Non-high-density lipoprotein cholesterol may predict the cardio-cerebrovascular risk in patients on maintenance hemodialysis

Denggui Luo,Yueming Luo,Shunmin Li,Airong Qi,Yuanzhao Xu,Dong Yang,Jun Yang,Cai Xu,Bo Fu,Shuyi Ling,Yanhong Zou

doi:10.1186/s12944-021-01546-1

Abstract

BackgroundNon-high-density lipoprotein cholesterol (non-HDL-C) may be an independent risk factor for cardio-cerebrovascular disease (CVD); however, the cutoff level in patients on maintenance hemodialysis (MHD) is unknown.MethodsThis was a retrospective multicenter study of MHD patients treated at 10 dialysis centers in Guangdong Province from July 1, 2016, to April 1, 2017. Laboratory test data were collected and CVD complications and outcomes recorded.ResultsIn total, 1288 eligible patients were included in this study; the non-HDL-C interquartile range was 2.76 (2.24–3.45) mmol/L. Over a median follow-up time of 24 months, 141 patients developed CVD. The non-HDL-C level was a principal risk factor for such events (P < 0.05; 95% confidence interval 0.800–0.842). The maximum Youden index was 0.549 and the best cutoff > 3.39 mmol/L.ConclusionHigher baseline non-HDL-C levels may increase the CVD risk in MHD patients. Thus, non-HDL-C effectively predicts CVD.

Highlights

Non-high-density lipoprotein cholesterol may be an independent risk factor for cardiocerebrovascular disease (CVD); the cutoff level in patients on maintenance hemodialysis (MHD) is unknown
The Kaplan-Meier survival curve revealed a positive correlation between the non-high-density lipoprotein cholesterol (HDL-C) level and CVD incidence (P < 0.01; Fig. 3)
The ROC curves suggested that, compared to the total cholesterol (TC) (AUC 0.710, 95% confidence intervals (CIs) 0.684–0.735), TG (AUC 0.777, 95% CI 0.753– 0.799), and LDL-C (AUC 0.583, 95% CI 0.753–0.799) levels, the non-HDL-C level (AUC 0.822, 95% CI 0.800– 0.842) better predicted CVD (Fig. 4)

Summary

Introduction

Non-high-density lipoprotein cholesterol (non-HDL-C) may be an independent risk factor for cardiocerebrovascular disease (CVD); the cutoff level in patients on maintenance hemodialysis (MHD) is unknown. In 2017, 1.2 million people worldwide died from CKD [1]. End-stage renal disease (ESRD) has become a major public health problem given increased life expectancies worldwide [2]. More than 2.5 million people are on renal replacement therapy; the number is projected to double by 2030 [3]. Such patients are at high risk of cardio-cerebrovascular disease (CVD), which independently predicts a need for dialysis [4, 5].

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Results

Conclusion