Abstract

This study examined whether the triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio is associated with cardiovascular and all-cause mortality among non-diabetic patients undergoing hemodialysis. From June 2017 to December 2023, patients followed until December 2024 were categorized into two groups based on their baseline TG/HDL-C ratio: those with a high TG/HDL-C ratio (>3.29) and those with a non-elevated TG/HDL-C ratio (≤3.29). The association between TG/HDL-C ratio and CV and all-cause mortality was examined by univariate and multivariate Cox regression analyses. Of the 138 patients, 43 were categorized into the high TG/HDL-C ratio group and 95 into the non-elevated TG/HDL-C ratio group. The non-elevated TG/HDL-C ratio group had significantly increased cardiovascular survival rates of 1, 3, and 5 years (97.8% vs. 85.2%, 96.2% vs. 70.0%, and 87.0% vs. 52.2%, respectively; p < 0.05) and overall survival rates of 1, 3, and 5 years (95.8% vs. 79.1%, 89.6% vs. 62.9%, and 73.9% vs. 40.7%, respectively; p < 0.05). In the proportional hazards model, a high TG-HDL ratio was an independent predictor of cardiovascular mortality (hazard ratio [HR]: 6.799; 95% confidence interval [CI]: 2.276–20.313; p = 0.001) and all-cause mortality (HR: 2.88; 95% CI: 1.16–7.17; p = 0.023). A high TG/HDL-C ratio was associated with CV and overall mortality in non-diabetic HD patients. Further research will be required to explore changes in the serum TG/HDL-C ratio, assess lipoprotein profiles, and determine their outcomes in this group.