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甘油三酯/高密度脂蛋白和总胆固醇/高密度脂蛋白对新发腹膜透析患者死亡风险和心血管事件的预测价值。

The predictive value of TG/HDL and TC/HDL for risk of mortality and cardiovascular events in incident peritoneal dialysis patients.

作者信息

Ma Tiantian, Gao Shuang, Zhang Beiru, Li Xinqiu, Dong Jie, Bai Yu

机构信息

Renal Division, Department of Medicine, Peking University First Hospital; Institute of Nephrology, Peking University, Beijing 100034, China.

Key Laboratory of Renal Disease, Ministry of Health, Beijing 100034, China.

出版信息

Clin Kidney J. 2025 May 27;18(6):sfaf165. doi: 10.1093/ckj/sfaf165. eCollection 2025 Jun.

Abstract

BACKGROUND

This study investigated the association between triglyceride/high-density lipoprotein cholesterol (TG/HDL-C), total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C) and clinical outcomes in patients with peritoneal dialysis (PD) through the present prospective cohort study.

METHODS

This study is an observational analysis based on PD Telemedicine-assisted Platform Cohort Study. The lipid data was defined as the average levels for the first 3 months after receiving PD, including TG, TG and HDL-C. The primary outcome was all-cause mortality, and the secondary outcomes were major adverse cardiovascular events (MACE), modified MACE+ and hemodialysis transfer.

RESULTS

A total of 5875 PD patients were enrolled. By cubic spline regression analysis, the cut-off value of TG/HDL-C and TC/HDL-C were 1.25 and 4.20, respectively. During the follow-up time, 1098 (7.75/100 person-years) patients died, and the leading cause of mortality was cardiovascular diseases [686 (4.85/100 person-years)]. MACE and modified MACE+ occurred in 845 (6.09/100 person-years) and 1459 (10.83/100 person-years) patients, respectively. There were 719 patients (5.08/100 person-years) transferred to hemodialysis. The incidence of all-cause mortality, MACE and modified MACE+ were significant higher in groups with elevated TG/HDL-C and TC/HDL-C ( < .001).

CONCLUSIONS

Among patients treated with PD, the elevated TG/HDL-C and TC/HDL-C were independently associated with increased risk of mortality and cardiovascular events.

摘要

背景

本前瞻性队列研究探讨了腹膜透析(PD)患者甘油三酯/高密度脂蛋白胆固醇(TG/HDL-C)、总胆固醇/高密度脂蛋白胆固醇(TC/HDL-C)与临床结局之间的关联。

方法

本研究是基于PD远程医疗辅助平台队列研究的观察性分析。脂质数据定义为开始PD治疗后前3个月的平均水平,包括TG、TC和HDL-C。主要结局为全因死亡率,次要结局为主要不良心血管事件(MACE)、改良MACE+和血液透析转换。

结果

共纳入5875例PD患者。通过三次样条回归分析,TG/HDL-C和TC/HDL-C的截断值分别为1.25和4.20。随访期间,1098例(7.75/100人年)患者死亡,主要死亡原因是心血管疾病[686例(4.85/100人年)]。MACE和改良MACE+分别发生在845例(6.09/100人年)和1459例(10.83/100人年)患者中。719例患者(5.08/100人年)转为血液透析。TG/HDL-C和TC/HDL-C升高组的全因死亡率、MACE和改良MACE+发生率显著更高(P<0.001)。

结论

在接受PD治疗的患者中,TG/HDL-C和TC/HDL-C升高与死亡风险和心血管事件增加独立相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5043/12188193/9d11ab3b1ac3/sfaf165fig1.jpg

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