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Higher Serum Total Cholesterol to High-Density Lipoprotein Cholesterol Ratio Is Associated with Increased Mortality among Incident Peritoneal Dialysis Patients
Authors:Hee-Won Noh  Yena Jeon  Ji-Hye Kim  Ga-Young Lee  Soo-Jee Jeon  Kyu-Yeun Kim  Jeong-Hoon Lim  Hee-Yeon Jung  Ji-Young Choi  Sun-Hee Park  Chan-Duck Kim  Yong-Lim Kim  Jang-Hee Cho
Affiliation:1.Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea; (H.-W.N.); (J.-H.K.); (G.-Y.L.); (S.-J.J.); (K.-Y.K.); (J.-H.L.); (H.-Y.J.); (J.-Y.C.); (S.-H.P.); (C.-D.K.);2.Department of Statistics, Kyungpook National University, Daegu 41566, Korea;3.Cell and Matrix Research Institute, Kyungpook National University, Daegu 41944, Korea
Abstract:
This study evaluated the association of the serum total cholesterol to high-density lipoprotein cholesterol ratio (TC/HDL-C) with mortality in incident peritoneal dialysis (PD) patients. We performed a multi-center, prospective cohort study of 630 incident PD patients from 2008 to 2015 in Korea. Participants were stratified into quintiles according to baseline TC, HDL-C, LDL-C and TC/HDL-C. The association between mortality and each lipid profile was evaluated using multivariate Cox regression analysis. During a median follow-up period of 70.3 ± 25.2 months, 185 deaths were recorded. The highest TC/HDL-C group had the highest body mass index, percentage of diabetes and serum albumin level. Multivariate analysis demonstrated that the highest quintile of TC/HDL-C was associated with increased risk of all-cause mortality (hazard ratio 1.69, 95% confidence interval 1.04–2.76; p = 0.036), whereas TC, HDL-C and LDL-C were not associated with mortality. Linear regression analysis showed a positive correlation between TC/HDL-C and body mass index. Increased serum TC/HDL-C was an independent risk factor for mortality in the subgroup of old age, female, cardiovascular disease and low HDL-C. The single lipid marker of TC or HDL-C was not able to predict mortality in PD patients. However, increased serum TC/HDL-C was independently associated with all-cause mortality in PD patients.
Keywords:total cholesterol   high-density lipoprotein cholesterol   mortality   peritoneal dialysis
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