Hyperlipidemia and mortality associated with diabetes mellitus co-existence in Chinese peritoneal dialysis patients

Lipids Health Dis. 2020 Nov 7;19(1):234. doi: 10.1186/s12944-020-01405-5.

Abstract

Background: To evaluate associations between diabetes mellitus (DM) coexisting with hyperlipidemia and mortality in peritoneal dialysis (PD) patients.

Methods: This was a retrospective cohort study with 2939 incident PD patients in China from January 2005 to December 2018. Associations between the DM coexisting with hyperlipidemia and mortality were evaluated using the Cox regression.

Results: Of 2939 patients, with a median age of 50.0 years, 519 (17.7%) died during the median of 35.1 months. DM coexisting with hyperlipidemia, DM, and hyperlipidemia were associated with 1.93 (95% CI 1.45 to 2.56), 1.86 (95% CI 1.49 to 2.32), and 0.90 (95% CI 0.66 to 1.24)-time higher risk of all-cause mortality, compared with without DM and hyperlipidemia, respectively (P for trend < 0.001). Subgroup analyses showed a similar pattern. Among DM patients, hyperlipidemia was as a high risk of mortality as non-hyperlipidemia (hazard ratio 1.02, 95%CI 0.73 to 1.43) during the overall follow-up period, but from 48-month follow-up onwards, hyperlipidemia patients had 3.60 (95%CI 1.62 to 8.01)-fold higher risk of all-cause mortality than those non-hyperlipidemia (P interaction = 1.000).

Conclusions: PD patients with DM coexisting with hyperlipidemia were at the highest risk of all-cause mortality, followed by DM patients and hyperlipidemia patients, and hyperlipidemia may have an adverse effect on long-term survival in DM patients.

Keywords: Diabetes mellitus; Follow-up; Hyperlipidemia; Long-term survival; Mortality; Peritoneal dialysis; Prognosis.

MeSH terms

  • Adult
  • Aged
  • China / epidemiology
  • Diabetes Complications / mortality*
  • Diabetes Complications / pathology
  • Diabetes Mellitus / mortality*
  • Diabetes Mellitus / pathology
  • Female
  • Humans
  • Hyperlipidemias / complications
  • Hyperlipidemias / mortality*
  • Hyperlipidemias / pathology
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Peritoneal Dialysis / adverse effects
  • Peritoneal Dialysis / mortality*
  • Risk Factors