Objective To investigate the correlation of atherogenic index of plasma (AIP) and non-high-density lipoprotein cholesterol (non-HDL-C) with the vascular access failure (VAF) in hemodialysis patients, and to evaluate the prediction value of AIP and non-HDL-C for VAF risks. Methods A total of 277 patients on maintenance hemodialysis (MHD) with autologous arteriovenous fistula (AVF) treated in the Dialysis Center of Beijing Chaoyang Hospital from January 2017 to December 2021 were recruited. They were divided into VAF group (n=85) and non-VAF group (n=192). AIP, non-HDL-C and clinical characteristics were compared between the two groups. Multivariate COX regression was used to analyze the independent factors for VAF risks. ROC curve was drawn to evaluate the prediction value for VAF risks by AIP and non-HDL-C in MHD patients. Results AIP (Z=7.331, P<0.001) and non-HDL-C (Z=6.566, P<0.001) were statistically higher in the VAF group than in the non-VAF group. After adjustment for sex, age, blood creatinine and uric acid, AIP (HR=8.757; 95% CI: 4.134, 18.548; P< 0.001) and non-HDL-C (HR=1.533; 95% CI:1.094, 2.150; P<0.001) remained the independent factors for VAF risks. AUC of the prediction for VAF risks by AIP was 0.776 (95% CI:0.722, 0.831), by non-HDL-C was 0.747 (95% CI:0.690, 0.805), and by combined both was 0.805 (95% CI:0.690, 0.805). Conclusions AIP and non-HDL-C are the independent factors for VAF risks. AIP, non-HDL-C or combination of the two have a good predictive value for VAF risks.
[1]中国医院协会血液净化中心分会血管通路工作组.中国血液透析用血管通路专家共识第版[J].中国血液净化, 2019, 18(6):365-381
[2]Chazan J.A., London M.R., Pono L.M. Long-term survival of vascular accesses in a large chronic hemodialysis population. [J].Nephron, 1995, 69(0):228-233
[3]Girerd S， Girerd N， Frimat L， et a1.Arteriovenous fistula thrombosis is associated with increased all-cause and cardiovascular mortality in haemodialysis patients from the AURORA trial. [J]. Clin Kidney J, 219, 13(1):116-12
[4]Faure V, Dou L, Sabatier F, et al.Elevation of circulating endothelial microparticles in patients with chronic renal failure.[J].J. Thromb. Haemost., 2006, 4(0):566-573
[5]Dong Ho Shin，So Yon Rhee，Hee Jung Jeon.An Increase in Mean Platelet Volume/Platelet Count Ratio Is Associated with Vascular Access Failure in Hemodialysis Patients.[J].PLoS One. , 2017, 12(1):e0170357.-e0170357.
[6]Kalantar-Zadeh K, Block G, Horwich T, Fonarow GC: .Reverse epidemiology of conventional cardiovascular risk factors in patients with chronic heart failure[J].J Am Coll Cardiol, 2004, 43(0):1439-1444
[7]Zhan Y, Xu T and Tan X.Two parameters reflect lipiddriven inflammatory state in acute coronary syndrome: atherogenic index of plasma, neutrophillymphocyte ratio.[J]. BMC Cardiovasc Disord , 2016, 16(0):96-96
[8]Yildiz G, Duman A, Aydin H, Yilmaz A, et al.Evaluation of association between atherogenic index of plasma and intima-media thickness of the carotid artery for subclinic atherosclerosis in patients on maintenance hemodialysis.[J]. Hem Int., 2013, 17(3):397-405
[9]Mi Jung Lee, Jung Tak Park, Seung Hyeok Han, et al.The atherogenic index of plasma and the risk of mortality in incident dialysis patients: Results from a nationwide prospective cohort in Korea. [J].PLoS One., 2017, 12(5): e0177499.- e0177499.
[10]Wanner C, Krane V: .Non-high-density lipoprotein cholesterol: A target of lipid-lowering in dialysis patients.[J].Am J Kidney Dis ., 2003, 41(0):s72-75
[11]Shoji T, Masakane I, Watanabe Y, et al.Elevated non‐high‐density lipoprotein cholesterol (non‐HDL‐C) predicts atherosclerotic cardiovascular events in hemodialysis patients. [J].Clin J Am Soc Nephrol. , 2011, 6(0):1112-1120
[12]Hofstra L, Tordoir JH, Kitslaar PJ, et al.Enhanced cellular proliferation in intact stenotic lesions derived from human arteriovenous fistulas and peripheral bypass grafts. Does it correlate with flow parameters? [J].Circulation. , 1996 Sep 15, 94(6):1283-120
[13]文洁.血浆致动脉粥样硬化指数与非酒精性脂肪性肝病的相关性[J].临床荟萃, 2022, 37(1):35-38
[14]Feldman HI, Joffe M, Rosas SE, et al.Predictors of successful arteriovenous fistula maturation. [J].Am J Kidney Dis. , 2003, 42(0):1000-1012
[15]Salmela B, Hartman J, Peltonen S, et al.Thrombophilia and arteriovenous fistula survival in ESRD. [J].Clin. J. Am. Soc. Nephrol., 2013, 8(0):962-968
[16]Gian Manlio Gagliardi, Stefania Rossi, Francesca Condino, et al.Malnutrition, infection and arteriovenous fistula failure: is there a link?[J]. J Vasc Access. , 2011Jan-Mar, 12(1):57-62
[17]Dobiásová M, Frohlich J.The plasma parameter log (TG/HDL-C) as an atherogenic index: correlation with lipoprotein particle size and esterification rate in apoB-lipoprotein-depleted plasma (FER (HDL)). [J].Clin Biochem., 2001, 34(7):583-588
[18]Cai G, Shi G, Xue S, et al.The atherogenic index of plasma is a strong and independent predictor for coronary artery disease in the Chinese Han population.[J]. Medicine (Baltimore). , 2017, 96(37):e8058.-e8058.
