Journal
INTERNATIONAL UROLOGY AND NEPHROLOGY
Volume 52, Issue 7, Pages 1357-1365Publisher
SPRINGER
DOI: 10.1007/s11255-020-02498-8
Keywords
High-density lipoprotein cholesterol; Dialysis initiation; Gender difference; Multicenter prospective cohort study; Cardiovascular event
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Purpose This study aimed to clarify the relationship between serum high-density lipoprotein cholesterol (HDL-C) level and incidence of CV events. Moreover, the relationship stratified by gender was evaluated. Methods The study database was derived from a multicenter, prospective, cohort study that included 1520 incident dialysis patients in Aichi Prefecture, Japan. Baseline was defined as the time of dialysis initiation and outcome as incidence of CV event. The enrolled patients were first classified into four quartile groups (Q1, Q2, Q3, and Q4; Q1 was the lowest serum HDL-C) based on serum HDL-C level. A multivariate Cox proportional hazards analysis was conducted using the stepwise regression method to determine factors associated with outcomes and was performed in each gender. Results The log-rank test revealed significant differences in the incidence of CV events between not only the four groups (p = 0.003) but also the male and female patients (HR, 0.74; 95% CI, 0.59-0.92;p < 0.001). Stepwise regression analysis indicated that higher serum HDL-C level was significantly associated with lower incidence of CV events (HR, 0.88; 95% CI, 0.82-0.95;p = 0.001). The association between serum HDL-C and incidence of CV events could be clarified in only female patients (male patients; HR, 0.92; 95% CI, 0.84-1.01;p = 0.067 and female patients; HR, 0.81; 95% CI, 0.72-0.92;p = 0.001). Conclusions HDL-C level at the initiation of dialysis was associated with the incidence of CV events. Moreover, the association was prominent in female patients.
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