Gender-specific association of decreased estimated glomerular filtration rate and left vertical geometry in the general population from rural Northeast China

BACKGROUND: Left ventricular hypertrophy (LVH) is common and associated with cardiovascular outcomes among patients with known chronic kidney disease (CKD). However, the link between decreased estimated glomerular filtration rate (eGFR) and left ventricular (LV) geometry remains poorly explored in general population. In this study, we examined the gender-specific association between eGFR and LVH in the general population from rural Northeast China. METHODS: This survey was conducted from July 2012 to August 2013. A total of 10907 participants (5,013 men and 5,894 women) from the rural Northeast China were randomly selected and examined. LV mass index (LVMI) was used to define LVH (LVMI > 46.7 g/m(2.7) in women; > 49.2 g/m(2.7) in men). LV geometry was defined as normal, or with concentric remodeling, eccentric or concentric hypertrophy, according to relative wall thickness (RWT) and LVMI. Mildly decreased eGFR was defined as eGFR ≥ 60 and < 90 ml/min/1.73 m(2), and moderate-severely decreased eGFR was defined as eGFR < 60 ml/min/1.73 m(2). RESULTS: As eGFR decreased, LVH showed a gradual increase in the entire study population. Multivariate analysis revealed a gender-specific relationship between eGFR and LV geometry. Only in men, mildly decreased eGFR was associated with concentric remodeling [odds ratio (OR): =1.58; 95% CI: 1.14–2.20; P < 0.01] and concentric LVH OR = 1.63; 95% CI: 1.15–2.31; P < 0.01). And only in men, moderate-severely decreased eGFR was a risk factor for concentric LVH (OR = 4.56; 95% CI: 2.14–9.73; P < 0.001) after adjusting for confounding factors. CONCLUSIONS: These findings suggested that decreased eGFR was a risk factor for LV geometry in men, and a gender-specific difference should be taken into account in clinical practice.