Department of Geriatrics, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, China.
Department of Clinical Laboratory, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, China.
Clin Exp Nephrol. 2022 Feb;26(2):113-121. doi: 10.1007/s10157-021-02134-4. Epub 2021 Sep 14.
To explore the relationship between low-density lipoprotein cholesterol (LDL-C) level and infection risk in elderly stage 5 kidney disease (CKD) patients.
This study retrospectively analyzed all 378 patients with grade 5 CKD over 60 years old treated in the Nephrology Department of our hospital from February 2014 to July 2019, including 286 cases with infection and 92 cases without. According to LDL-C levels, the patients were divided into three groups (Tertile 1-Tertile 3). Basic patient data and laboratory test results were collected for all three groups for analysis.
The incidence of infection showed a gradually decreasing trend in the three groups (from 80.2, 78.6 to 68.3%), along with increasing LDL-C levels from Tertile 1 to Tertile 3, although the differences were not statistically significant (p = 0.075). After fully adjusting for confounding factors, the risk of infection was significantly reduced (OR = 0.646, 95% CI 0.420-0.993, p = 0.046) with increasing LDL-C levels. For the LDL-C levels of the three groups, the rising trend of LDL-C was significantly associated with the reduction in infection risk (OR = 0.545, 95% CI 0.317-0.937, p = 0.028). Curve fitting revealed that LDL-C levels were linearly negatively associated with the risk of infection, and the relationship between the two was not affected by the other factors (p for interaction: 0.567-1.000).
LDL-C level is linearly negatively associated with the risk of infection in elderly patients with stage 5 CKD.
探讨老年 5 期肾病（CKD）患者低密度脂蛋白胆固醇（LDL-C）水平与感染风险的关系。
本研究回顾性分析了 2014 年 2 月至 2019 年 7 月我院肾病科收治的 378 例 60 岁以上 5 级 CKD 患者，其中感染 286 例，无感染 92 例。根据 LDL-C 水平，将患者分为三组（三分位 1-三分位 3）。收集三组患者的基本临床资料和实验室检查结果进行分析。
三组感染发生率呈逐渐下降趋势（80.2%、78.6%、68.3%），随着 LDL-C 水平从三分位 1 逐渐升高至三分位 3，但差异无统计学意义（p=0.075）。充分调整混杂因素后，感染风险随着 LDL-C 水平的升高而显著降低（OR=0.646，95%CI 0.420-0.993，p=0.046）。对于三组 LDL-C 水平，随着 LDL-C 水平的升高，感染风险呈下降趋势（OR=0.545，95%CI 0.317-0.937，p=0.028）。曲线拟合显示 LDL-C 水平与感染风险呈线性负相关，且两者之间的关系不受其他因素影响（p 交互项：0.567-1.000）。
老年 5 期 CKD 患者 LDL-C 水平与感染风险呈线性负相关。
