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The predictive study of the relation between elevated low-density lipoprotein cholesterol to high-density lipoprotein
Tong Lin1,2, Xi Xia1,2, Jing Yu1,2
1Department of Nephrology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 58th, Zhongshan Road II, Guangzhou, 510080, People's Republic of China.
Insights
A high low-density lipoprotein cholesterol to high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio independently predicts increased cardiovascular and all-cause mortality in peritoneal dialysis (PD) patients. This finding highlights the ratio
Area of Science:
- Nephrology and Cardiovascular Medicine
- Clinical Epidemiology
- Biomarker Research
Background:
- The LDL-C/HDL-C ratio is a recognized cardiovascular risk predictor.
- Its association with mortality in peritoneal dialysis (PD) patients remains unclear.
- Understanding this link is crucial for risk stratification in PD populations.
Purpose of the Study:
- To investigate the predictive value of a high LDL-C/HDL-C ratio for cardiovascular mortality in PD patients.
- To assess the association between the LDL-C/HDL-C ratio and all-cause mortality in this cohort.
Main Methods:
- Prospective cohort study of 1616 incident PD patients followed for up to 12 years.
- Patients categorized into tertiles based on their LDL-C/HDL-C ratio.
- Cardiovascular mortality and all-cause mortality served as primary and secondary endpoints, respectively.
Main Results:
- The highest LDL-C/HDL-C ratio tertile was significantly associated with increased CVD mortality (HR: 1.84) and all-cause mortality (HR: 1.35) after multivariate adjustment.
- Elevated CVD mortality risk was observed in subgroups including females, younger patients (<65 years), those without malnutrition, and patients with diabetes or prior CVD.
- A median follow-up of 47.6 months revealed 492 deaths, with 50% attributed to cardiovascular disease.
Conclusions:
- A high LDL-C/HDL-C ratio is an independent predictor of both cardiovascular and all-cause mortality in patients undergoing PD.
- This lipid ratio can serve as a valuable prognostic marker in the PD population.
Background:
The low-density lipoprotein cholesterol to high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio constitutes a strong risk predictor of cardiovascular events. However, the association between this ratio and cardiovascular death in peritoneal dialysis (PD) patients is uncertain. The study aimed to investigate whether a high LDL-C/HDL-C ratio could predict both cardiovascular and all-cause mortalities in patients on PD.
Methods:
A total of 1616 incident patients on PD included from January 1, 2006 to December 31, 2013 were followed up with until 31 December 2018 in this single-center prospective cohort study. Participants were divided into three categories according to LDL-C/HDL-C ratio tertile. The primary endpoint was cardiovascular mortality; the secondary endpoint was all-cause mortality.
Results:
The mean age of the study cohort was 47.5 years and the mean body mass index (BMI) was 21.6 kg/m2. During a median follow-up period of 47.6 months, 492 patients died, including 246 (50.0%) due to cardiovascular disease (CVD). A multivariate analysis revealed that the highest LDL-C/HDL-C ratio tertile was significantly associated with increased CVD mortality [hazard ratio (HR): 1.69, 95% CI: 1.24-2.29; P = 0.001] and all-cause mortality (HR: 1.46, 95% CI: 1.18-1.81; P = 0.001) relative to the lowest tertile. After adjusting for covariates, the HRs of cardiovascular and all-cause mortalities were 1.84 (95% CI: 1.25-2.71; P = 0.002) and 1.35 (95% CI: 1.03-1.77; P = 0.032). Subgroup analysis showed that the risk of CVD death rose with a higher LDL-C/HDL-C ratio among PD patients who were female, younger than 65 years old, without being malnourished (BMI ≥ 18.5 kg/m2 or albumin ≥35 g/L), and with a history of diabetes or CVD, respectively.
Conclusions:
A high LDL-C/HDL-C ratio is an independent risk factor for both cardiovascular and all-cause mortalities among PD patients.
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