ORIGINAL RESEARCH article
Front. Med.
Sec. Nephrology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1629303
This article is part of the Research TopicModifiable Risk Factors for Chronic Kidney Disease ProgressionView all 18 articles
Association Between the ratio of triglyceride to high-density lipoprotein cholesterol (TG/HDL-c) and Chronic Kidney Disease Risk: A Large-Scale Cross-Sectional Study in a Chinese Population
Provisionally accepted- 1The First Affiliated Hospital of Shenzhen University, SHENZHEN, China
- 2Shenzhen Second People’s Hospital, Shenzhen, China
- 3Shenzhen University, shenzhen, China
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Objective: The association between lipid metabolism markers, particularly the TG/HDL-c ratio, and kidney dysfunction has not been thoroughly investigated in Chinese wellness examination cohorts. This study examines the correlation between these parameters and evaluates the role of TG/HDL-c as an independent predictor of CKD. Methods: Our multicenter investigation encompassed data from 33,850 consecutive participants across eight major Chinese metropolitan areas (Shanghai, Guangzhou, Wuhan, Dalian, Zhengzhou, Lanzhou, Luzhou, and Guangxi). To evaluate the relationship between TG/HDL-c ratio and CKD, we employed multiple statistical approaches. The primary analysis utilized binary logistic regression to assess the independent association between these variables. We further characterized the relationship pattern through generalized additive modeling (GAM) with smooth curve fitting, implementing the penalty spline method. The reliability of our findings was validated through comprehensive sensitivity analyses, complemented by stratified subgroup evaluations. Results: The average age of the study participants was (57.65±9.28) years, with females accounting for 67.15%. The prevalence of CKD was 15.9%, and the median TG/HDL-C ratio was 1.06 (0.69-1.65). After adjusting for covariates, the results indicated a positive correlation between the TG/HDL-C ratio and CKD (OR=1.17, 95% CI: 1.13, 1.21). There was also a nonlinear relationship between the TG/HDL-C ratio and CKD, with an inflection point at 1.086. The effect sizes on either side of the inflection point were 1.800 (1.542, 2.100) and 1.049 (1.049, 1.411), respectively. Sensitivity analysis confirmed the robustness of the study findings. Conclusion: This study demonstrates a positive and non-linear relationship between TG/HDL-c ratio and CKD in the Chinese health check-up population. TG/HDL-c ratio is strongly related to CKD when TG/HDL-c ratio is more than 1.086. It makes sense to reduce the TG/HDL-c ratio level below the inflection point from a treatment perspective.
Keywords: Chronic Kidney Disease, Triglyceride/high-density lipoprotein ratio, Cross-sectional study, Non-linear association, logistic (logit) regression
Received: 15 May 2025; Accepted: 30 Sep 2025.
Copyright: © 2025 Liao, Wan, Hu and Song. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Qijun Wan, yiyuan2224@sina.com
Haofei Hu, huhaofei0319@126.com
Haiying Song, haiyingsong2024@126.com
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