Department of Nephrology, The First Affiliated Hospital of Nanchang University, 17# Yongwai Street, Nanchang, 330006, China.
Lipids Health Dis. 2019 Nov 15;18(1):199. doi: 10.1186/s12944-019-1147-8.
The triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio (TG/HDL-C) has been suggested as a simple method to identify unfavorable cardiovascular (CV) outcomes in the general population. The aim of this study was to investigate the association between the TG/HDL-C ratio and all-cause and CV mortality in peritoneal dialysis (PD) patients.
We retrospectively analyzed patients on PD from November 1, 2005, to February 28, 2017, with a follow-up period lasting until May 31, 2017. The main outcomes were all-cause and CV mortality.
Among the 973 PD patients, the mean age was 49.67 ± 14.58 (y). During a median follow-up period of 27.2 months (IQR = 13.4-41.5 months), 229 (23.5%) patients died, with 120 (12.3%) dying as a result of CV diseases. The median serum TG/HDL-C ratio was 1.11 (IQR = 0.71-1.80). In a multivariate Cox regression analysis, patients with higher TG/HDL-C ratio levels (tertile 3) had a higher incidence of CV mortality (adjusted HR = 2.12; 95% CI: 1.21-3.72; P = 0.009) and all-cause mortality (adjusted HR = 2.08; 95% CI: 1.37-3.14; P = 0.001) compared to patients in tertile 1. These associations persisted after excluding the patients who have already taken lipid-lowering medications. For older patients (> 60 years), each 1-unit higher baseline TG/HDL-C level was associated with a 48% (95% CI: 1.06-2.07; P = 0.021) increased risk of all-cause mortality and a 59% (95% CI: 1.03-2.45; P = 0.038) increased risk of CV mortality; however, this association was not observed in patients ≤60 years of age.
A higher serum TG/HDL-C ratio was an independent predictor of all-cause and CV mortality in PD patients. Furthermore, an elevated TG/HDL-C ratio was significantly associated with higher all-cause and CV mortality in older PD patients.
甘油三酯（TG）与高密度脂蛋白胆固醇（HDL-C）比值（TG/HDL-C）已被建议作为一种简单的方法来识别普通人群中不利的心血管（CV）结局。本研究旨在探讨 TG/HDL-C 比值与腹膜透析（PD）患者全因和 CV 死亡率之间的关系。
我们回顾性分析了 2005 年 11 月 1 日至 2017 年 2 月 28 日期间接受 PD 的患者，随访时间截至 2017 年 5 月 31 日。主要结局为全因和 CV 死亡率。
在 973 例 PD 患者中，平均年龄为 49.67±14.58（岁）。在中位随访 27.2（IQR=13.4-41.5）个月期间，229（23.5%）例患者死亡，其中 120（12.3%）例死于 CV 疾病。中位血清 TG/HDL-C 比值为 1.11（IQR=0.71-1.80）。在多变量 Cox 回归分析中，TG/HDL-C 比值较高的患者（三分位 3）CV 死亡率（校正 HR=2.12；95%CI：1.21-3.72；P=0.009）和全因死亡率（校正 HR=2.08；95%CI：1.37-3.14；P=0.001）更高。与三分位 1 的患者相比，这些关联在排除已接受降脂药物治疗的患者后仍然存在。对于年龄较大的患者（>60 岁），基线 TG/HDL-C 水平每增加 1 个单位，全因死亡率的风险增加 48%（95%CI：1.06-2.07；P=0.021），CV 死亡率的风险增加 59%（95%CI：1.03-2.45；P=0.038）；然而，这种关联在年龄≤60 岁的患者中并未观察到。
较高的血清 TG/HDL-C 比值是 PD 患者全因和 CV 死亡率的独立预测因子。此外，升高的 TG/HDL-C 比值与老年 PD 患者较高的全因和 CV 死亡率显著相关。
