Correlation Of Serum Non-HDL-C/HDL-C Ratio In All-cause Mortality And Cardiovascular Mortality In Maintenance Hemodialysis Patients

Objective: In recent years,the non-HDL-C/HDL-C ratio has been reported to play an important role in promoting coronary atherosclerosis,but how the role of non-HDLC/HDL-C in maintenance hemodialysis is less reported.thus we aim to investigate the relationship between serum non-HDL-C/HDL-C ratio and all-cause mortality and cardiovascular death in maintenance hemodialysis patients.Methods: Patients with end-stage renal disease who started hemodialysis treatment for 3 months or more at the Hemodialysis Center,Department of Nephrology,The First Affiliated Hospital of Nanchang University,from May14,2010 to December 31,2019,were collected for inclusion in the study.Fasting laboratoryparameters and related data were collected within the first 1 week before the first dialysis as the basic information and a retrospective study with telephone follow-up until September30,2021,with the endpoints of all-cause and cardiovascular mortality.The non-HDL-C/HDL-C ratio from the collected baseline data was divided into N1 patient group(non-HDL-C/HDL-C≤2.055)and N2 patient group(non-HDLC/HDL-C>2.055)according to X-tile software,and the Kaplan-Meier survival curves were used to compare the survival rates of the 2 groups.The correlation between nonHDL-C/HDL-C and all-cause mortality and cardiovascular event(CVD)mortality in MHD patients was analyzed using Cox regression analysis.Results: According to the inclusion criteria,a total of 442 patients were included,with an average age of 65(52,75.25)years and 280(63.35%)males.Negatively correlated follow-up at 44 months to end point,with all-cause mortality as the outcome in 155 patients,including 60 cardiovascular deaths(38.7%).Among the causes of endstage renal disease,chronic glomerulonephritis was found in 200 cases(45.25%),diabetic nephropathy in 134 cases(30.32%)and hypertensive nephropathy in 66 cases(14.93%).Survival analysis of the data after grouping of non-HDL-C/HDLC,According to Kaplan-Meier survival curves,the all-cause survival and cardiovascular survival rates of patients in the lower non-HDL-C/HDL-C group were significantly higher than those in the higher group(P<0.05).Cox proportional risk regression model analysis showed that non-HDL-C/HDL-C in the N2 group was the leading cause of allcause death in patients with MHD,using the N1 group as the control group [HR(95%CI)= 1.57(1.06-2.31),P<0.05],while the non-HDL-C/HDL-C ratio in the non-HDLC/HDL-C>2.055 group was an independent risk factor for the occurrence of death from cardiovascular events [HR(95% CI)= 2.81(1.38～5.73),P<0.01].Conclusions: This study investigated the relationship between non-HDL-C/HDLC ratio and all-cause and cardiovascular mortality in maintenance hemodialysis patients.It was found that the mortality rate of cardiovascular in maintenance hemodialysis patients was high,and non-HDL-C/HDL-C>2.055 was an independent risk source for all-cause mortality and cardiovascular mortality in maintenance hemodialysis patients.particularly significant in cardiovascular mortality,After calibration for each risk factor.