综合糖脂代谢指标与冠状动脉病变严重程度的相关性研究

Correlation between glycolipid metabolism index and the severity of coronary artery disease

目的:探讨综合糖脂代谢指标与冠状动脉(冠脉)病变程度的关系及其临床意义。方法:入选2012年3月至2013年12月于我院接受冠脉造影的717例患者,根据造影结果分为冠脉造影阴性的对照组(n=385)和冠心病组(n=332)。检测所有研究对象的血清糖化血红蛋白(HbA1c)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、三酰甘油(TG)等,采用Gensini评分评估冠脉病变严重程度。采用Pearson相关系数分析连续性变量之间的相关性,Spearman相关系数检测分类变量之间的相关性。线性回归分析综合糖脂代谢指标HbA1c×LDL-C/HDL-C与Gensini积分的线性关系,非条件Logistic回归分析HbA1c×LDL-C/HDL-C与冠脉病变支数的相关性,受试者工作特征(ROC)曲线评价HbA1c×LDL-C/HDL-C预测冠脉严重程度、冠脉多支病变的价值。结果:血清HbA1c、LDL-C水平、HbA1c×LDL-C/HDLC与Gensini积分呈正相关,而HDL-C水平与Gensini积分呈负相关。线性回归显示HbA1c×LDL-C/HDL-C与Gensini积分呈线性相关,其判断冠脉病变严重程度的ROC曲线下面积为0.724(P<0.01)。Logistic回归分析显示HbA1c×LDL-C/HDL-C与冠脉病变支数显著相关,其判断冠脉病变支数的ROC曲线下面积为0.638(P<0.01)。结论:综合糖脂代谢指标对冠脉粥样硬化病变严重程度、病变支数有一定的预测价值。

Objective：To investigate the relation between comprehensive glycolipid metabolism index and the severity of coronary artery disease. Methods：From March 2012 to December 2013,a total of 385 patients were enrolled into the control group,and 332 patients were enrolled into the case group according to the result of coronary angiography.Levels of serum HbA1 c,total cholesterol（TC）,low-density lipoproteincholesterol（LDL-C）, high-density lipoprotein cholesterol（HDL-C） and triglyceride（TG）were detected.The severity of coronary artery disease was assessed by Gensini score.Pearson correlation analysis was used to detect the relationship between continuous variables,and Spearman correlation analysis was used to detect the relationship between categorical variables.Linear regression was used to analyze the linear relation between glycolipid metabolism index and the Gensini score.Non-conditional logistic regression was used to identify the correlation between HbA1c×LDL-C/HDL-C and the number of coronary artery lesion vessels.Receiver operating characteristic（ROC）curve was used to evaluate the predictive value of HbA1c×LDL-C/HDL-C for the severity of coronary artery disease and the number of coronary artery lesion vessels. Results：Correlation analysis showed that there were positive correlation between levels of HbA1 c,LDL-C,HbA1c×LDL-C/HDL-C and the Gensini score,and there was a negative correlation between level of HDL-C and the Gensini score.Linear regression analysis revealed a strong correlation between HbA1c×LDL-C/HDL-C and the Gensini score,and the area under the ROC curve was 0.724（P〈0.01）.Logistic regression analysis showed that HbA1c×LDL-C/HDL-C was closely related with the number of lesion branches,and the area under the ROC curve was 0.638（P〈0.01）. Conclusion：Glycolipid metabolism index has certain predictive value of the severity of coronary artery disease and number of coronary artery lesion vessels.