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Association between lipoprotein combine index and all-cause and cardiovascular mortality in patients undergoing
Caixia Yan1,2, Qing Zhan3, Qingdong Xu4
1Department of Nephrology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
Insights
Higher lipoprotein combine index (LCI) is linked to increased mortality in peritoneal dialysis (PD) patients. This finding supports LCI
Area of Science:
- Nephrology
- Cardiology
- Lipidology
Background:
- Cardiovascular disease (CVD) is the primary cause of death in peritoneal dialysis (PD) patients.
- The lipoprotein combine index (LCI) integrates multiple lipids to assess atherogenic burden.
- Traditional lipid measures may not fully capture CVD risk in PD patients.
Purpose of the Study:
- To investigate the association between baseline LCI and mortality in incident PD patients.
- To determine if LCI is an independent predictor of all-cause and CVD mortality.
- To explore the utility of LCI for risk stratification in PD.
Main Methods:
- A multicenter retrospective cohort study of 1,986 incident PD patients.
- LCI was analyzed in quartiles (Q1-Q4).
- Cox models were used to estimate hazard ratios (HRs) for all-cause and CVD mortality, with adjustments for covariates.
Main Results:
- Higher LCI quartiles were associated with progressively increased all-cause and CVD mortality.
- Adjusted HRs for all-cause death were 1.41, 1.59, and 1.70 for Q2-Q4 vs. Q1.
- A non-linear trend for all-cause mortality was observed, with risk increasing above LCI ~20.
Conclusions:
- Higher baseline LCI independently predicts all-cause and CVD mortality in PD patients.
- LCI demonstrates utility for risk stratification in PD patients.
- LCI may aid in age-specific lipid management strategies for PD patients.
Background:
Cardiovascular disease (CVD) is the leading cause of death in patients undergoing peritoneal dialysis (PD). The lipoprotein combine index (LCI), integrating total cholesterol, triglycerides, LDL-C and HDL-C, may better reflect atherogenic burden than traditional single-lipid measures. We hypothesized that higher baseline LCI would be independently associated with increased risks of all-cause and cardiovascular mortality in incident PD patients.
Methods:
In this multicenter retrospective cohort, 1,986 incident PD patients from six centers (2005-2021) were analyzed. LCI was divided into quartiles (Q1-Q4). Outcomes were all-cause and CVD mortality. Missing covariates were imputed. Centre-stratified Cox models estimated hazard ratios (HRs), and restricted cubic splines assessed non-linear trends.
Results:
Over a median 35-month follow-up, 662 deaths occurred, including 328 CVD deaths. Higher LCI quartiles showed progressively higher mortality. For all-cause death, adjusted HRs (95% CI) were 1.41 (1.10-1.80), 1.59 (1.25-2.02) and 1.70 (1.34-2.15) for Q2-Q4 vs. Q1. For CVD death, HRs were 1.45 (1.03-2.02), 1.29 (0.92-1.82) and 1.68 (1.22-2.33). A non-linear pattern was observed for all-cause mortality, with risk increasing when LCI exceeded ~20. The association with CVD mortality was stronger in younger patients (<60 years) (P interaction = 0.048).
Conclusion:
Higher baseline LCI independently predicted all-cause and CVD mortality in PD patients, supporting its usefulness for risk stratification and age-specific lipid management.
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