Aim： To study the relationship between circulating androgens （total testosterone [TT], free testosterone [IT] and dihydrotestosterone [DHT]） and high-density lipoprotein cholesterol （HDL-C） in men with and withou...Aim： To study the relationship between circulating androgens （total testosterone [TT], free testosterone [IT] and dihydrotestosterone [DHT]） and high-density lipoprotein cholesterol （HDL-C） in men with and without cardiovascular disease （CVD）. Methods： Cross-sectional analyses included 1 661 baseline samples from the Massachusetts Male Aging Study （MMAS）, a population-based cohort of men ages 40-70 years. Serum hormones were measured by radioimmunoassay and HDL-C was determined following precipitation of the lower density lipoproteins. CVD was determined by self-report. Analyses were performed using multiple linear regression. Results： TT and HDL-C were positively correlated in the entire sample （r = 0.11, P = 0.0001）. After adjusting for confounders, we found this relationship was mostly limited to the 209 men with CVD. Among men with CVD, TT （P = 0.0004）, iT （P = 0.0172） and DHT （P = 0.0128） were all positively correlated with HDL-C, whereas in men without CVD only TT correlated with HDL-C （P = 0.0099）. Conclusion： Our results suggest that if androgens contribute to CVD in middle-aged men, the effect is not related to a suppressive effect of endogenous T on HDL-C. （Asian JAndrol 2008 Mar; 10： 193-200）展开更多
The association between high-density lipoprotein cholesterol（HDL-C） and mortality in patients with acute aortic dissection（AAD） is unclear. From January 2007 to January 2014, a total of 928 consecutive AAD patient...The association between high-density lipoprotein cholesterol（HDL-C） and mortality in patients with acute aortic dissection（AAD） is unclear. From January 2007 to January 2014, a total of 928 consecutive AAD patients who were admitted within 48 h after the onset of symptoms were enrolled in the study. Patients were divided into two groups according to whether serum HDL-C level was below the normal lower limit or not. The Cox proportional hazard regression model was used to identify the predictive value of HDL-C for in-hospital mortality in patients with AAD. As compared with normal HDL-C group（n=585）, low HDL-C group（n=343） had lower levels of systolic blood pressure and hemoglobin and higher levels of leukocyte, alanine aminotransferase, blood glucose, blood urea nitrogen, creatinine and urea acid. Low HDL-C group had significantly higher in-hospital mortality than normal HDL-C group（21.6% vs. 12.6%, log-rank=10.869, P=0.001）. After adjustment for baseline variables including demographics and biologic data, the increased risk of in-hospital mortality in low HDL-C group was substantially attenuated and showed no significant difference（adjusted hazard ratio, 1.23; 95% confidence interval, 0.86–1.77; P=0.259）. Low HDL-C is strongly but not independently associated with in-hospital mortality in patients with AAD.展开更多
