Xie Xishao, Zhang Xiaohui, Xiang Shilong, Yan Xingqun, Huang Haojie, Tian Yuanshi, Shou Zhangfei, Chen Jianghua
Kidney Blood Press Res. 2017;42(1):52-61. doi: 10.1159/000469714. Epub 2017 Mar 17.
BACKGROUND/AIMS: Cardiovascular disease (CVD) is the leading cause of death in dialysis patients. Little is known about the relationship between very low-density lipoprotein cholesterol (VLDL-C) and cardiovascular mortality in these patients.
A total of 1324 incident patients who began continuous ambulatory peritoneal dialysis (CAPD) therapy at our hospital between January 1, 2005, and September 30, 2014, with baseline serum VLDL-C values were investigated. The associations of the VLDL-C levels with all-cause and cardiovascular mortality were assessed.
The mean age of the cohort was 50.2 ± 14.8 years, and the mean VLDL-C level was 33.6 ± 18.0 mg/dl. One hundred sixty-five (12.5%) patients died during the study period. Multivariable models revealed that the high VLDL-C group was associated with significantly higher all-cause (HR, 2.08, 95% CI, 1.13 to 3.29, P = 0.002) and cardiovascular mortality (HR, 1.92, 95% CI, 1.18 to 4.29, P = 0.013) compared with the low VLDL-C group even after adjusting for various covariates. Using the VLDL-C level as a continuous variable, the hazard ratios (HRs) of all-cause and cardiovascular mortality associated with a 10-mg/dl increase in VLDL-C level were 1.12 (95% CI, 1.02 to 1.26, P = 0.025) and 1.11 (95% CI, 1.02 to 1.22, P = 0.029), respectively. VLDL-C was associated more strongly to all-cause (e.g., Akaike information criteria of 1990.205 vs. 1994.451) and cardiovascular (e.g., Akaike information criteria of 984.146 vs. 985.634) mortality than triglyceride (TG) levels.
An elevated VLDL-C level is an independent risk factor for all-cause and cardiovascular mortality in peritoneal dialysis (PD) patients.
背景/目的：心血管疾病（CVD）是透析患者的主要死因。对于极低密度脂蛋白胆固醇（VLDL-C）与这些患者心血管死亡率之间的关系，人们知之甚少。
对2005年1月1日至2014年9月30日期间在我院开始持续非卧床腹膜透析（CAPD）治疗且有基线血清VLDL-C值的1324例新发病例患者进行了调查。评估了VLDL-C水平与全因死亡率和心血管死亡率之间的关联。
该队列的平均年龄为50.2±14.8岁，平均VLDL-C水平为33.6±18.0mg/dl。165例（12.5%）患者在研究期间死亡。多变量模型显示，即使在调整了各种协变量后，与低VLDL-C组相比，高VLDL-C组的全因死亡率（HR，2.08，95%CI，1.13至3.29，P=0.002）和心血管死亡率（HR，1.92，95%CI，1.18至4.29，P=0.013）显著更高。将VLDL-C水平作为连续变量，VLDL-C水平每升高10mg/dl，全因死亡率和心血管死亡率的风险比（HR）分别为1.12（95%CI，1.02至1.26，P=0.025）和1.11（95%CI，1.02至1.22，P=0.029）。与甘油三酯（TG）水平相比，VLDL-C与全因死亡率（例如，赤池信息准则为1990.205对1994.451）和心血管死亡率（例如，赤池信息准则为984.146对985.634）的关联更强。
VLDL-C水平升高是腹膜透析（PD）患者全因死亡率和心血管死亡率的独立危险因素。
