title: Investigation of Metabolic Factors Associated with eGFR Decline Over 1 Year in a Japanese Population without CKD.
abstract: OBJECTIVE
  Early intervention before the progression of chronic kidney disease (CKD) is essential to prevent end-stage renal disease (ESRD) and cardiovascular complications. This study evaluated the correlation between metabolic and lifestyle-related factors and the decline of estimated glomerular filtration rate (eGFR) over 1 year in a Japanese population without CKD.
  
  
  METHODS
  Subjects who received two consecutive annual health checkups from 2013 to 2015 were involved. Factors associated with eGFR decline were identified using multiple regression models.
  
  
  RESULTS
  A total of 2531 subjects aged 58.9±11.7 years old were included in this study. Baseline levels of HDL-C and ApoA1 correlated with the eGFR decline over 1 year defined as eGFR reduction rate of 15% or more and/or eGFR at the next year ＜60 ml/min/m2(odds ratio (OR) 0.87 (per 10 mg/dl); 95% CI, 0.80-0.94; p=0.0012, 0.90 (per 10 mg/dl); 0.86-0.96; p=0.0004, respectively). A U-shaped relationship between the eGFR decline and HDL-C or ApoA1 levels was not observed in non-CKD population of this study. Metabolic syndrome was significantly associated with eGFR decline (OR 1.32; 1.04-1.67; p=0.0205), although obesity-related factors did not show a significant correlation with eGFR decline over 1 year.
  
  
  CONCLUSIONS
  Low HDL-C and ApoA1 levels significantly correlated with eGFR decline in a short period of 1 year. Metabolic syndrome also showed a significant association with eGFR decline. This study suggests the importance of hypertension and low HDL-C in the metabolic syndrome effect on eGFR decline rather than obesity in non-CKD population.
authors.affiliation: Center for Preventive Medicine, Keio University Hospital.|Department of Internal Medicine, School of Medicine, Keio University.
authors.forename: Kaori
authors.initials: K
authors.lastname: Hayashi
authors.affiliation: Center for Preventive Medicine, Keio University Hospital.
authors.forename: Michiyo
authors.initials: M
authors.lastname: Takayama
authors.affiliation: Department of Preventive Medicine and Public Health, Clinical and Translational Research Center, School of Medicine, Keio University.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Abe
authors.affiliation: Department of Internal Medicine, School of Medicine, Keio University.|Health Center, Keio University.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kanda
authors.affiliation: Center for Preventive Medicine, Keio University Hospital.|Department of Internal Medicine, School of Medicine, Keio University.|Health Center, Keio University.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hirose
authors.affiliation: Center for Preventive Medicine, Keio University Hospital.
authors.forename: Ryoko
authors.initials: R
authors.lastname: Shimizu-Hirota
authors.affiliation: Center for Preventive Medicine, Keio University Hospital.
authors.forename: Eisuke
authors.initials: E
authors.lastname: Shiomi
authors.affiliation: Center for Preventive Medicine, Keio University Hospital.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Iwao
authors.affiliation: Department of Internal Medicine, School of Medicine, Keio University.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Itoh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016632:Apolipoprotein A-I / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult
chemical_list: C505693:APOA1 protein, human; D016632:Apolipoprotein A-I; D015415:Biomarkers; D008076:Cholesterol, HDL
keywords: ApoA1; HDL-C; Metabolic syndrome; eGFR decline