Association of Serum High-Density Lipoprotein Cholesterol with High Blood Pressures at Checkup: Results of Kanagawa Investigation of Total Checkup Data from the National Database-9 (KITCHEN-9)

Nakajima, Kei; Igata, Manami; Higuchi, Ryota; Tanaka, Kotone; Mizusawa, Kaori; Nakamura, Teiji

doi:10.3390/jcm10215118

Cited by 5 publications

(7 citation statements)

References 46 publications

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“…The main analysis is as follows: (1) Males and overweight/obese people generally have higher ALT levels ( 45 , 46 ) and lower HDL-C levels than females and non-obese people ( 47 – 50 ); from a numerical analysis, higher ALT or lower HDL-C means that the ALT/HDL-C ratio will increase; Judging from the results, an elevated ALT/HDL-C ratio corresponded to a heightened risk of diabetes in males and overweight/obese people. (2) From the longitudinal relationship between ALT, HDL-C and age, ALT usually decreases gradually with age ( 51 , 52 ), while HDL-C usually changes less ( 48 , 53 , 54 ); these characteristics will further lead to a reduction in ALT/HDL-C ratio values, thereby reducing the risk of diabetes related to ALT/HDL-C ratio in people over 60 years old. In addition, it should be noted that older people generally have larger HDL particle size, a phenotype that is closely associated with a lower risk of diabetes ( 55 ).…”

Section: Discussionmentioning

confidence: 99%

Alanine aminotransferase to high- density lipoprotein cholesterol ratio is positively correlated with the occurrence of diabetes in the Chinese population: a population-based cohort study

He,

Yu,

Kuang

et al. 2023

Front. Endocrinol.

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ObjectiveBoth alanine aminotransferase (ALT) and high-density lipoprotein cholesterol (HDL-C) are closely related to glucose homeostasis in the body, and the main objective of this study was to investigate the association between ALT to HDL-C ratio (ALT/HDL-C ratio) and the risk of diabetes in a Chinese population.MethodsThe current study included 116,251 participants who underwent a healthy physical examination, and the study endpoint was defined as a diagnosis of new-onset diabetes. Multivariate Cox regression models and receiver operator characteristic curves were used to assess the association of the ALT/HDL-C ratio with diabetes onset.ResultsDuring the average observation period of 3.10 years, a total of 2,674 (2.3%) participants were diagnosed with new-onset diabetes, including 1,883 (1.62%) males and 791 (0.68%) females. After fully adjusting for confounding factors, we found a significant positive association between the ALT/HDL-C ratio and the risk of diabetes [Hazard ratios 1.06, 95% confidence intervals: 1.05, 1.06], and this association was significantly higher in males, obese individuals [body mass index ≥ 28 kg/m2] and individuals aged < 60 years (All P interaction < 0.05). In addition, the ALT/HDL-C ratio was significantly better than its components ALT and HDL-C in predicting diabetes in the Chinese population.ConclusionThere was a positive relationship between ALT/HDL-C ratio and diabetes risk in the Chinese population, and this relationship was significantly stronger in males, obese individuals, and individuals younger than 60 years old.

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Section: Discussionmentioning

confidence: 99%

Alanine aminotransferase to high- density lipoprotein cholesterol ratio is positively correlated with the occurrence of diabetes in the Chinese population: a population-based cohort study

He,

Yu,

Kuang

et al. 2023

Front. Endocrinol.

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“…Dyslipidemia, either an increase in LDL-C or a decrease in HDL-C, also plays an important role in the development of CVD. Meanwhile, the biological interrelation between hypertension and LDL-C [ 13 , 68 ] or HDL-C [ 12 , 69 , 70 ] has been documented. The structural and functional change in LDL-C and HDL-C, inflammation, and oxidative stress may be associated with vascular atherosclerotic processes, and lead to elevation of blood pressure [ 71 ].…”

Section: Discussionmentioning

confidence: 99%

“…The relationships between HDL-C concentration categories and blood pressure are U- or J-shaped [ 69 , 70 , 72 , 73 , 74 ]. In the Kanagawa Investigation of Total Checkup Data from the National Database-9 study, Nakajima et al [ 70 ] found inverted J-shaped relationships between HDL-C and odds ratios for hypertension (≥140/90 mmHg) using the logistic regression analysis method, and both low and extremely high HDL-C concentrations are associated with high blood pressure within both sexes. In the South-West Seoul (SWS) Study, the elderly population with prehypertension combined with low HDL-C showed a twofold higher risk of all-cause mortality (HR: 2.01; 95% CI: 1.11–3.64) [ 69 ].…”

