title: Serum non-high-density lipoprotein cholesterol (non-HDL-C) levels and cardiovascular mortality in chronic hemodialysis patients.
abstract: 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).
  
  
  CONCLUSIONS
  The results of this study suggest that serum non-HDL-C level is a significant CV mortality predictor of chronic HD patients.
authors.affiliation: Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Echida
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ogawa
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Otsuka
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Ando
authors.forename: Kosaku
authors.initials: K
authors.lastname: Nitta
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality*; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D006435:Renal Dialysis / Q000401:mortality*; D018570:Risk Assessment
chemical_list: D008076:Cholesterol, HDL; D002784:Cholesterol