总胆固醇/高密度脂蛋白胆固醇比值与无症状颈动脉粥样硬化斑块稳定性的相关性

Correlation between total cholesterol/high-density lipoprotein cholesterol ratio and asymptomatic carotid atherosclerotic plaque stability

目的探讨总胆固醇(total cholesterol,TC)/高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)比值与颈动脉不稳定斑块的相关性。方法回顾性纳入2021年2月至2021年5月期间连云港市第一人民医院神经内科收治的成年无症状颈动脉粥样硬化斑块患者。收集人口统计学和相关临床资料,采用超声检测颈动脉斑块,并将研究对象分为稳定斑块组和不稳定斑块组。应用多变量logistic回归分析评估颈动脉不稳定斑块的独立危险因素。采用受试者工作特征(receiver operating characteristic,ROC)曲线评估TC/HDL-C比值对颈动脉不稳定斑块的预测效能。结果共纳入362例无症状颈动脉粥样硬化斑块患者,稳定斑块组226例(62.43%),不稳定斑块组136例(37.57%)。多变量logistic回归分析显示,校正混杂因素后,只有TC/HDL-C比值是颈动脉不稳定斑块的独立危险因素(以TC/HDL-C比值第1五分位数组为参照,第4五分位数组:优势比3.13,95%置信区间1.50~6.55,P=0.002;第5五分位数组:优势比6.75,95%置信区间3.21~14.22,P<0.001)。ROC曲线分析显示,TC/HDL-C比值预测颈动脉不稳定斑块的曲线下面积为0.691(95%置信区间0.634~0.748;P<0.001),最佳截断值为4.38,敏感性和特异性分别为50.0%和82.7%。结论TC/HDL-C比值是颈动脉不稳定斑块的独立危险因素,对颈动脉不稳定斑块有一定的预测价值。

Objective To investigate the correlation between total cholesterol(TC)/high-density lipoprotein cholesterol(HDL-C)ratio and unstable carotid plaque.Methods From February 2021 to May 2021,adult patients with asymptomatic carotid atherosclerotic plaque admitted to the Department of Neurology,the First People's Hospital of Lianyungang were retrospectively enrolled.The demographic and related clinical data were collected.Carotid artery plaques were detected by ultrasound,and the subjects were divided into a stable plaque group and an unstable plaque group.Multivariate logistic regression analysis was used to assess the independent risk factors for unstable carotid plaques.Receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of TC/HDL-C ratio for unstable carotid plaques.Results A total of 362 patients with asymptomatic carotid atherosclerotic plaque were enrolled,including 226(62.43%)in the stable plaque group and 136(37.57%)in the unstable plaque group.Multivariate logistic regression analysis showed that after adjusting for confounding factors,only TC/HDL-C ratio was the independent risk factor for unstable carotid plaque(taking the 1st quintile array of TC/HDL-C ratio as a reference,the 4th quintile array:odds ratio 3.13,95%confidence interval 1.50-6.55,P=0.002;the 5th quintile array:odds ratio 6.75,95%confidence interval 3.21-14.22,P<0.001).ROC curve analysis showed that the area under the curve of TC/HDL-C ratio for predicting unstable carotid plaque was 0.691(95%confidence interval 0.634-0.748;P<0.001),the optimal cut-off value was 4.38,and the sensitivity and specificity were 50.0%and 82.7%,respectively.Conclusion TC/HDL-C ratio is an independent risk factor for unstable carotid plaques and has a certain predictive value for unstable carotid plaques.