The relationship between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and tubular atrophy/interstitial fibrosis in patients with IgA nephropathy.

چکیده اصلی

Background: The tubular atrophy/interstitial fibrosis (T) lesions of the Oxford Classification is a key prognostic determinant in IgA nephropathy (IgAN). The non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) is an emerging lipid marker, but its link with renal histologic damage in IgAN is unknown.Methods: This cross-sectional and retrospective study investigated the relationship between NHHR and T lesions in 400 biopsy-proven IgAN patients. Participants were divided into NHHR quartiles. The association between NHHR and T lesions was assessed using Spearman's rank correlation analysis, binary logistic regression analysis, restricted cubic spline (RCS) analysis, receiver operating characteristic (ROC) curve analysis, and subgroup analysis.Results: Compared to the lowest quartile (Q1), the highest NHHR quartile (Q4) showed significantly adverse clinical profiles and a higher prevalence of T1/T2 lesions (p < 0.05). NHHR was positively correlated with T lesions (r = 0.229, p < 0.001). Multivariate logistic regression analysis identified elevated NHHR and reduced estimated glomerular filtration rate (eGFR) as independent risk factors for T1/T2 lesions. RCS analysis demonstrated a linear association between NHHR and the risk of T1/T2 lesions (p for nonlinearity = 0.343). The ROC curve analysis yielded an area under the curve (AUC) of 0.635 for NHHR alone (optimal cutoff value = 3.54, sensitivity = 58.2%, specificity = 63.6%), and the composite NHHR+eGFR model achieved an AUC of 0.814. Subgroup analysis showed a consistent association between NHHR and the risk of T1/T2 lesions across all subgroups, with no significant interaction effects.Conclusion: Elevated NHHR is an independent risk factor for the progression of T lesions in patients with IgAN.

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