Section: Discussionmentioning

confidence: 99%

Integrating Health Data-Driven Machine Learning Algorithms to Evaluate Risk Factors of Early Stage Hypertension at Different Levels of HDL and LDL Cholesterol

et al. 2022

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Purpose: Cardiovascular disease (CVD) is a major worldwide health burden. As the risk factors of CVD, hypertension, and hyperlipidemia are most mentioned. Early stage hypertension in the population with dyslipidemia is an important public health hazard. This study was the application of data-driven machine learning (ML), demonstrating complex relationships between risk factors and outcomes and promising predictive performance with vast amounts of medical data, aimed to investigate the association between dyslipidemia and the incidence of early stage hypertension in a large cohort with normal blood pressure at baseline. Methods: This study analyzed annual health screening data for 71,108 people from 2005 to 2017, including data for 27 risk-related indicators, sourced from the MJ Group, a major health screening center in Taiwan. We used five machine learning (ML) methods—stochastic gradient boosting (SGB), multivariate adaptive regression splines (MARS), least absolute shrinkage and selection operator regression (Lasso), ridge regression (Ridge), and gradient boosting with categorical features support (CatBoost)—to develop a multi-stage ML algorithm-based prediction scheme and then evaluate important risk factors at the early stage of hypertension, especially for groups with high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels within or out of the reference range. Results: Age, body mass index, waist circumference, waist-to-hip ratio, fasting plasma glucose, and C-reactive protein (CRP) were associated with hypertension. The hemoglobin level was also a positive contributor to blood pressure elevation and it appeared among the top three important risk factors in all LDL-C/HDL-C groups; therefore, these variables may be important in affecting blood pressure in the early stage of hypertension. A residual contribution to blood pressure elevation was found in groups with increased LDL-C. This suggests that LDL-C levels are associated with CPR levels, and that the LDL-C level may be an important factor for predicting the development of hypertension. Conclusion: The five prediction models provided similar classifications of risk factors. The results of this study show that an increase in LDL-C is more important than the start of a drop in HDL-C in health screening of sub-healthy adults. The findings of this study should be of value to health awareness raising about hypertension and further discussion and follow-up research.

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“…In recent years, we have demonstrated the association of extremely high HDL-C, mostly defined as > 100 mg/dL, with diabetes [17], high blood pressure [18], and hypertensive retinopathy [31]. All of these are well-known risk factors for the incidence of kidney disease and proteinuria [1,2,4].…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, we conducted large community-based studies [17,18] showing that very or extremely high HDL-C levels, such as levels over 100 mg/dL or below 50 mg/ dL, may be associated with diabetes and hypertension. These two diseases can impair kidney function over the time and eventually elicit proteinuria, mostly involving albuminuria [1,4].…”

Section: Introductionmentioning

confidence: 99%

U-Shaped Relationship Between Proteinuria and High-Density Lipoprotein Cholesterol: Results of Cross-Sectional and Six Years Cohort Studies (KITCHEN-10)

Igata

Nakajima

2022

J Clin Med Res

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Background: Although a very high level of high-density lipoprotein cholesterol (HDL-C) may be a potential cardiovascular disease risk factor, the detail and underlying mechanism remain unclear. Therefore, we examined the associations of serum HDL-C with the incidence of proteinuria, a predictor for cardiovascular disease, in a community-based study. Methods:We investigated clinical parameters, including serum HDL-C and proteinuria, among 1,191,409 people aged 40 -74 years who underwent a health checkup in a cross-sectional study. In the cohort study, the incidence of proteinuria after 6 years was investigated in 451,987 participants without proteinuria at baseline, who were simultaneously enrolled in the cross-sectional study. Results:The prevalence of proteinuria showed a U-shaped relationship with 10 HDL-C categories, with a minimum of 60 -89 mg/dL in the cross-sectional study. Logistic regression analysis showed similar U-shaped relationships between odds ratios for proteinuria and HDL-C categories, with a minimum of 70 -79 mg/dL. The associations between very high HDL-C (≥ 90 mg/dL) and proteinuria were strengthened after adjustment for body mass index (BMI). In the cohort study, a crude L-shaped relationship was observed between the incidence of proteinuria and baseline HDL-C, which turned into U-shaped relationship after adjustment for baseline BMI and HDL-C after 6 years.Conclusions: Low and very high levels of HDL-C may be associated with the incidence of proteinuria, and BMI may be a potent contributing factor to the underlying mechanism.

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Association of Serum High-Density Lipoprotein Cholesterol with High Blood Pressures at Checkup: Results of Kanagawa Investigation of Total Checkup Data from the National Database-9 (KITCHEN-9)

Cited by 5 publications

References 46 publications

Alanine aminotransferase to high- density lipoprotein cholesterol ratio is positively correlated with the occurrence of diabetes in the Chinese population: a population-based cohort study

Alanine aminotransferase to high- density lipoprotein cholesterol ratio is positively correlated with the occurrence of diabetes in the Chinese population: a population-based cohort study

Integrating Health Data-Driven Machine Learning Algorithms to Evaluate Risk Factors of Early Stage Hypertension at Different Levels of HDL and LDL Cholesterol

U-Shaped Relationship Between Proteinuria and High-Density Lipoprotein Cholesterol: Results of Cross-Sectional and Six Years Cohort Studies (KITCHEN-10)

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