Circulating level of low HDLC （high-density lipoprotein cholesterol） represents a common critical risk factor for IHD （ischemic heart disease） and may further aggravate the condition in anemic subjects, as the pre...Circulating level of low HDLC （high-density lipoprotein cholesterol） represents a common critical risk factor for IHD （ischemic heart disease） and may further aggravate the condition in anemic subjects, as the presence of anemia itself is a threat to cardiovascular consequences. To investigate the relationship of circulating HDLC with anemia, first we determined the levels of total hemoglobin （Hb） in a total of 301 subjects （male, n = 158; female, n = 143） randomly, and then examined the circulating levels of HDLC in fasting condition. Age of the study subjects was 47.9 ~ 16.6 （mean ＋ SD） years. Both the male and female subjects were divided into three groups according to their levels of Hb. The relationship of circulating levels of HDLC with the levels of total Hb was statistically analyzed. In case of the male subjects, we found that the levels of HDLC differed significantly among the three groups with different levels of Hb （P = 0.0233） and decrease in the levels of HDLC correlated significantly with the gradual decrease of total Hb level （r = 0.2504; P = 0.0015）. In female subjects, we observed a similar trend of difference among the three groups （P = 0.0685）. However, decrease in the levels of HDLC correlated significantly with the gradual decrease of Hb level （r = 0,2199; P = 0.0083）. Altogether, this study demonstrates that decrease in the circulating HDLC is related to the gradual decrease of Hb level. This study also indicates that circulating level of HDLC may be influenced by the level of total Hb and reveals the cardiovascular risks in anemia as well.展开更多
This study investigated the role of glucose in the biogenesis of high-density lipoprotein cholesterol(HDL-C).Mouse primary peritoneal macrophages were harvested and maintained in Dulbecco’s modified Eagle’s medium(D...This study investigated the role of glucose in the biogenesis of high-density lipoprotein cholesterol(HDL-C).Mouse primary peritoneal macrophages were harvested and maintained in Dulbecco’s modified Eagle’s medium(DMEM) containing glucose of various concentrations.The cells were divided into 3 groups in terms of different glucose concentrations in the cultures:Control group(5.6 mmol/L glucose),high glucose concentration groups(16.7 mmol/L and 30 mmol/L glucose).ATP-binding cassette transporter A1(ABCA1) mRNA expression in the macrophages was detected by semi-quantitative RT-PCR 24,48 and 72 h after glucose treatment.The results showed that ABCA1 mRNA expression in the 16.7 mmol/L glucose group was not significantly different from that in the control group at all testing time points(P>0.05 for each).In the 30 mmol/L glucose group,macrophage ABCA1 mRNA expression was not changed significantly at 24 h(P=0.14),but was substantially decreased by 40.4% at 48 h(P=0.009) and by 48.1% at 72 h(P=0.015) as compared with that in the control group.It was concluded that ABCA1 is of vital importance for HDL-C biogenesis.High glucose may hamper HDL-C biogenesis by decreasing ABCA1 expression,which contributes to low HDL-C level in diabetes.展开更多
