LDL-C/HDL-C比值、TyG指数与绝经期女性冠心病的相关性研究  

Correlation Between LDL-C/HDL-C Ratio,TyG Index and Coronary Heart Disease in Postmenopausal Women

作　　者：王亚柱 扶桂升[2] 梁涛 陈烈 郭云飞 吴露[2] WANG Ya-zhu;FU Gui-sheng;LIANG Tao;CHEN Lie;GUO Yun-fei;WU Lu(Department of Cardiology,the Affiliated Hospital of Chengde Medical University,Chengde 067000,Hebei,China;Department of Cardiovascular Diseases,Liuyang Traditional Chinese Medicine Hospital,Liuyang 410300,Hunan,China)

机构地区：[1]承德医学院附属医院心脏内科,河北承德067000 [2]浏阳市中医医院心血管病科,湖南浏阳410300

出　　处：《医学信息》2023年第5期85-89,97,共6页Journal of Medical Information

基　　金：湖南省中医药管理局青年神农学者项目(编号:430S00/2022-01015273);河北省科学技术厅指令性计划项目(编号:17277769D)。

摘　　要：目的探讨LDL-C/HDL-C比值、三酰甘油葡萄糖乘积指数(TyG指数)与绝经期女性合并冠心病(CHD)的关系。方法连续入选2016年1月-2018年12月在承德医学院附属医院心血管内科拟诊为CHD,并行冠状动脉造影(CAG)检查的绝经期女性989例,依据CAG的结果将诊断为CHD的患者设为病例组(n=605),非CHD患者设为对照组(n=384)。比较两组患者的临床基线资料、LDL-C/HDL-C比值、TyG指数的差异。采用受试者工作特征曲线(ROC)评估LDL-C/HDL-C比值、TyG指数对绝经期女性合并CHD的诊断价值,并确定最佳诊断界值。Logistic回归分析绝经期女性合并CHD的危险因素,Spearman相关性分析LDL-C/HDL-C比值、TyG指数与Gensini评分的相关性。结果病例组LDL-C/HDL-C比值、TyG指数均高于对照组(P<0.05);ROC曲线分析显示,LDL-C/HDL-C比值、TyG指数诊断绝经期女性合并CHD的曲线下面积(AUC)分别为0.565、0.620(P<0.05),当LDL-C/HDL-C比值、TyG指数的最佳诊断界值分别为2.164、8.960时,诊断绝经期女性合并CHD效能最高,敏感度和特异度分别为45.60%、66.70%和61.50%、58.20%;多因素Logistic回归分析显示,高血压(OR=2.186,95%CI:1.544~3.095,P<0.05)、2型糖尿病(OR=1.958,95%CI:1.293~2.964,P<0.05)、脉压≥55 mmHg(OR=1.714,95%CI:1.207~2.435,P<0.05)、年龄(OR=1.040,95%CI:1.015~1.064,P<0.05)、LDL-C/HDL-C比值≥2.164(OR=1.438,95%CI:1.123~2.031,P<0.05)、TyG指数≥8.960(OR=1.689,95%CI:1.195~2.388,P<0.05)为绝经期女性合并CHD的独立危险因素。Spearman相关性分析显示,LDL-C/HDL-C比值、TyG指数与绝经期女性的Gensini评分呈正相关(r=0.185、0.220,P<0.05)。结论在绝经期女性中,LDL-C/HDL-C比值、TyG指数与冠脉病变严重程度呈正相关,对诊断CHD具有提示意义,高LDL-C/HDL-C比值、TyG指数为绝经期女性合并CHD的独立危险因素。Objective To investigate the relationship between LDL-C/HDL-C ratio,triglyceride glucose product index(TyG index)and coronary heart disease(CHD)in postmenopausal women.Methods From January 2016 to December 2018,989 menopausal women who were diagnosed as CHD and underwent coronary angiography(CAG)in the Department of Cardiology,Affiliated Hospital of Chengde Medical College were selected.According to the results of CAG,the patients diagnosed as CHD were set as the case group(n=605),and the non-CHD patients were set as the control group(n=384).The clinical baseline data,LDL-C/HDL-C ratio and TyG index were compared between the two groups.The receiver operating characteristic curve(ROC)was used to evaluate the diagnostic value of LDL-C/HDL-C ratio and TyG index in postmenopausal women with CHD,and the optimal diagnostic threshold was determined.Logistic regression was used to analyze the risk factors of CHD in postmenopausal women.Spearman correlation was used to analyze the correlation between LDL-C/HDL-C ratio,TyG index and Gensini score.Results The LDL-C/HDL-C ratio and TyG index in the case group were higher than those in the control group(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of LDL-C/HDL-C ratio and TyG index in the diagnosis of CHD in postmenopausal women was 0.565 and 0.620,respectively(P<0.05).When the optimal diagnostic thresholds of LDL-C/HDL-C ratio and TyG index were 2.164 and 8.960,respectively,the diagnostic efficacy of CHD in postmenopausal women was the highest,with sensitivity and specificity of 45.60%,66.70%and 61.50%,58.20%,respectively.Multivariate Logistic regression analysis showed that hypertension(OR=2.186,95%CI:1.544-3.095,P<0.05),type 2 diabetes mellitus(OR=1.958,95%CI:1.293-2.964,P<0.05),pulse pressure≥55 mmHg(OR=1.714,95%CI:1.207-2.435,P<0.05),age(OR=1.040,95%CI:1.015-1.064,P<0.05),LDL-C/HDL-C ratio≥2.164(OR=1.438,95%CI:1.123-2.031,P<0.05),TyG index≥8.960(OR=1.689,95%CI:1.195-2.388,P<0.05)were independent risk factors for CHD in postmenopausal women.Sp

关 键 词：绝经期 冠心病 三酰甘油葡萄糖乘积指数 LDL-C/HDL-C 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]