title: Serum Non-High-Density Lipoprotein Cholesterol and Risk of Cardiovascular Disease in Community Dwellers with Chronic Kidney Disease: the Hisayama Study.
abstract: OBJECTIVE
  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 m2or 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.
authors.affiliation: Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.|Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Usui
authors.affiliation: Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.|Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Nagata
authors.affiliation: Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.|Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University.|Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University.
authors.forename: Jun
authors.initials: J
authors.lastname: Hata
authors.affiliation: Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.|Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University.|Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University.
authors.forename: Naoko
authors.initials: N
authors.lastname: Mukai
authors.affiliation: Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.|Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University.
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Hirakawa
authors.affiliation: Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.|Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University.
authors.forename: Daigo
authors.initials: D
authors.lastname: Yoshida
authors.affiliation: Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.
authors.forename: Hiro
authors.initials: H
authors.lastname: Kishimoto
authors.affiliation: Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University.|Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University.
authors.forename: Takanari
authors.initials: T
authors.lastname: Kitazono
authors.affiliation: Hisayama Research Institute for Lifestyle Diseases.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kiyohara
authors.affiliation: Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University.|Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University.
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Ninomiya
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D008078:Cholesterol, LDL / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D014280:Triglycerides / Q000097:blood*
chemical_list: D015415:Biomarkers; D008078:Cholesterol, LDL; D014280:Triglycerides
keywords: Cardiovascular disease; Chronic kidney disease; Cohort study; Non-high-density lipoprotein cholesterol; Risk factors