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Triglyceride to high-density lipoprotein cholesterol ratio predicts cardiovascular outcomes in prevalent dialysis

Hung-Yuan Chen1, Wan-Chuan Tsai, Yen-Ling Chiu

  • 1From the Division of Nephrology (H-YC, W-CT, Y-LC, S-PH, M-FP, J-YY, Y-SP), Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City; and Division of Nephrology (H-YC, Y-LC, S-PH, M-FP, J-YY, Y-SP), Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.

Medicine
|March 12, 2015
PubMed

Insights

The triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio predicts cardiovascular events and mortality in nondiabetic dialysis patients. This ratio is a valuable tool for assessing risk in this population.

Area of Science:

  • Cardiology
  • Nephrology
  • Biochemistry

Background:

  • The triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio is an established marker of atherogenic dyslipidemia and cardiovascular risk in the general population.
  • Its predictive value for cardiovascular (CV) outcomes and survival specifically in dialysis patients remains largely unknown.

Purpose of the Study:

  • To investigate the association between the TG/HDL-C ratio and cardiovascular outcomes, including CV events, CV death, and all-cause mortality in dialysis patients.
  • To determine if the TG/HDL-C ratio can serve as a reliable predictor of CV outcomes and survival in this specific patient group.

Main Methods:

  • A prospective, observational cohort study involving 602 dialysis patients (539 hemodialysis, 63 peritoneal dialysis).
  • Patients were followed for a median of 3.9 years, with outcomes including CV events, CV death, and all-cause mortality.
  • Cox regression models, adjusted for demographic and inflammatory/nutritional markers, were used to analyze the association of baseline TG/HDL-C ratio with outcomes.

Main Results:

  • Higher TG/HDL-C ratios were significantly associated with increased incidence of CV events (adjusted HR 2.03), CV mortality (adjusted HR 1.91), composite CV outcomes (adjusted HR 2.2), and all-cause mortality (adjusted HR 1.94) compared to the lowest quintile.
  • These associations were observed in the overall dialysis population but not in diabetic dialysis patients.
  • The TG/HDL-C ratio demonstrated predictive capability for CV outcomes and survival in nondiabetic dialysis patients.

Conclusions:

  • The TG/HDL-C ratio is a valuable and accessible predictor of cardiovascular outcomes and survival in prevalent nondiabetic dialysis patients.
  • The TG/HDL-C ratio does not appear to predict cardiovascular outcomes in dialysis patients with diabetes.
  • This ratio can aid clinicians in risk stratification for cardiovascular disease in nondiabetic individuals undergoing dialysis.

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