Association between the Triglyceride to High-Density Lipoprotein Cholesterol Ratio and Mortality in Maintenance Haemodialysis Patients

Background: In the general population, TG/HDL-C is as a marker of cardiovascular (CV) events and death. However, studies on TG/HDL-C in haemodialysis (HD) patients are limited, and the results are controversial. This study investigated the TG/HDL-C ratio and all-cause and CV mortality in HD patients. Methods: In this retrospective cohort study, 582 HD patients were enrolled from June 2015 to September 2016 and followed through September 2021. The outcomes were all-cause death and CV mortality. The optimal threshold for the TG/HDL-C ratio was determined by Youden's index in receiver-operating characteristic curve analyses, and the Kaplan–Meier method and log rank test were applied to assess groups. The association between TG/HDL-C and mortality was analysed by adjusted multivariate Cox proportional hazard regression models. Results: During the median follow-up of 68 months, 159 patients died, with 82 (51.6%) classified as CV death. The optimal threshold of the TG/HDL-C ratio was determined to be 1.71. Kaplan–Meier curves confirmed that patients with TG/HDL-C ≥1.71 had significantly lower all-cause mortality (log rank test, p = 0.007) and cardiovascular mortality (log rank test, p = 0.006). After adjusting for confounders, multivariate Cox regression analysis showed that TG/HDL-C ≥1.71 was associated with decreased all-cause mortality (adjusted hazard ratio [HR] 0.67, 95% confidence interval [CI] 0.47-0.95, P=0.026) and cardiovascular mortality (adjusted HR: 0.59; 95% CI: 0.36-0.99; P=0.045) in HD patients. Conclusion: TG/HDL-C is an independent protective factor for mortality in HD patients. High TG/HDL-C was associated with decreased all-cause and CV mortality in HD patients.