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Remnant cholesterol predicts cardiovascular mortality beyond low-density lipoprotein cholesterol in patients with

Jing Guo1, Yuan Peng2, Ruihua Liu1

  • 1Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China (Drs Guo, Peng, Liu, Yi, Guo and Yang); NHC Key Laboratory of Clinical Nephrology (Sun Yat-Sen University) and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou 510080, China (Drs Guo, Peng, Liu, Yi, Guo and Yang).

Journal of Clinical Lipidology
|September 18, 2023
PubMed

Insights

Remnant cholesterol (RC) levels are elevated in patients on peritoneal dialysis (PD) and predict cardiovascular mortality independently of low-density lipoprotein cholesterol (LDL-C). Higher RC levels are particularly concerning in older PD patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Lipidology

Background:

  • Patients on peritoneal dialysis (PD) frequently experience dyslipidemia.
  • Limited research exists on remnant cholesterol (RC) in PD patients.
  • Dyslipidemia is a known risk factor for cardiovascular disease in PD patients.

Purpose of the Study:

  • To investigate the association between remnant cholesterol (RC) levels and cardiovascular (CV) mortality in patients undergoing PD.
  • To determine if RC is an independent predictor of CV mortality in PD patients.
  • To explore the combined impact of RC and LDL-C on CV mortality risk.

Main Methods:

  • Retrospective enrollment of 2333 patients initiating PD between 2006 and 2018.
  • Utilized adjusted Cox models to assess the independent association between baseline RC and CV mortality.
  • Categorized patients based on concordant/discordant LDL-C and RC levels to analyze mortality risk.

Main Results:

  • Elevated RC levels were positively associated with increased CV mortality risk in PD patients (HR: 1.05).
  • Patients with high LDL-C and high RC levels exhibited a significantly higher CV mortality risk (HR: 1.52).
  • In older PD patients, higher RC levels independently increased CV mortality risk, irrespective of LDL-C levels.

Conclusions:

  • Remnant cholesterol (RC) is elevated in PD patients and predicts CV mortality beyond LDL-C.
  • RC levels should be assessed alongside LDL-C for comprehensive cardiovascular risk assessment in PD patients.
  • Particular attention to RC is warranted over LDL-C for risk stratification in elderly PD patients.
Abstract

Keywords:
Cardiovascular mortalityLow-density lipoprotein cholesterolPeritoneal dialysisRemnant cholesterol

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