Objective To investigate the relationship between non-high-density lipoprotein cholesterol (non-HDL-C) and cardiovascular disease (CVD) in maintenance hemodialysis (MHD) patients.

Methods A total of 124 MHD patients were enrolled and divided into CVD group (53 patients) and non-CVD group (71 patients) based on the presence or absence of CVD. Clinical data between the two groups were compared. Additionally, patients were divided into severe calcification group coronary artery calcification score (CACS) ≥400, 40 patients and non-severe calcification group (CACS < 400, 84 patients) based on CACS, and clinical data between these two groups were also compared. Multivariate Logistic regression analysis was used to explore the independent risk factors for CVD in MHD patients, and the predictive performance of related indicators for CVD in MHD patients was assessed using receiver operating characteristic (ROC) curves.

Results The levels of serum total cholesterol, low-density lipoprotein cholesterol (LDL-C), and non-HDL-C were higher, while the level of high-density lipoprotein cholesterol (HDL-C) was lower in the CVD group compared with the non-CVD group (P < 0.05). The levels of serum total cholesterol, LDL-C, and non-HDL-C were higher, and the level of HDL-C was lower in the severe calcification group compared with the non-severe calcification group (P < 0.05). Multivariate Logistic regression analysis showed that high levels of LDL-C and non-HDL-C were both independent risk factors for CVD in MHD patients (P < 0.05). ROC curve analysis showed that the areas under the curve for predicting CVD in MHD patients were 0.858 and 0.723 for non-HDL-C and LDL-C, respectively, and non-HDL-C had higher specificity and Youden index than LDL-C.

Conclusion Elevated non-HDL-C level is an independent risk factor and has high predictive performance for CVD in MHD patients.