Precise data of the specific lipid fractions levels in the cardiorenal metabolic syndrome (CRMs) are still unclear despite the known connections between the lipid metabolism and the state of the heart, kidneys, and liver.

Objective: to assess the manifestations of lipid distress in the patients with different stages of cardiorenal metabolic syndrome.

Materials and methods. 100 patients with acute forms of coronary heart disease were examined in compliance with the principles of the Helsinki Declaration of Human Rights and with their informed consent. Patients were divided into groups (G0, G1, G2, G3a) according the stage of CRMs. Glomerular filtration rate was determined by MDRD and Cockcroft-Gault, carbohydrate metabolism was assessed by oral glucose tolerance test, insulin and C-protein contents and areas under the glucose and insulin curves calculations. The ratios of waist to hip circumference and to height, triglyceride-glucose index, atherogenicity coefficient, lipid indices Castelli 1 and Castelli 2, the ratios of triglyceride to high-density lipoproteins and to body mass index; deFronzо, Stumvoll early, Stumvoll late, and Philips insulin resistance indices, neutrophils to lymphocytes ratio, and the de Ritis index were calculated additionally. The results were processed with statistical methods, the significance level was taken as p < 0.05.

Results. It was established that lipid distress parameters were less pronounced according renal parameters worsening. Total cholesterol levels were highest in patients without CRMs and were independent of its stage. They remained moderately elevated in all stages. Correlations of total cholesterol levels were dependent on the CRMs stage. Both a decrease and an increase of total cholesterol level can be considered unfavorable, because they were associated with the inflammation activation, carbohydrate metabolism disorders progression with tissue insulin resistance, heart geometry changes, and liver steatosis. Conclusions. Lipid distress decreased a little during the progression of cardiorenal metabolic syndrome. Both a decrease and an increase of total cholesterol levels can be considered unfavorable.

Keywords: cardiorenal metabolic syndrome, stages, total cholesterol, carbohydrate metabolism, heart geometry

Full text: PDF (Ukr) 223K

1. Ndumele CE, Neeland IJ, Tuttle KR, Chow SL, Mathew RO, Khan SS, et al. A Synopsis of the Evidence for the Science and Clinical Management of Cardiovascular-Kidney-Metabolic (CKM) Syndrome: A Scientific Statement From the American Heart Association Circulation.2023;148(20):1636-1664. doi.org/10.1161/CIR.0000000000001186
2. Li W, Shen C, Kong W, Zhou X, Fan H, Zhang Y, Liu Z, Zheng L. Association between the triglyceride glucose-body mass index and future cardiovascular disease risk in a population with Cardiovascular-Kidney-Metabolic syndrome stage 0-3: a nationwide prospective cohort study. Cardiovasc Diabetol. 2024;23(1):292. doi.org/10.1186/s12933-024-02352-6
3. Banach M, Reiner Ž, Surma S, Bajraktari G, Bielecka-Dabrowa A, Bunc M, et al. 2024 Recommendations on the Optimal Use of Lipid-Lowering Therapy in Established Atherosclerotic Cardiovascular Disease and Following Acute Coronary Syndromes: A Position Paper of the International Lipid Expert Panel (ILEP)Drugs. 2024;84(12):1541-1577. doi.org/10.1007/s40265-024-02105-5
4. Han YZ, Du BX, Zhu XY, Wang YZ, Zheng HJ, Liu WJ. Lipid metabolism disorder in diabetic kidney disease. Front Endocrinol (Lausanne). 2024;15:1336402. doi.org/10.3389/fendo.2024.133640
5. Huanan C, SangsangL, Amoah AN et al. Relationship between triglyceride glucose index and the incidence of non-alcoholic fatty liver disease in the elderly: a retrospective cohort study in China. BMJ Open 2020; 10:e039804. doi.org/10.1136/bmjopen-2020-039804
6. Park YS, Gautier J-F, Chon S. Assessment of insulin secretion and insulin resistance in human. Diabetes Metab J. 2021;45:641-654 http
7. Комариця О.Й., Зімба О.О. Відношення нейтрофілів до лімфоцитів при геморагічному васкуліті зі стеатозом печінки. Інтегральні гематологічні індекси у діагностиці та прогнозуванні перебігу внутрішніх хвороб (Моногр.). Львів-Простір-М, 2021:68-71
8. Zhang YB, Sheng LT, Wei W, Guo H, Yang H, Min X, Guo K, Yang K, Zhang X, He M, Wu T, Pan A. Association of blood lipid profile with incident chronic kidney disease: A Mendelian randomization study Atherosclerosis. 2020;300:19-25.doi.org/10.1016/j.atherosclerosis.2020.03.020
9. Melsom T, Norvik JV, Enoksen IT, Stefansson V, Rismo R, Jenssen T, Solbu MD, Eriksen BO. Association of High-Density Lipoprotein Cholesterol With GFR Decline in a General Nondiabetic Population Kidney Int Rep. 2021;6(8):2084-2094. doi.org/10.1016/10.1016/j.ekir.2021.05.007
10. Khanam A, Nessa A, Zannat MR, Nasreen S, Sultana R, Tajkia T, et al. Study on Serum Total Cholesterol in Patient with Chronic Kidney Disease Mymensingh Med J. 2022; (1):10-14.
11. Mitu SA, Hoque MR, Banu M, Mili MY, Jenea AT, Sharmi TZ, Momo FR, Mahi SA. Status of Lipid Profile among Patients with Chronic Kidney Disease. Mymensingh Med J. 2025;34(2):338-342.
12. Huang Y, Zhong Q, Chen J, Qin X, Yang Y, He Y, Lin Z, Li Y, Yang S, Lu Y, Zhao Y, Kong Y, Wan Q, Wang Q, Huang S, Liu Y, Liu A, Liu F, Hou F, Liang M . Relationship of serum total cholesterol and triglyceride with risk of mortality in maintenance hemodialysis patients: a multicenter prospective cohort study Ren Fail. 2024 Dec;46(1):2334912. doi.org/10.1080/0886022X.2024.2334912
13. D’Elia JA, Weinrauch LA. Lipid Toxicity in the Cardiovascular-Kidney-Metabolic Syndrome (CKMS) Biomedicines. 2024;12(5):978. doi.org/10.3390/biomedicines12050978
14. Yang Q, Zou Y, Lang Y, Yang J, Wu Y, Xiao X, Qin C, Zhao Y, Liu F. Estimated small dense low-density lipoprotein-cholesterol and the risk of kidney and cardiovascular outcomes in diabetic kidney disease Ren Fail. 2024;46(2):2369701. doi.org/10.1080/0886022X.2024.2369701
15. Lyu K, Liu S, Liu Y, You J, Wang X, Jiang M, Yin C, Zhang D, Bai Y, Wang M, Zheng S. The Effect of Blood Lipid Profiles on Chronic Kidney Disease in a Prospective Cohort: Based on a Regression Discontinuity Design Biomed Environ Sci. 2024;37(10):1158-1172. doi.org/10.3967/bes2024.113