China: Patients with diabetes and concurrent low HDL-C levels are at a higher risk for peritoneal dialysis-related peritonitis (PDRP) in peritoneal dialysis (PD) patients, shows a recent study in the journal Diabetology & Metabolic Syndrome.
In patients undergoing peritoneal dialysis, low levels of high-density lipoprotein cholesterol (HDL-C) and diabetes are common. Considering this, Yajuan Huang, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China, and colleagues aimed to examine the association between the coexistence of diabetes and a low level of HDL-C and the first episode of PDRP in patients with PD.

For this purpose, the researchers retrospectively investigated patients with PD from January 1, 2003, to May 31, 2020, in four PD centers. PD patients were categorized into four groups: no comorbidities, low HDL-C only, diabetes only, and diabetes plus low HDL-C. They collected and compared the clinical and laboratory baseline data of the four groups. Multivariate Cox regression analysis was used to analyze the association between diabetes coexisting with low HDL-C levels and the first episode of PDRP.
The study included a total of 1013 patients with PD. The mean age was 49.94 ± 14.32 years, and 597 (58.99%) patients were males.
The study led to the following findings:
A total of 301 (29.7%) patients had their first episodes of PDRP, and low HDL-C levels coexisted with diabetes in 72 patients with PD.
After adjusting for confounding factors, a low level of HDL-C coexisting with diabetes was significantly associated with the first episode of PDRP in our study (hazard ratio: 2.81).
The associations among HDL-C, diabetes, and PDRP were consistent in the following subgroups: sex, age, and pre-existing CVD.
"The results showed that compared to no comorbidities, the presence of both diabetes and t low HDL-C levels were more associated with the first episode of PDRP in patients with PD than either diabetes or low HDL levels alone," wrote the authors. "Therefore, in order to avoid PDRP, it is important to maintain normal levels of HDL-C in patients with diabetes with PD."
Reference:
Zhang, R., Zhang, X., Tang, X. et al. The association between diabetes coexisting with low levels of high-density lipoprotein cholesterol and peritoneal dialysis-related peritonitis. Diabetol Metab Syndr 14, 60 (2022). https://doi.org/10.1186/s13098-022-00832-x