Abstract
BackgroundTo investigate the association between the ratio of apolipoprotein B (apo B) / apolipoprotein A1 (apo A1) with all-cause mortality and cardiovascular events in peritoneal dialysis (PD) patients.MethodsEight hundred and sixty incident PD patients were enrolled from November 1, 2005, to February 28, 2017, and followed until May 31, 2017. Outcomes were all-cause mortality and cardiovascular events. Associations between the apo B/apo A1 ratio with all-cause mortality and cardiovascular events were evaluated using multivariable-adjusted Cox models.ResultsOf the 860 patients, the mean age was 49.9 ± 14.5 years, 57.6% were men, and 19.3% were diabetic patients. The median apo B/apo A1 ratio was 0.65 (range: 0.22–2.24). During a median follow-up period of 27 months (interquartile range, 13 – 41 months), 202 deaths, and 145 cardiovascular events were recorded. After adjustment for age, sex, body mass index, diabetes, cardiovascular disease, systolic blood pressure, total Kt/V, estimated glomerular filtration rate, hemoglobin level, neutrophil to lymphocyte ratio and albumin, triglyceride, and cholesterol, as well as the use of lipid-lowering agents, the highest apo B/apo A1 ratio tertile was significantly associated with a hazard ratio for all-cause mortality of 1.60 (95% CI: 1.02 to 2.49, P = 0.040) and for cardiovascular events of 2.04 (95% CI: 1.21 to 3.44, P = 0.008).ConclusionAn increased apo B/apo A1 ratio was independently associated with all-cause mortality and cardiovascular events in PD patients.
Highlights
To investigate the association between the ratio of apolipoprotein B / apolipoprotein A1 with all-cause mortality and cardiovascular events in peritoneal dialysis (PD) patients
We hypothesized that a higher ratio of apolipoprotein B (apo B)/apolipoprotein A1 (apo A1) is a critical parameter to predict the risk of cardiovascular events and all-cause mortality in PD patients
Thirty-four of the patients were excluded by our experimental criteria and listed as below: 3 subjects were under 18 years of age, 2 subjects were transferred from failed renal transplantation, 8 subjects were transferred from permanent HD, and 21 subjects were treated with PD for less than 3 months
Summary
To investigate the association between the ratio of apolipoprotein B (apo B) / apolipoprotein A1 (apo A1) with all-cause mortality and cardiovascular events in peritoneal dialysis (PD) patients. Peritoneal dialysis (PD) patients have an increased risk of morbidity and mortality associated with cardiovascular disease (CVD), which is, at least in part, due to lipid abnormalities, typically called uremic dyslipidemia [1]. In particular the lipid profile is more atherogenic in nature with more altered dyslipidemia when compared with those in HD patients [10]. We hypothesized that a higher ratio of apo B/apo A1 is a critical parameter to predict the risk of cardiovascular events and all-cause mortality in PD patients. In this longitudinal cohort study, we assessed the associations between the apo B/apo A1 ratio with all-cause mortality and cardiovascular events in PD patients, and followed the patients for a median of 27 months at our PD center
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