Citation: | ZHANG Shuyuan, HUANG Yongtao, YU Wenjin. Relationship between non-high-density lipoprotein cholesterol and cardiovascular disease in maintenance hemodialysis patients[J]. Journal of Clinical Medicine in Practice, 2025, 29(5): 106-111. DOI: 10.7619/jcmp.20244504 |
To investigate the relationship between non-high-density lipoprotein cholesterol (non-HDL-C) and cardiovascular disease (CVD) in maintenance hemodialysis (MHD) patients.
A total of 124 MHD patients were enrolled and divided into CVD group (53 patients) and non-CVD group (71 patients) based on the presence or absence of CVD. Clinical data between the two groups were compared. Additionally, patients were divided into severe calcification group [coronary artery calcification score (CACS) ≥400, 40 patients] and non-severe calcification group (CACS < 400, 84 patients) based on CACS, and clinical data between these two groups were also compared. Multivariate Logistic regression analysis was used to explore the independent risk factors for CVD in MHD patients, and the predictive performance of related indicators for CVD in MHD patients was assessed using receiver operating characteristic (ROC) curves.
The levels of serum total cholesterol, low-density lipoprotein cholesterol (LDL-C), and non-HDL-C were higher, while the level of high-density lipoprotein cholesterol (HDL-C) was lower in the CVD group compared with the non-CVD group (P < 0.05). The levels of serum total cholesterol, LDL-C, and non-HDL-C were higher, and the level of HDL-C was lower in the severe calcification group compared with the non-severe calcification group (P < 0.05). Multivariate Logistic regression analysis showed that high levels of LDL-C and non-HDL-C were both independent risk factors for CVD in MHD patients (P < 0.05). ROC curve analysis showed that the areas under the curve for predicting CVD in MHD patients were 0.858 and 0.723 for non-HDL-C and LDL-C, respectively, and non-HDL-C had higher specificity and Youden index than LDL-C.
Elevated non-HDL-C level is an independent risk factor and has high predictive performance for CVD in MHD patients.
[1] |
WANG H F, LIU J, XIE D M, et al. Elevated serum uric acid and risk of cardiovascular or all-cause mortality in maintenance hemodialysis patients: a meta-analysis[J]. Nutr Metab Cardiovasc Dis, 2021, 31(2): 372-381. doi: 10.1016/j.numecd.2020.11.017
|
[2] |
LIU S X, WU Q J, ZHANG S, et al. Serum Galectin-3 levels and all-cause and cardiovascular mortality in maintenance hemodialysis patients: a prospective cohort study[J]. BMC Nephrol, 2022, 23(1): 5. doi: 10.1186/s12882-021-02636-z
|
[3] |
MIZUIRI S, NISHIZAWA Y, DOIT, et al. Iron, coronary artery calcification, and mortality in patients undergoing hemodialysis[J]. Ren Fail, 2021, 43(1): 371-380. doi: 10.1080/0886022X.2021.1880937
|
[4] |
DOMANSKI M J, TIAN X, WU C O, et al. Time course of LDL cholesterol exposure and cardiovascular disease event risk[J]. J Am Coll Cardiol, 2020, 76(13): 1507-1516. doi: 10.1016/j.jacc.2020.07.059
|
[5] |
SNIDERMAN A D. ApoB vs non-HDL-C vs LDL-C as markers of cardiovascular disease[J]. Clin Chem, 2021, 67(11): 1440-1442. doi: 10.1093/clinchem/hvab140
|
[6] |
PENCINA K M, THANASSOULIS G, WILKINS J T, et al. Trajectories of non-HDL cholesterol across midlife implications for cardiovascular prevention[J]. J Am Coll Cardiol, 2019, 74(1): 70-79. doi: 10.1016/j.jacc.2019.04.047
|
[7] |
江玉波, 王少清, 赖玮婧. 维持性血液透析患者冠状动脉钙化危险因素分析[J]. 临床心血管病杂志, 2021, 37(5): 428-432.