Objective: To seek a new biochemical index for diagnosis of coronary heart disease (CHD) of shen-Yang deficiency syndrom (CHD-SYD). Methods: Sixty-one patients with CHD were divided into 3 groups according to their TC...Objective: To seek a new biochemical index for diagnosis of coronary heart disease (CHD) of shen-Yang deficiency syndrom (CHD-SYD). Methods: Sixty-one patients with CHD were divided into 3 groups according to their TCM Syndrome type, 10 patients in the group without Xin-Qi deficiency (Group A), 25 in the group with Xin-Qi deficiency but without Shen-Yang deficiency (Group B) and 26 in the group both with Xin-Qi deficiency and Shen-Yang deficiency (Group C). Levels of 17-hydroxy-corticoste-roid in urine (urinary 17-OHCS) per 24 hrs, and serum level of high density lipoprotein cholesterol (HDL-C) and high density lipoprotein phospholipid (HDL-PL) in them were determined in synchrostep and compared with those in the control group of 23 healthy aged persons, urinary 17-OHCS per 24 hrs was taken as the diagnostic standard to screen a new index for diagnosis of Shen-Yang deficiency Syndrome, and preliminary appraisal to the index was made. Results: Serum HDL-PL in the CHD-SYD patients( Group C) was 616+157 mg/L, which was obviously lower than that in the patients of Group A and B. With low HDL-PL(<650 mg/L) used as the index to diagnose CHD-SYD, the sensitivity was 73%, the specificity 86% and the accuracy 80%. Conclusion: HDL-PL <650 mg/L could be adopted as an index for CHD-SYD diagnosis, which is simple and practical.展开更多
目的探讨非高密度脂蛋白胆固醇/高密度脂蛋白胆固醇比值(non-high-density lipoprotein cholesterol to high density lipoprotein cholesterol ratio,non-HDL-C/HDL-C)和中性粒细胞计数/高密度脂蛋白胆固醇比值(neutrophil to high-den...目的探讨非高密度脂蛋白胆固醇/高密度脂蛋白胆固醇比值(non-high-density lipoprotein cholesterol to high density lipoprotein cholesterol ratio,non-HDL-C/HDL-C)和中性粒细胞计数/高密度脂蛋白胆固醇比值(neutrophil to high-density lipoprotein cholesterol ratio,NHR)与冠状动脉病变严重程度的相关性。方法选取2022年1月至2023年6月因胸闷、胸痛于华北理工大学附属医院心内科住院初次行冠状动脉造影检查的患者284例,根据冠状动脉造影结果分为冠状动脉病变组(n=223)和对照组(n=61)。收集两组临床资料(一般资料和实验室资料),计算non-HDL-C/HDL-C和NHR,比较两组临床资料。根据Gensini评分将冠状动脉病变组分为低、高分值两个亚组,Gensini评分<30分为低分值亚组、Gensini评分≥30分为高分值亚组,比较两亚组实验室资料。采用Spearman相关性分析探讨冠状动脉病变患者Gensini评分与non-HDL-C/HDL-C、NHR的相关性。应用多因素Logistic回归分析探讨冠状动脉病变患者高Gensini评分的影响因素,并绘制受试者工作特征(receiver operating characteristic,ROC)曲线以评价non-HDL-C/HDL-C和NHR对冠状动脉病变患者高Gensini评分的预测价值。结果冠状动脉病变组non-HDL-C/HDL-C和NHR水平高于对照组(均P<0.05);Gensini评分高分值亚组non-HDL-C/HDL-C、NHR水平高于低分值亚组(均P<0.05)。相关性分析显示,non-HDL-C/HDL-C、NHR与Gensini评分均呈正相关(均P<0.05)。多因素Logistic回归分析显示,NHR升高是冠状动脉病变患者高Gensini评分的独立危险因素(OR=1.650,95%CI:1.262-2.158,P<0.05)。绘制ROC曲线,non-HDL-C/HDL-C和NHR预测冠状动脉病变严重程度的ROC曲线下面积分别为0.657(95%CI:0.582-0.732,P<0.01)和0.736(95%CI:0.666-0.807,P<0.01)。结论non-HDL-C/HDL-C、NHR与冠状动脉病变严重程度呈正相关,且NHR是冠状动脉病变患者高Gensini评分的独立预测因子。展开更多
目的:探讨体检人群甘油三酯/高密度脂蛋白胆固醇(triglyceride/high density lipoprotein cholesterol ratio,TG/HDL-C)、甘油三酯-葡萄糖乘积(riglyceride-glucose index,TyG)指数及其衍生指数水平与白蛋白尿异常的相关性,同时分析TG/H...目的:探讨体检人群甘油三酯/高密度脂蛋白胆固醇(triglyceride/high density lipoprotein cholesterol ratio,TG/HDL-C)、甘油三酯-葡萄糖乘积(riglyceride-glucose index,TyG)指数及其衍生指数水平与白蛋白尿异常的相关性,同时分析TG/HDL-C、TyG以及TyG-BMI(riglyceride-glucose index-body mass index,TyG-BMI)预测白蛋白尿的能力。方法:获取2022年1月至12月体检中心年龄在18岁以上3739例受检者进行回顾性分析,将研究对象分为白蛋白尿异常组(n=841)和对照人群(n=2898),将TG/HDL-C、TyG以及TyG-BMI按四分位数进行分组,采用logistic回归模型分析与体检人群白蛋白尿异常风险之间的关系。采用限制性立方样条回归模型分析不同水平TG/HDL-C、BMI、TyG以及TyG-BMI与白蛋白尿的剂量反应关系。通过受试者工作特征曲线分析单一指标与联合指标对白蛋白尿的预测价值。