Zeng Chuanfei, Zhan Qing, Lv Linghai, Chen Yanbing, Zhan Xiaojiang
Department of Nephrology, The First Affiliated Hospital of Nanchang University, 17#Yongwai Street, Nanchang, 330006, Jiangxi, China.
Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
Int Urol Nephrol. 2023 Aug;55(8):2015-2023. doi: 10.1007/s11255-023-03514-3. Epub 2023 Feb 18.
The ratio of low-density lipoprotein cholesterol (LDL-C)/apolipoprotein B (apo B) is associated with all-cause mortality and cardiovascular events in chronic kidney disease patients. The aim of this study was to investigate the association between the LDL-C/apo B ratio (LAR) and all-cause mortality and cardiovascular events in peritoneal dialysis (PD) patients.
A total of 1199 incident PD patients were enrolled from November 1, 2005 to August 31, 2019. The LAR was used to divide the patients into two groups by X-Tile software and restricted cubic splines using 1.04 as the cutoff. The incidence of all-cause mortality and cardiovascular events at follow-up was compared according to LAR.
Of the 1199 patients, 58.0% were men, the mean age was 49.3 ± 14.5 years, 225 patients had a history of diabetes, and 117 patients had prior cardiovascular disease. During the follow-up period, 326 patients died, and 178 patients experienced cardiovascular events. After full adjustment, a low LAR was significantly associated with HRs for all-cause mortality of 1.37 (95% CI 1.02-1.84, P = 0.034) and for cardiovascular events of 1.61 (95% CI 1.10-2.36, P = 0.014).
This study suggests that a low LAR is an independent risk factor for all-cause mortality and cardiovascular events in PD patients, indicating that the LAR may provide significant information when assessing all-cause mortality and cardiovascular risks.
低密度脂蛋白胆固醇（LDL-C）/载脂蛋白B（apo B）的比值与慢性肾脏病患者的全因死亡率和心血管事件相关。本研究旨在探讨腹膜透析（PD）患者中LDL-C/apo B比值（LAR）与全因死亡率和心血管事件之间的关联。
2005年11月1日至2019年8月31日共纳入1199例新发PD患者。使用X-Tile软件并采用限制立方样条曲线以1.04为切点将患者分为两组。根据LAR比较随访期间全因死亡率和心血管事件的发生率。
在1199例患者中，58.0%为男性，平均年龄为49.3±14.5岁，225例患者有糖尿病史，117例患者有心血管疾病史。随访期间，326例患者死亡，178例患者发生心血管事件。经过全面调整后，低LAR与全因死亡率的风险比（HR）为1.37（95%可信区间1.02-1.84，P=0.034）以及心血管事件的HR为1.61（95%可信区间1.10-2.36，P=0.014）显著相关。
本研究表明低LAR是PD患者全因死亡率和心血管事件的独立危险因素，这表明LAR在评估全因死亡率和心血管风险时可能提供重要信息。
