The low-density lipoprotein cholesterol to high-density lipoprotein cholesterol (LDL-C/HDL-C) ratio constitutes a strong risk predictor of cardiovascular events. However, the association between this ratio and cardiovascular death in peritoneal dialysis (PD) patients is uncertain. The study aimed to investigate whether a high LDL-C/HDL-C ratio could predict both cardiovascular and all-cause mortalities in patients on PD. A total of 1616 incident patients on PD included from January 1, 2006 to December 31, 2013 were followed up with until 31 December 2018 in this single-center prospective cohort study. Participants were divided into three categories according to LDL-C/HDL-C ratio tertile. The primary endpoint was cardiovascular mortality; the secondary endpoint was all-cause mortality. The mean age of the study cohort was 47.5 years and the mean body mass index (BMI) was 21.6 kg/m2. During a median follow-up period of 47.6 months, 492 patients died, including 246 (50.0%) due to cardiovascular disease (CVD). A multivariate analysis revealed that the highest LDL-C/HDL-C ratio tertile was significantly associated with increased CVD mortality [hazard ratio (HR): 1.69, 95% CI: 1.24–2.29; P = 0.001] and all-cause mortality (HR: 1.46, 95% CI: 1.18–1.81; P = 0.001) relative to the lowest tertile. After adjusting for covariates, the HRs of cardiovascular and all-cause mortalities were 1.84 (95% CI: 1.25–2.71; P = 0.002) and 1.35 (95% CI: 1.03–1.77; P = 0.032). Subgroup analysis showed that the risk of CVD death rose with a higher LDL-C/HDL-C ratio among PD patients who were female, younger than 65 years old, without being malnourished (BMI ≥ 18.5 kg/m2 or albumin ≥35 g/L), and with a history of diabetes or CVD, respectively. A high LDL-C/HDL-C ratio is an independent risk factor for both cardiovascular and all-cause mortalities among PD patients.

中文翻译：

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腹膜透析中低密度脂蛋白胆固醇升高与高密度脂蛋白胆固醇比值升高与死亡率关系的预测研究


低密度脂蛋白胆固醇与高密度脂蛋白胆固醇（LDL-C/HDL-C）比率是心血管事件的强有力的风险预测因子。然而，该比率与腹膜透析（PD）患者心血管死亡之间的关系尚不确定。该研究旨在调查高 LDL-C/HDL-C 比率是否可以预测 PD 患者的心血管死亡率和全因死亡率。在这项单中心前瞻性队列研究中，从2006年1月1日至2013年12月31日，共有1616名PD事件患者被随访至2018年12月31日。根据 LDL-C/HDL-C 比率三分位，参与者被分为三类。主要终点是心血管死亡率；次要终点是全因死亡率。研究队列的平均年龄为 47.5 岁，平均体重指数 (BMI) 为 21.6 kg/m2。在中位随访时间 47.6 个月内，492 名患者死亡，其中 246 名患者 (50.0%) 死于心血管疾病 (CVD)。多变量分析显示，最高的 LDL-C/HDL-C 比率三分位与 CVD 死亡率增加显着相关[风险比 (HR)：1.69，95% CI：1.24–2.29； P = 0.001] 和全因死亡率（HR：1.46，95% CI：1.18-1.81；P = 0.001）相对于最低三分位数。调整协变量后，心血管死亡率和全因死亡率的 HR 分别为 1.84（95% CI：1.25-2.71；P = 0.002）和 1.35（95% CI：1.03-1.77；P = 0.032）。亚组分析显示，年龄小于 65 岁、无营养不良的女性 PD 患者（BMI ≥ 18.5 kg/m2 或白蛋白≥35 g/ L)，并且分别有糖尿病或CVD病史。 高 LDL-C/HDL-C 比值是 PD 患者心血管死亡和全因死亡的独立危险因素。