结果:除平均血红蛋白浓度、高密度脂蛋白胆固醇外,异常组年龄、中性粒细胞、单核细胞、血小板、血白细胞计数、平均红细胞体积、红细胞分布宽度SD、红细胞分布宽度、血小板压积、总蛋白、白蛋白、谷氨酰转肽酶、空腹血糖、糖化血红蛋白、总胆固醇、低密度脂蛋白胆固醇、甘油三酯(triglyceride,TG)、体质指数(body mass index,BMI)、收缩压、舒张压、脉率、碱性磷酸酶、TyG指数、TyG-BMI、TG/HDL-C均高于对照组。调整混杂因素后,逻辑回归结果显示,与第2、第3分位数相比,TG/HDL-C、TyG、TyG-BMI指数第4四分位数组发生风险最高,其分别为1.895倍(95%CI=1.355~2.653)、2.377倍(95%CI=1.657~3.417)、2.319(95%CI=1.666~3.237)。BMI、TyG-BMI指数与白蛋白尿异常呈明显的非线性剂量反应关系,曲线呈近似“U”型,TyG、TG/HDL-C与白蛋白尿异常之间的剂量反应关系呈逐渐递增趋势,曲线呈近似“J”型。受试者工作特征(receiver operating characteristic,ROC)曲线结果显示,TyG-BMI预测能力优于其他3个指标,其AUC值为0.640。除TyG-BMI+TG/HDL-C之外,其余联合预测能力均优于单一预测指标,TyG-BMI+TG/HDL-C+TyG指数预测白蛋白尿的能力最优,AUC为0.6504。结论:TyG指数、TG/HDL-C比值升高与白蛋白尿异常密切相关,均对白蛋白尿具有一定的预测价值。综合考虑,TyG-BMI+TG/HDL-C+TyG指数是较佳白蛋白尿预测联合指标。展开更多
文摘Aim： To study the relationship between circulating androgens （total testosterone [TT], free testosterone [IT] and dihydrotestosterone [DHT]） and high-density lipoprotein cholesterol （HDL-C） in men with and without cardiovascular disease （CVD）. Methods： Cross-sectional analyses included 1 661 baseline samples from the Massachusetts Male Aging Study （MMAS）, a population-based cohort of men ages 40-70 years. Serum hormones were measured by radioimmunoassay and HDL-C was determined following precipitation of the lower density lipoproteins. CVD was determined by self-report. Analyses were performed using multiple linear regression. Results： TT and HDL-C were positively correlated in the entire sample （r = 0.11, P = 0.0001）. After adjusting for confounders, we found this relationship was mostly limited to the 209 men with CVD. Among men with CVD, TT （P = 0.0004）, iT （P = 0.0172） and DHT （P = 0.0128） were all positively correlated with HDL-C, whereas in men without CVD only TT correlated with HDL-C （P = 0.0099）. Conclusion： Our results suggest that if androgens contribute to CVD in middle-aged men, the effect is not related to a suppressive effect of endogenous T on HDL-C. （Asian JAndrol 2008 Mar; 10： 193-200）
基金supported by National Natural Science Foundation of China(No.81170259)
文摘The association between high-density lipoprotein cholesterol（HDL-C） and mortality in patients with acute aortic dissection（AAD） is unclear. From January 2007 to January 2014, a total of 928 consecutive AAD patients who were admitted within 48 h after the onset of symptoms were enrolled in the study. Patients were divided into two groups according to whether serum HDL-C level was below the normal lower limit or not. The Cox proportional hazard regression model was used to identify the predictive value of HDL-C for in-hospital mortality in patients with AAD. As compared with normal HDL-C group（n=585）, low HDL-C group（n=343） had lower levels of systolic blood pressure and hemoglobin and higher levels of leukocyte, alanine aminotransferase, blood glucose, blood urea nitrogen, creatinine and urea acid. Low HDL-C group had significantly higher in-hospital mortality than normal HDL-C group（21.6% vs. 12.6%, log-rank=10.869, P=0.001）. After adjustment for baseline variables including demographics and biologic data, the increased risk of in-hospital mortality in low HDL-C group was substantially attenuated and showed no significant difference（adjusted hazard ratio, 1.23; 95% confidence interval, 0.86–1.77; P=0.259）. Low HDL-C is strongly but not independently associated with in-hospital mortality in patients with AAD.
