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在接受腹膜透析的女性患者中,较高的血清甘油三酯与高密度脂蛋白胆固醇比值与心血管死亡率增加相关。

Higher serum triglyceride to high-density lipoprotein cholesterol ratio was associated with increased cardiovascular mortality in female patients on peritoneal dialysis.

作者信息

Wu H, Xiong L, Xu Q, Wu J, Huang R, Guo Q, Mao H, Yu X, Yang X

机构信息

Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Key Laboratory of Nephrology, Ministry of Health, Guangzhou, Guangdong, China.

Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Key Laboratory of Nephrology, Ministry of Health, Guangzhou, Guangdong, China.

出版信息

Nutr Metab Cardiovasc Dis. 2015 Aug;25(8):749-55. doi: 10.1016/j.numecd.2015.05.006. Epub 2015 May 19.

Abstract

BACKGROUND AND AIMS

High serum triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio has been found to be an independent predictor for cardiovascular events in the general population. We aimed to evaluate whether a high TG/HDL-C ratio was associated with an increased risk of mortality in patients on continuous ambulatory peritoneal dialysis (CAPD).

METHODS AND RESULTS

In this single-center retrospective cohort study, 1170 incident patients on peritoneal dialysis (PD) from 1 January 2007 to 31 December 2011 were recruited and followed up until 31 December 31 2013. The mean age was 47.4 ± 15.2 years, and 24.7% were diabetic. During a median of the 34.5-month follow-up period, 213 (18.2%) deaths occurred, 121 of which (56.8%) were caused by cardiovascular disease (CVD). The serum median TG/HDL-C ratio at baseline was 2.57 (range: 0.06-39.39). On multivariate Cox regression analysis, the highest quartile of the TG/HDL-C ratio (≥4.19) was associated with increased risk of all-cause mortality (hazard ratio (HR) 1.98, 95% confidence interval (CI), 1.17-3.36; P = 0.011) and CVD mortality (HR 2.28, 95% CI, 1.16-4.47; P = 0.017). For female patients, each one-unit higher baseline TG/HDL-C was associated with 13% (95% CI 1.06-1.22; P = 0.001) increased risk of CVD mortality, whereas such an association was not observed for male patients, (HR 1.00, 95% CI 0.92-1.08; P = 0.977).

CONCLUSIONS

A higher serum TG/HDL-C ratio was associated with an increased risk of all-cause and CVD mortality in PD patients. Moreover, the increased risk of CVD mortality was significantly higher in female than male PD patients.

摘要

背景与目的

血清甘油三酯与高密度脂蛋白胆固醇(TG/HDL-C)比值升高已被发现是普通人群心血管事件的独立预测因素。我们旨在评估高TG/HDL-C比值是否与持续非卧床腹膜透析(CAPD)患者的死亡风险增加相关。

方法与结果

在这项单中心回顾性队列研究中,招募了2007年1月1日至2011年12月31日期间开始腹膜透析(PD)的1170例新发病例,并随访至2013年12月31日。平均年龄为47.4±15.2岁,24.7%为糖尿病患者。在中位34.5个月的随访期内,发生213例(18.2%)死亡,其中121例(56.8%)由心血管疾病(CVD)导致。基线时血清TG/HDL-C比值中位数为2.57(范围:0.06 - 39.39)。多因素Cox回归分析显示,TG/HDL-C比值最高四分位数(≥4.19)与全因死亡风险增加相关(风险比(HR)1.98,95%置信区间(CI),1.17 - 3.36;P = 0.011)以及CVD死亡风险增加相关(HR 2.28,95% CI,1.16 - 4.47;P = 0.017)。对于女性患者,基线TG/HDL-C每升高一个单位与CVD死亡风险增加13%(95% CI 1.06 - 1.22;P = 0.001)相关,而男性患者未观察到这种关联(HR 1.00,95% CI 0.92 - 1.08;P = 0.977)。

结论

较高的血清TG/HDL-C比值与PD患者的全因和CVD死亡风险增加相关。此外,女性PD患者CVD死亡风险增加显著高于男性。

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