[19]McLaughlin T, Reaven G, Abbasi F, Lamendola C, et al.Is there a simple way to identify insulin-resistant individuals at increased risk of cardiovascular disease? [J].Am J Cardiol. , 2005, 96(3):399-404
[20]Onat A, Can G, Kaya H, et al." Atherogenic index of plasma" (log10 triglyceride/high-density lipoprotein-cholesterol) predicts high blood pressure, diabetes, and vascular events. [J].J Clin Lipidol., 2010, 4(2):89-98
[21]Jing Wu, Qiang Zhou, Zhouxia Wei，et al.Atherogenic Index of Plasma and Coronary Artery Disease in the Adult Population: A Meta-Analysis. [J].Front Cardiovasc Med. , 2021 Dec 16; , 8(0):817441-817441
[22]Hongbing Liu, Kai Liu, Lulu Pei，et al.Atherogenic Index of Plasma Predicts Outcomes in Acute Ischemic Stroke. [J].Front Neurol. , 2021 Oct, 12(0):741754-741754
[23]Cengiz Güven, Arda Aybars Pala, Yusuf Salim Urcun.Effects of plasma atherogenic index and plasma osmolality on arteriovenous fistula patency in hemodialysis patients. J Vasc Access, [J].J Vasc Access, , 2021 Jun 11, 0(0): 11297298211011864. Online ahead of print.- 11297298211011864. Online ahead of print.
[24]Johansen O, Abdelnoor M, Brekke M, et al.Predictors of restenosis after coronary angioplasty. A study on demographic and metabolic variables.[J]. Scand Cardiovasc J. , 2001, 35(0):86-91
[25]Kilpatrick RD, McAllister CJ, Kovesdy CP, et al.Association between serum lipids and survival in hemodialysis patients and impact of race.[J]. J Am Soc Nephrol., 2007, 18(1):293-303
[26]Peng J, Luo F, Ruan G, et al.Hypertriglyceridemia and atherosclerosis. [J].Lipids Health Dis , 2017, 16(1):233-233
[27]Verbeek R, Hovingh GK, Boekholdt SM.Non‐high‐density lipoprotein cholesterol: current status as cardiovascular marker. [J].Curr Opin Lipidol. , 2015, 26(0):502-510
[28]Tetsuo Shoji，Ikuto Masakane, Yuzo Watanabe, et al.Elevated Non-high-density Lipoprotein Cholesterol (Non-HDL-C) Predicts Atherosclerotic Cardiovascular Events in Hemodialysis Patients. [J].Clin J Am Soc Nephrol. , 2011 May, 6(5):1112-1120
[29]Hsuan Chiu, Pei-Yu Wu, Jiun-Chi Huang, et al.There is a U shaped association between non high density lipoprotein cholesterol with overall and cardiovascular mortality in chronic kidney disease stage 3–5. [J].Sci Rep. , 2020, 10(0):12749-12749
[30]Shapiro MD, Fazio S.Apolipoprotein B-containing lipoproteins and atherosclerotic cardiovascular disease. [J].F1000Res. , 2017, 6(0):134-134
[31]Karim El Harchaoui, Wim A van der Steeg, Erik S G Stroes, et al.Value of low-density lipoprotein particle number and size as predictors of coronary artery disease in apparently healthy men and women: the EPIC-Norfolk Prospective Population Study. [J].J. Am. Coll. Cardiol. 2007; 49:547–553., 2007, 49(0):547-553
[32]Desmeules S, Arcand‐Bossé JF, Bergeron J, et al.Nonfasting non‐high‐density lipoprotein cholesterol is adequate for lipid management in hemodialysis patients. [J].Am J Kidney Dis, 2005, 45(0):1067-1072
[33]Moradi H, Vaziri ND.Molecular mechanisms of disorders of lipid metabolism in chronic kidney disease. [J].Front Biosci (Landmark Ed)., 2018, 23(0):146-161
[34]Wanner C, Tonelli M.KDIGO Clinical Practice Guideline for Lipid Management in CKD: summary of recommendation statements and clinical approach to the patient. [J].Kidney Int., 2014, 85(0):1303-1309
