三酰甘油与高密度脂蛋白胆固醇比值与脑小血管病总体负担的相关性

Association between the triglyceride to high-density lipoprotein cholesterol ratio and the total burden of cerebral small vessel disease

目的:探讨三酰甘油与高密度脂蛋白胆固醇比值(triglyceride to high-density lipoprotein cholesterol ratio,TG/HDL-C)与脑小血管病(cerebral small vessel disease,CSVD)总体负担之间的关系。方法:共纳入236例CSVD患者,平均年龄(67.31±7.54)岁。CSVD对大脑的整体影响采用CSVD总体负担描述。根据TG/HDL-C中位值将患者分成低TG/HDL-C组(<1.28)和高TG/HDL-C组(≥1.28),比较两组的基线特征。通过有序Logistic回归分析探讨TG/HDL-C与CSVD总体负担的相关性。采用Jonckheere-Terpstra检验评估TG/HDL-C和CSVD总体负担之间是否存在线性趋势。结果:高TG/HDL-C组患者无症状性腔隙性梗死、中-重度白质高信号、深部脑微出血、中-重度血管周围间隙扩大的比例高于低TG/HDL-C组(P<0.05)。在调整年龄、高血压和其他可能的预测因素后,以低TG/HDL-C作为参考,高TG/HDL-C是CSVD总体负担的独立危险因素(OR=2.093,95%CI:1.270~3.448,P=0.004)。TG/HDL-C水平与CSVD总体负担之间呈剂量依赖性正相关(趋势P<0.001)。结论:高TG/HDL-C与CSVD总体负担密切相关。

Objective:To explore the association between the triglyceride to high-density lipoprotein cholesterol ratio(TG/HDL-C)and the total burden of cerebral small vessel disease(CSVD).Methods:A total of 236 CSVD patients with an average aged of(67.31±7.54)years were enrolled in this retrospective study.The total effect of CSVD on the brain was described by the total CSVD burden.Patients were divided into low TG/HDL-C group(<1.28)and high TG/HDL-C group(≥1.28)according to the median level of TG/HDL-C,and baseline characteristics of the two groups were compared.We evaluated the association between TG/HDL-C and total burden of CSVD by ordered Logistic regression.The Jonckheere-Terpstra test was used to assess whether a linear trend was present between TG/HDL-C and total burden of CSVD.Results:The proportion of silent lacunar infarction,moderate to severe white matter hyperintensity,deep cerebral microbleeds and moderate to severe enlarged perivascular space in the high TG/HDL-C group were higher than those in the low TG/HDL-C group.The differences were statistically significant(P<0.05).After adjustment for age,hypertension,and other traditional risk factors,using the low TG/HDL-C as the reference,high TG/HDL-C was a significant independent risk factor of total burden of CSVD(OR=2.093,95%CI:1.270-3.448,P=0.004).TG/HDL-C levels were positively related with the total burden of CSVD in a dose-dependent manner(trend for P<0.001).Conclusion:High TG/HDL-C was closely associated with total burden of CSVD.