文摘Circulating level of low HDLC （high-density lipoprotein cholesterol） represents a common critical risk factor for IHD （ischemic heart disease） and may further aggravate the condition in anemic subjects, as the presence of anemia itself is a threat to cardiovascular consequences. To investigate the relationship of circulating HDLC with anemia, first we determined the levels of total hemoglobin （Hb） in a total of 301 subjects （male, n = 158; female, n = 143） randomly, and then examined the circulating levels of HDLC in fasting condition. Age of the study subjects was 47.9 ~ 16.6 （mean ＋ SD） years. Both the male and female subjects were divided into three groups according to their levels of Hb. The relationship of circulating levels of HDLC with the levels of total Hb was statistically analyzed. In case of the male subjects, we found that the levels of HDLC differed significantly among the three groups with different levels of Hb （P = 0.0233） and decrease in the levels of HDLC correlated significantly with the gradual decrease of total Hb level （r = 0.2504; P = 0.0015）. In female subjects, we observed a similar trend of difference among the three groups （P = 0.0685）. However, decrease in the levels of HDLC correlated significantly with the gradual decrease of Hb level （r = 0,2199; P = 0.0083）. Altogether, this study demonstrates that decrease in the circulating HDLC is related to the gradual decrease of Hb level. This study also indicates that circulating level of HDLC may be influenced by the level of total Hb and reveals the cardiovascular risks in anemia as well.
基金supported by a grant from the Scientific Research Foundation for the Returned Overseas Chinese Scholars by the State Education Ministry of China (No.2005383-6144)
文摘This study investigated the role of glucose in the biogenesis of high-density lipoprotein cholesterol(HDL-C).Mouse primary peritoneal macrophages were harvested and maintained in Dulbecco’s modified Eagle’s medium(DMEM) containing glucose of various concentrations.The cells were divided into 3 groups in terms of different glucose concentrations in the cultures:Control group(5.6 mmol/L glucose),high glucose concentration groups(16.7 mmol/L and 30 mmol/L glucose).ATP-binding cassette transporter A1(ABCA1) mRNA expression in the macrophages was detected by semi-quantitative RT-PCR 24,48 and 72 h after glucose treatment.The results showed that ABCA1 mRNA expression in the 16.7 mmol/L glucose group was not significantly different from that in the control group at all testing time points(P>0.05 for each).In the 30 mmol/L glucose group,macrophage ABCA1 mRNA expression was not changed significantly at 24 h(P=0.14),but was substantially decreased by 40.4% at 48 h(P=0.009) and by 48.1% at 72 h(P=0.015) as compared with that in the control group.It was concluded that ABCA1 is of vital importance for HDL-C biogenesis.High glucose may hamper HDL-C biogenesis by decreasing ABCA1 expression,which contributes to low HDL-C level in diabetes.
