaHiro KishimotoTakanari KitazonoYutaka KiyoharaToshiharu Ninomiya
Author information

2017 Volume 24 Issue 7 Pages 706-715


Aim: It is not clear whether elevated serum non-high-density lipoprotein cholesterol (non-HDL-C) levels are a risk factor for cardiovascular disease (CVD) in subjects with chronic kidney disease (CKD) in the general population.

Methods: A total of 2,630 community-dwelling Japanese subjects (1,107 men and 1,523 women) without history of CVD and aged ≥40 years were prospectively followed up for an average of 19 years, and the association between serum non-HDL-C levels and the incidence of type-specific CVD was estimated using a Cox proportional hazards model. CKD was defined as estimated glomerular filtration rate <60 mL/min/1.73 m2 or proteinuria (≥1+ on dipstick).

Results: At baseline, 357 subjects had CKD. During the follow up, 186 coronary heart disease (CHD) and 277 stroke events occurred. The age- and sex-adjusted incidence of CHD was significantly higher in subjects with higher non-HDL-C levels, both in those with and without CKD. In the CKD group, the risk of CHD was significantly higher in those with non-HDL-C levels of 150– 189 mg/dL [adjusted hazard ratio (HR), 2.23; 95% confidence interval (CI), 1.04–4.77] and those with levels ≥190 mg/dL (adjusted HR, 3.20; 95% CI, 1.46–7.03) than in those with levels <150 mg/dL. In the non-CKD group, the risk of CHD was significantly higher only in those with nonHDL-C levels ≥190 mg/dL (adjusted HR, 2.12; 95% CI, 1.33–3.38). However, no such association was observed for the risk of stroke.

Conclusions: Our findings suggest that higher serum non-HDL-C levels are associated with greater risk of CHD in subjects with and without CKD and that this association is greater in subjects with CKD than in those without CKD.

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