The association of fasting triglyceride variability with renal dysfunction and proteinuria in medical checkup participants

TL;DR

This study found that greater variability in fasting triglyceride levels is linked to faster progression of chronic kidney disease.

Contribution

The study demonstrates a novel association between triglyceride variability and CKD progression using longitudinal medical checkup data.

Findings

Higher triglyceride variability (measured by SD and MMD) was associated with lower renal survival.

Greater triglyceride variability was linked to increased incidence of proteinuria.

The associations remained significant in adjusted models.

Abstract

The association between the variability of triglyceride (TG) and chronic kidney disease (CKD) progression remains unclear. We examined whether intraindividual variability in fasting TG was associated with the exacerbation of CKD.

We conducted a retrospective and observational study. 18,339 participants, who went through medical checkups and had checked their estimated glomerular filtration rate (eGFR) and semi-quantitative proteinuria by urine dipstick every year since 2017 for 4 years were registered. Variability in fasting TG was determined using the standard deviation (SD), and maximum minus minimum difference (MMD) between 2017 and 2021. The primary end point for the analysis of eGFR decline was eGFR < 60 mL/min/1.73 m2. The secondary end point for the analysis of proteinuria was the incidence of proteinuria ≥ ( ±) by urine dipstick.

The renal survival was lower in the higher-SD, and higher-MMD groups than in the lower-SD, and lower-MMD groups, respectively (log-rank test p < 0.001, and < 0.001, respectively). Lower SD and lower MMD were significantly associated with renal survival in the adjusted model (hazard ratio (HR), 1.12; 95% confidence intervals (CI), 1.04–1.21, and HR, 1.13; 95% CI 1.05–1.23, respectively). The non-incidence of proteinuria was lower in the higher-SD, and higher-MMD groups than in the lower-SD, and lower-MMD groups, respectively (log-rank test p < 0.001 and < 0.001, respectively).

Fasting TG variability was associated with CKD progression in participants who went through medical checkups.

The online version contains supplementary material available at 10.1007/s10157-025-02640-9.

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