Association Between Dyslipidemia and Serum Level of 25-Hydroxyvitamin-D in Early Chronic Kidney Disease, Not on Dialysis: An Observational Cross-Sectional Study from the Himalayan Country

Abstract

Shiv Kumar Sah,1,2 Laxman Prasad Adhikary3 1Department of Pharmacy, Purbanchal University, Little Buddha College of Health Science, Kathmandu, Nepal; 2Gastro and Liver Foundation, Kathmandu, Nepal; 3Nephrology Unit, Department of Medicine, Kathmandu Medical Hospital Teaching Hospital, Kathmandu, NepalCorrespondence: Shiv Kumar Sah Email [email protected]: Patients with CKD have a higher prevalence of dyslipidemia and hypovitaminosis than the normal population. Recent studies in the general population have shown a potential link between 25(OH)D and dyslipidemia. However, such evidence in the early CKD population, especially in the Nepalese setting, is lacking. Thus, the present study aimed at investigating the status of 25(OH)D and dyslipidemia in the early CKD patients, and further to establish an association between 25(OH)D and lipid profile.Patients and Methods: In this cross-sectional study, we analyzed 136 clinically stable non-dialyzed CKD patients. 25(OH)D and lipid profile were evaluated as a core variable, and their direction and magnitude of a relationship were evaluated.Results: The estimated prevalence of dyslipidemia was 49.3%, and 63.2% population had a deficiency of 25(OH)D level. Compared with the patient with normal 25(OH)D level, the patient with deficient 25(OH)D level had a significantly higher level of LDL-c (P=0.04) and lower level of HDL-C (P=0.048). Serum 25(OH)D level was significantly lower in dyslipidemic patients than non-dyslipidemic patients (P=0.015). Regression analysis demonstrated a significant inverse relationship between serum 25(OH)D levels and LDL-c (β=− 1.5; P=< 0.001), and TC levels (β=− 1.4;P=0.003), and the association remained unchanged with further adjustment for age, sex, HTN, DM, serum albumin and eGFR.Conclusion: Our study unveiled a high rate of dyslipidemia and hypovitaminosis in a considerable number of early CKD patients. Low serum level of 25(OH)D was significantly correlated with a higher rate of dyslipidemia. These findings indicate some evidence for 25(OH)D level as a marker of dyslipidemia prediction, and that decrease in serum level of 25(OH)D is associated with increased serum level of LDL and TC; it could increase the risk of cardiovascular disease. Therefore, early recognition and timely management of hypovitaminosis and dyslipidemia is vital to prevent an inevitable cardiovascular event.Keywords: chronic kidney disease, dyslipidemia, 25(OH)D

Keywords

• chronic kidney disease
• dyslipidemia
• 25(oh)d