新型营养指数与稳定性冠心病及冠状动脉钙化斑块负荷的相关性

Association of a novel nutritional index with coronary artery disease and coronary artery calcified plaque burden

目的:探讨甘油三酯(triglycerides,TG)总胆固醇(total cholesterol,TC)体质量(body weight,BW)指数[TG×TC×BW index,TCBI]与冠状动脉心脏病(coronary artery disease,CAD)及冠状动脉钙化患病的相关性。方法:连续入选2015年9月至2017年6月承德医学院附属医院可疑稳定性CAD,符合纳入标准的住院患者561例。根据冠状动脉CT血管造影结果将所有研究对象分为CAD组(n=402)和非CAD组(n=159)。收集所有患者的临床资料,测量冠状动脉钙化(coronary artery calcification,CAC)及冠状动脉钙化评分。建立多因素二元logistic回归模型,分析CAD和CAC以及CAD合并CAC的患病危险因素。结果:TCBI≥1 818.7的曲线下面积为0.557(P=0.036),TCBI≥1 818.7联合CAD经典危险因素男性、吸烟史、高血压病、2型糖尿病和缺血性脑卒中的曲线下面积为0.726(P<0.001)。CAD组TCBI升高的患病率较非CAD组高(P=0.008)。高TCBI组CAD、2型糖尿病、血脂异常和CAC的患病率均较低TCBI组高(均P<0.05)。TCBI与心表面脂肪组织体积、心外膜脂肪组织体积、三酰甘油-葡萄糖指数、血浆动脉粥样硬化指数呈正相关(均P<0.05)。TCBI≥1 818.7是新发现的CAD和CAC以及CAD合并CAC的独立危险因素(P<0.05)。结论:TCBI≥1 818.7是CAD和CAC以及CAD合并CAC患病的独立危险因素,有望成为临床诊断和评估CAD病情的新型标志物。

Objective:To explore the association of triglycerides total cholesterol body weight index(TCBI)with coronary artery disease(CAD)and coronary artery calcified plaque burden. Methods:A total of 561 inpatients meeting the inclusion criteria with suspected stable CAD were consecutively enrolled from September 2015 to June 2017 in the Affiliated Hospital of Chengde Medical University.All of them were divided into the CAD group(n=402)and the non-CAD group(n=159)according to coronary computed tomographic angiography results. We collected clinical data,measured coronary artery calcification(CAC),and assessed CAC scores of all the subjects. A binary logistic multivariate regression model was established on the risk factors of CAD,CAC,and CAD with CAC. Results:The area under the curve of TCBI≥1 818.7 was 0.557(P=0.036),and that of TCBI≥1 818.7 combined with CAD classic risk factors,such as male,smoking,hypertension,type 2 diabetes,and ischemic stroke,was 0.726(P<0.001). The prevalence of TCBI increased in the CAD group was higher than that in the non-CAD group(P=0.008). The prevalence of CAD,type 2 diabetes,dyslipidemia,and CAC incidence in the high TCBI group was higher than that in the low TCBI group(all P<0.05). TCBI was positively correlated with epicardial adipose tissue volume,pericardial adipose tissue volume,triglyceride-glucose index,and plasma atherosclerosis index(all P<0.05). Besides classic CAD risk factors,TCBI ≥1 818.7 was a newly discovered independent risk factor for CAD,CAC,and CAD with CAC(all P<0.05). Conclusion:TCBI≥1 818.7 is an independent risk factor for CAD,CAC,and CAD with CAC,which may be a novel marker for the diagnosis and evaluation of CAD.