|
[8] |
KHODABANDEH N, TAZIKI E, ALIREZAEI T. Serum uric acid as a predictor of cardio- and cerebro-vascular diseases in maintenance hemodialysis patients[J]. Rom J Intern Med, 2022, 60(2): 115-122.
|
[9] |
李明, 李灿明, 叶增纯, 等. 维持性血液透析患者死亡及其危险因素的单中心分析[J]. 中山大学学报: 医学科学版, 2020, 41(4): 620-626.
|
[10] |
PACKARD C, CHAPMAN M J, SIBARTIE M, et al. Intensive low-density lipoprotein cholesterol lowering in cardiovascular disease prevention: opportunities and challenges[J]. Heart, 2021, 107(17): 1369-1375. doi: 10.1136/heartjnl-2020-318760
|
[11] |
于洋杰, 谢坤, 高秀芳, 等. 非高密度脂蛋白胆固醇可以替代低密度脂蛋白胆固醇吗[J]. 心血管病学进展, 2021, 42(1): 12-16.
|
[12] |
AGGARWAL D J, KATHARIYA M G, VERMA D P K. LDL-C, NON-HDL-C and APO-B for cardiovascular risk assessment: Looking for the ideal marker[J]. Indian Heart J, 2021, 73(5): 544-548. doi: 10.1016/j.ihj.2021.07.013
|
[13] |
MACH F, BAIGENT C, CATAPANO A L, et al. 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk[J]. Eur Heart J, 2020, 41(1): 111-188.
|
[14] |
WU J, ZHANG J, WANG A, et al. Association between non-high-density lipoprotein cholesterol levels and asymptomatic vulnerable carotid atherosclerotic plaques[J]. Eur J Neurol, 2019, 26(12): 1433-1438.
|
[15] |
BRUNNER F J, WALDEYER C, OJEDA F, et al. Application of non-HDL cholesterol for population-based cardiovascular risk stratification: results from the Multinational Cardiovascular Risk Consortium[J]. Lancet, 2019, 394(10215): 2173-2183.
|
[16] |
HU H, FUKUNAGA A, YOKOYA T, et al. Non-high-density lipoprotein cholesterol and risk of cardiovascular disease: the Japan epidemiology collaboration on occupational health study[J]. J Atheroscler Thromb, 2022, 29(9): 1295-1306.
|
[17] |
SUH S H, OH T R, CHOI H S, et al. Non-high-density lipoprotein cholesterol and cardiovascular outcomes in chronic kidney disease: results from KNOW-CKD study[J]. Nutrients, 2022, 14(18): 3792.
|
[18] |
ARMSTRONG M K, FRASER B J, HARTIALA O, et al. Association of non-high-density lipoprotein cholesterol measured in adolescence, young adulthood, and mid-adulthood with coronary artery calcification measured in mid-adulthood[J]. JAMA Cardiol, 2021, 6(6): 661-668.
|
[19] |
GENTILE M, IANNUZZI A, GIALLAURIA F, et al. Association between very low-density lipoprotein cholesterol (VLDL-C) and carotid intima-media thickness in postmenopausal women without overt cardiovascular disease and on LDL-C target levels[J]. J Clin Med, 2020, 9(5): 1422.
|
[20] |
HOOGEVEEN R C, BALLANTYNE C M. Residual cardiovascular risk at low LDL: remnants, lipoprotein(a), and inflammation[J]. Clin Chem, 2021, 67(1): 143-153.
|
[21] |
曹岩, 颜培实. 残余胆固醇与动脉粥样硬化性心血管疾病[J]. 心血管病学进展, 2021, 42(10): 920-923.
|
[22] |
CARBAYO HERENCIA J A, SIMARRO RUEDA M, PALAZÓN BRU A, et al. Evaluation of non-HDL cholesterol as a predictor of non-fatal cardiovascular events in a prospective population cohort[J]. Clin Investig Arterioscler, 2018, 30(2): 64-71.
|