文摘目的建立陕西省延安市成年人血清非高密度脂蛋白-胆固醇(non-high-density lipoprotein cholesterol,n-HDL-C)的参考区间并分析影响因素。方法采用随机整体抽样的方法,抽取2023年1~9月陕西省延安市10个乡镇16921例成人为研究对象。调查年龄、性别、吸烟、饮酒、锻炼、高血压、糖尿病、血脂异常、慢性病、居住、饮食习惯、婚姻状况、文化程度、月收入等。测量身高、体重、腰围和血压。检测血清三酰甘油(TG)、总胆固醇(TCHO)、高密度脂蛋白-胆固醇(HDL-C)、低密度脂蛋白-胆固醇(LDL-C)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)及脂蛋白a[Lp(a)]水平,计算n-HDL-C水平,n-HDL-C(mmol/L)=TCHO(mmol/L)-HDL-C(mmol/L)。按照WS/T402-2012《中华人民共和国卫生行业标准》建议的百分位数法计算95%参考区间(P_(2.5)~P_(97.5))。采用多因素Logistic回归分析影响血清n-HDL-C水平的影响因素。结果男性和女性血清n-HDL-C水平均呈非正态分布(S=2.119,2.091,均P<0.001)。男性>60岁血清n-HDL-C水平[2.98(2.50,3.37)mmol/L]与18~30岁[2.84(2.49,3.26)mmol/L],31~40岁[2.98(2.62,3.42)mmol/L],41~50岁[3.10(2.62,3.47)mmol/L]和51~60岁[3.05(2.64,3.46)mmol/L]比较,差异具有统计学意义(H=3.618~5.680,均P<0.05);女性51~60岁血清n-HDL-C水平[3.08(2.71,3.44)mmol/L]与18~30岁[2.64(2.29,3.07)mmol/L],31~40岁[2.67(2.31,3.08)mmol/L],41~50岁[2.94(2.58,3.29)mmol/L]比较(H=8.161~13.445,均P<0.001),>60岁血清n-HDL-C水平[2.98(2.57,3.34)mmol/L]与18~30岁、31~40岁、41~50岁比较,差异具有统计学意义(H=7.985~14.018,均P<0.001)。将无统计学意义的年龄组合并,得到成年人群血清n-HDL-C水平参考区间:男性18~60岁(1.97~3.97mmol/L),>60岁(1.86~3.91mmol/L);女性18~50岁(1.82~3.74mmol/L),>50岁(1.94~3.88mmol/L)。将纳入的16921例成人分为n-HDL-C水平正常组和异常组,两组血清TG(1.02±0.31 mmol/L vs 1.24±0.37mmol/L),TCHO(3.97±1.02 mmol/L vs 4.66±1.25 mmol/L),LDL-C(2.37±0.58mmol/L vs 2.59±0.67 mmol/L)水平及年龄(43.55±11.52岁vs 46.27±8.13岁)比较,差异具有统计学意义(t=2.041~3.151,均P<0.05),血清n-HDL-C水平异常率42.50%。经多因素Logistic回归分析,男性、锻炼缺乏、超重和肥胖、血脂异常、城市居民、高中及以上学历是该地区成年人血清n-HDL-C水平的影响因素(均P<0.05)。结论初步建立了该地区成年人血清n-HDL-C水平参考区间,男性、锻炼缺乏、超重和肥胖、血脂异常、城市居民、高中及以上学历是该地区成年人血清n-HDL-C水平异常的影响因素。
文摘Objective: To seek a new biochemical index for diagnosis of coronary heart disease (CHD) of shen-Yang deficiency syndrom (CHD-SYD). Methods: Sixty-one patients with CHD were divided into 3 groups according to their TCM Syndrome type, 10 patients in the group without Xin-Qi deficiency (Group A), 25 in the group with Xin-Qi deficiency but without Shen-Yang deficiency (Group B) and 26 in the group both with Xin-Qi deficiency and Shen-Yang deficiency (Group C). Levels of 17-hydroxy-corticoste-roid in urine (urinary 17-OHCS) per 24 hrs, and serum level of high density lipoprotein cholesterol (HDL-C) and high density lipoprotein phospholipid (HDL-PL) in them were determined in synchrostep and compared with those in the control group of 23 healthy aged persons, urinary 17-OHCS per 24 hrs was taken as the diagnostic standard to screen a new index for diagnosis of Shen-Yang deficiency Syndrome, and preliminary appraisal to the index was made. Results: Serum HDL-PL in the CHD-SYD patients( Group C) was 616+157 mg/L, which was obviously lower than that in the patients of Group A and B. With low HDL-PL(<650 mg/L) used as the index to diagnose CHD-SYD, the sensitivity was 73%, the specificity 86% and the accuracy 80%. Conclusion: HDL-PL <650 mg/L could be adopted as an index for CHD-SYD diagnosis, which is simple and practical.
