Serum non-high-density lipoprotein cholesterol (non-HDL-C) levels and cardiovascular mortality in chronic hemodialysis patients.

Echida, Yoshihisa; Ogawa, Tetsuya; Otsuka, Kuniaki; Ando, Yoshitaka; Nitta, Kosaku

Background: Non-high-density lipoprotein cholesterol (non-HDL-C) has been proposed as a predictor of cardiovascular disease (CVD) in the general population. The aim of this study was to evaluate the utility of non-HDL-C in predicting CV mortality in chronic hemodialysis (HD) patients. Methods: We calculated the serum non-HDL-C level of 259 HD patients by subtracting their HDL-C levels from their total cholesterol. Cox proportional hazards models were used to estimate the hazards ratio (HR) for CV mortality and the 95% confidence interval (CI). A receiver-operating characteristic (ROC) analysis was performed to estimate the relationship between sensitivity and specificity of a diagnostic parameter. Results: There were 44 deaths (17.0%) during the follow-up period, 33 (12.7%) of which were due to CVD. A multivariate Cox analysis with adjustments for age, diabetes, dialysis vintage, systolic blood pressure, serum albumin, and lipid levels showed that non-HDL-C was an independent predictor of CV mortality (HR 1.015, 95% CI 1.004-1.025, p = 0.0083). An ROC analysis showed that the plots of the non-HDL-C levels yielded significant specificity and sensitivity for predicting the risk of CVD mortality in HD patients [area under the curve (AUC) 0.62416; p = 0.0366; cutoff value 111.0 mg/dl]. The Kaplan-Meier survival curves of HD patients showed significant differences in CV mortality according to their tertiles with respect to serum non-HDL-C levels ( p = 0.0165). Conclusion: The results of this study suggest that serum non-HDL-C level is a significant CV mortality predictor of chronic HD patients.

LIPOPROTEINS; BLOOD lipoproteins; CARDIOVASCULAR disease related mortality; HEMODIALYSIS patients; PROPORTIONAL hazards models; DYSLIPIDEMIA

Clinical & Experimental Nephrology, 2012, Vol 16, Issue 5, p767

1342-1751

Academic Journal

10.1007/s10157-012-0615-5