{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T11:43:00Z","timestamp":1793619780771,"version":"4.5.0"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,6,19]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              There is accumulating evidence that serum levels of non\u2013high\u2010density lipoprotein cholesterol (non\u2013\n              <jats:styled-content style=\"fixed-case\">HDL<\/jats:styled-content>\n              \u2010C) are a more accurate predictor of cardiovascular outcomes when compared with low\u2010density lipoprotein cholesterol. However, we recently found that higher serum concentrations of triglycerides are associated with better outcomes in patients undergoing hemodialysis. Therefore, we hypothesized that the association of serum levels of non\u2013\n              <jats:styled-content style=\"fixed-case\">HDL<\/jats:styled-content>\n              \u2010C (which includes triglyceride\u2010rich lipoproteins) with outcomes may also be different in patients undergoing hemodialysis when compared with other patient populations.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We studied the association of baseline and time\u2010dependent serum levels of non\u2013\n              <jats:styled-content style=\"fixed-case\">HDL<\/jats:styled-content>\n              \u2010C with all\u2010cause and cardiovascular mortality using Cox proportional hazard regression models in a nationally representative cohort of 50\u00a0118 patients undergoing incident hemodialysis from January 1, 2007, to December 31, 2011. In time\u2010dependent models adjusted for case mix and surrogates of malnutrition and inflammation, a graded inverse association between non\u2013\n              <jats:styled-content style=\"fixed-case\">HDL<\/jats:styled-content>\n              \u2010C level and mortality was demonstrated with hazard ratios (95% confidence intervals) of the lowest (&lt;60\u00a0mg\/dL) and highest (\u2265160\u00a0mg\/dL) categories: 1.88 (1.72\u20132.06) and 0.73 (0.64\u20130.83) for all\u2010cause mortality and 2.07 (1.78\u20132.41) and 0.75 (0.60\u20130.93) for cardiovascular mortality, respectively (reference, 100\u2013115\u00a0mg\/dL). In analyses using baseline values, non\u2013\n              <jats:styled-content style=\"fixed-case\">HDL<\/jats:styled-content>\n              \u2010C levels &lt;100\u00a0mg\/dL were also associated with significantly higher mortality risk across all levels of adjustment. Similar associations were found when evaluating non\u2010\n              <jats:styled-content style=\"fixed-case\">HDL<\/jats:styled-content>\n              \/\n              <jats:styled-content style=\"fixed-case\">HDL<\/jats:styled-content>\n              cholesterol ratio and mortality, with the highest all\u2010cause and cardiovascular mortality being observed in patients with decreased non\u2010\n              <jats:styled-content style=\"fixed-case\">HDL<\/jats:styled-content>\n              \/\n              <jats:styled-content style=\"fixed-case\">HDL\u2010C<\/jats:styled-content>\n              ratio (&lt;2.5).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Contrary to the general population, decrements in non\u2013\n              <jats:styled-content style=\"fixed-case\">HDL<\/jats:styled-content>\n              \u2010C and non\u2010\n              <jats:styled-content style=\"fixed-case\">HDL<\/jats:styled-content>\n              \/\n              <jats:styled-content style=\"fixed-case\">HDL<\/jats:styled-content>\n              cholesterol ratio were paradoxically associated with increased all\u2010cause and cardiovascular mortality in patients undergoing incident hemodialysis. The underlying mechanisms responsible for these associations await further investigation.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.118.009096","type":"journal-article","created":{"date-parts":[[2018,6,9]],"date-time":"2018-06-09T09:15:11Z","timestamp":1528535711000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":33,"title":["Inverse Association Between Serum Non\u2013High\u2010Density Lipoprotein Cholesterol Levels and Mortality in Patients Undergoing Incident Hemodialysis"],"prefix":"10.1161","volume":"7","author":[{"given":"Tae Ik","family":"Chang","sequence":"first","affiliation":[{"name":"Harold Simmons Center for Kidney Disease Research and Epidemiology School of Medicine University of California Irvine CA"},{"name":"Department of Internal Medicine National Health Insurance Service Medical Center Ilsan Hospital Goyangshi 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