文摘目的探讨非高密度脂蛋白胆固醇/高密度脂蛋白胆固醇比值(non-high-density lipoprotein cholesterol to high density lipoprotein cholesterol ratio,non-HDL-C/HDL-C)和中性粒细胞计数/高密度脂蛋白胆固醇比值(neutrophil to high-density lipoprotein cholesterol ratio,NHR)与冠状动脉病变严重程度的相关性。方法选取2022年1月至2023年6月因胸闷、胸痛于华北理工大学附属医院心内科住院初次行冠状动脉造影检查的患者284例,根据冠状动脉造影结果分为冠状动脉病变组(n=223)和对照组(n=61)。收集两组临床资料(一般资料和实验室资料),计算non-HDL-C/HDL-C和NHR,比较两组临床资料。根据Gensini评分将冠状动脉病变组分为低、高分值两个亚组,Gensini评分<30分为低分值亚组、Gensini评分≥30分为高分值亚组,比较两亚组实验室资料。采用Spearman相关性分析探讨冠状动脉病变患者Gensini评分与non-HDL-C/HDL-C、NHR的相关性。应用多因素Logistic回归分析探讨冠状动脉病变患者高Gensini评分的影响因素,并绘制受试者工作特征(receiver operating characteristic,ROC)曲线以评价non-HDL-C/HDL-C和NHR对冠状动脉病变患者高Gensini评分的预测价值。结果冠状动脉病变组non-HDL-C/HDL-C和NHR水平高于对照组(均P<0.05);Gensini评分高分值亚组non-HDL-C/HDL-C、NHR水平高于低分值亚组(均P<0.05)。相关性分析显示,non-HDL-C/HDL-C、NHR与Gensini评分均呈正相关(均P<0.05)。多因素Logistic回归分析显示,NHR升高是冠状动脉病变患者高Gensini评分的独立危险因素(OR=1.650,95%CI:1.262-2.158,P<0.05)。绘制ROC曲线,non-HDL-C/HDL-C和NHR预测冠状动脉病变严重程度的ROC曲线下面积分别为0.657(95%CI:0.582-0.732,P<0.01)和0.736(95%CI:0.666-0.807,P<0.01)。结论non-HDL-C/HDL-C、NHR与冠状动脉病变严重程度呈正相关,且NHR是冠状动脉病变患者高Gensini评分的独立预测因子。
文摘目的:探讨体检人群甘油三酯/高密度脂蛋白胆固醇(triglyceride/high density lipoprotein cholesterol ratio,TG/HDL-C)、甘油三酯-葡萄糖乘积(riglyceride-glucose index,TyG)指数及其衍生指数水平与白蛋白尿异常的相关性,同时分析TG/HDL-C、TyG以及TyG-BMI(riglyceride-glucose index-body mass index,TyG-BMI)预测白蛋白尿的能力。方法:获取2022年1月至12月体检中心年龄在18岁以上3739例受检者进行回顾性分析,将研究对象分为白蛋白尿异常组(n=841)和对照人群(n=2898),将TG/HDL-C、TyG以及TyG-BMI按四分位数进行分组,采用logistic回归模型分析与体检人群白蛋白尿异常风险之间的关系。采用限制性立方样条回归模型分析不同水平TG/HDL-C、BMI、TyG以及TyG-BMI与白蛋白尿的剂量反应关系。通过受试者工作特征曲线分析单一指标与联合指标对白蛋白尿的预测价值。结果:除平均血红蛋白浓度、高密度脂蛋白胆固醇外,异常组年龄、中性粒细胞、单核细胞、血小板、血白细胞计数、平均红细胞体积、红细胞分布宽度SD、红细胞分布宽度、血小板压积、总蛋白、白蛋白、谷氨酰转肽酶、空腹血糖、糖化血红蛋白、总胆固醇、低密度脂蛋白胆固醇、甘油三酯(triglyceride,TG)、体质指数(body mass index,BMI)、收缩压、舒张压、脉率、碱性磷酸酶、TyG指数、TyG-BMI、TG/HDL-C均高于对照组。调整混杂因素后,逻辑回归结果显示,与第2、第3分位数相比,TG/HDL-C、TyG、TyG-BMI指数第4四分位数组发生风险最高,其分别为1.895倍(95%CI=1.355~2.653)、2.377倍(95%CI=1.657~3.417)、2.319(95%CI=1.666~3.237)。BMI、TyG-BMI指数与白蛋白尿异常呈明显的非线性剂量反应关系,曲线呈近似“U”型,TyG、TG/HDL-C与白蛋白尿异常之间的剂量反应关系呈逐渐递增趋势,曲线呈近似“J”型。受试者工作特征(receiver operating characteristic,ROC)曲线结果显示,TyG-BMI预测能力优于其他3个指标,其AUC值为0.640。除TyG-BMI+TG/HDL-C之外,其余联合预测能力均优于单一预测指标,TyG-BMI+TG/HDL-C+TyG指数预测白蛋白尿的能力最优,AUC为0.6504。结论:TyG指数、TG/HDL-C比值升高与白蛋白尿异常密切相关,均对白蛋白尿具有一定的预测价值。综合考虑,TyG-BMI+TG/HDL-C+TyG指数是较佳白蛋白尿预测联合指标。
