原发性高血压患者残余脂蛋白胆固醇对动脉硬化预测价值的研究

Value of remnant lipoprotein cholesterol for predicting arteriosclerosis in patients with primary hypertension

目的:探索原发性高血压患者动脉硬化的相关因素,及残余脂蛋白胆固醇(RLP-C)对此类患者动脉硬化的预测价值。方法:本研究为横断面研究,连续选取2018年1月至2020年12月,南阳市中心医院心内科患者原发性高血压患者470例。根据RLP-C中位数分为RLP-C高组(RLP-C>0.66 mmol/L)和低RLP-C(RLP-C≤0.66 mmol/L)组,比较两组患者的血脂水平及动脉硬化程度差异,使用单因素和多因素Logistic回归模型分析RLP-C对动脉硬化的影响,并完善亚组分析,ROC曲线分析RLP-C对动脉硬化的预测价值。结果:RLP-C高组高脂血症患病率、BMI、24 h心率及脂代谢指标更高(P<0.05),多因素Logistics回归显示:高RLP-C[OR(95%CI):1.93(1.08~3.44)]、年龄[OR(95%CI):1.02(1.00~1.05)]、TG[OR(95%CI):1.33(1.14~1.54)]、FGB[OR(95%CI):1.23(1.03~1.46)]与动脉硬化相关。RLP-C两分组与相应的亚组变量对动脉硬化的影响均无交互作用。ROC曲线分析示RLP-C对动脉硬化具有预测价值(P<0.05),其敏感性为0.83,特异性为0.51,ROC曲线下面积为[0.71,95%CI:(0.66~0.76)]。结论:RLP-C与原发性高血压患者动脉硬化相关,对此类患者的动脉硬化有一定的预测价值。

Objective:To explore the factors associated with atherosclerosis in patients with primary hypertension and the predictive value of remnant lipoprotein cholesterol(RLP-C)for atherosclerosis in those patients.Methods:This was a cross-sectional study with 470 consecutively enrolled patients with primary hypertension hospitalized in the cardiology ward of NanYang First People’s Hospital from 2018.1 to 2020.12.The patients were divided into high RLP-C group(RLP-C>0.66 mmol/L)and low RLP-C(RLP-C≤0.66 mmol/L)group according to the median RLP-C.The differences in lipid levels and the degree of atherosclerosis between the two groups were compared.The effects of RLP-C on atherosclerosis were analyzed using univariate and multivariate logistic regression models,and subgroup analysis was completed.ROC curves were used to analyze the predictive value of RLP-C on atherosclerosis.Results:Hyperlipidemia,body mass index,24-hour heart rate and lipids were higher in the high RLP-C group(P<0.05),and multivariate logistic regression showed that high RLP-C[OR(95%CI):1.93(1.08-3.44)],age[OR(95%CI):1.02(1.00-1.05)],triglyceride[OR(95%CI):1.33(1.14-1.54)],and glucose[OR(95%CI):1.23(1.03-1.46)]were associated with atherosclerosis.There was no interaction between the different RLP-C groups and the corresponding subgroup variables on arterial stiffness.ROC curve showed that RLP-C had predictive value for atherosclerosis(P<0.05)with a sensitivity of 0.83 and specificity of 0.51,and its area under the curve was(95%CI):0.71(0.66-0.76).Conclusions:RLP-C was associated with atherosclerosis in patients with primary hypertension and had predictive value for atherosclerosis in those patients.