ArticleBMC cancer2025
U-shaped association of serum lactate dehydrogenase with all-cause mortality in cancer patients: a retrospective cohort study.
Article in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed.
- Prognostic Value of Serial Lactate Dehydrogenase Measurements for Determining Early Mortality in ICU Patients: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Baseline inflammatory and metabolic indicators associated with early PD-1 inhibitor resistance in advanced cervical cancer: a retrospective cohort study.Frontiers in medicine · 2026Article
- U-Shaped Relationship Between Serum Lactate Dehydrogenase With Diabetic Lower Extremity Ulcers Among Diabetic Patients Aged ≥ 40 Years in NHANES.Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair SocietyArticle
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Authors and funding
4 authors.
Funding
Abstract
backgroundLactate dehydrogenase (LDH) is a vital metabolic enzyme with significant prognostic value in various diseases. However, the association between LDH levels and mortality risk in cancer patients remains insufficiently characterized.
methodsThis retrospective cohort study included 4,337 cancer patients from the National Health and Nutrition Examination Survey (NHANES) (1999-2018). The exposure variable was serum LDH levels, and the outcome was all-cause mortality. Covariates included demographic characteristics, anthropometric measures, metabolic indicators, and comorbidities. Multivariable Cox proportional hazard models were used to evaluate the association between LDH and mortality. The nonlinear relationship was further investigated using generalized additive models with penalized splines and two-piecewise Cox models. All statistical analyses were performed using EmpowerStats software.
resultsDuring a follow-up of 39,217.58 person-years, 1,779 deaths occurred. After full adjustment, each 10 U/L increase in LDH was associated with a 5.0% increased mortality risk (Hazard ratio [HR] = 1.05, 95% confidence interval [CI]: 1.03-1.07). A U-shaped relationship between LDH levels and mortality was observed, with an inflection point at 128 U/L, with mortality risk reduced by 7% below this threshold (HR = 0.93, 95% CI: 0.89-0.97) and increasing by 8% above this threshold (HR = 1.08, 95% CI: 1.06-1.10). This pattern was consistent across sexes, with optimal thresholds of 121 U/L for males and 136 U/L for females.
conclusionLDH demonstrates a U-shaped association with all-cause mortality in cancer patients, with sex-specific optimal ranges identified. These findings suggest that LDH levels within the identified ranges are associated with improved survival outcomes in patients with cancer.
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