血清残粒脂蛋白胆固醇和甘油三酯水平与中年人群发生冠心病的相关性  

Correlation between serum remnant lipoprotein cholesterol,triglyceride levels and coronary heart disease in middle-aged people

作　　者：李其华[1] 苗柳 陈慧生[2] 陈见红[2] LI Qihua;MIAO Liu;CHEN Huisheng;CHEN Jianhong(Department of General Medicine,Liuzhou People's Hospital,Liuzhou,Guangxi 545006,China;Department of Cardiology,Liuzhou People's Hospital,Liuzhou,Guangxi 545006,China)

机构地区：[1]柳州市人民医院全科医学科,广西柳州市545006 [2]柳州市人民医院心血管内科,广西柳州市545006

出　　处：《中国动脉硬化杂志》2024年第11期963-971,共9页Chinese Journal of Arteriosclerosis

基　　金：国家自然科学基金项目(82060072);广西壮族自治区卫健委自筹经费科研项目(Z-B20241227)。

摘　　要：[目的]探讨血清残粒脂蛋白胆固醇(RLP-C)和甘油三酯(TG)水平与中年人群发生冠心病的相关性。[方法]选取2015年1月—2022年12月在柳州市人民医院心血管内科住院行冠状动脉造影的439例中年人群为研究对象。根据冠状动脉造影结果将研究对象分为冠心病组(190例)和对照组(249例)。收集两组一般资料和实验室检查指标,根据血脂谱计算RLP-C。采用双变量Spearman相关、多因素Logistic回归、限制性立方样条图分析RLP-C、TG与中年人群发生冠心病的相关性。采用受试者工作特征(ROC)曲线评估RLP-C、TG对中年人群发生冠心病的预测效度。[结果]冠心病组年龄大于对照组,男性占比、吸烟史占比、高血压发生率、糖尿病发生率、高脂血症发生率、体质指数(BMI)、收缩压(SBP)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDLC)、RLP-C高于对照组,高密度脂蛋白胆固醇(HDLC)低于对照组(P<0.05)。Spearman相关分析结果显示,RLP-C、TG、LDLC与中年人群发生冠心病呈正相关关系(r=0.227、0.279、0.105,P均<0.05);HDLC与中年人群发生冠心病呈负相关关系(r=-0.340,P<0.001)。多因素Logistic回归分析结果显示,无论作为连续变量还是分类变量,RLP-C、TG均是中年人群发生冠心病的独立危险因素(P<0.05),HDLC是中年人群发生冠心病的独立保护因素(P<0.05)。与最低四分位数组比较,RLP-C位于第3、4四分位数组的人群发生冠心病的OR(95%CI)分别为2.648(1.364~5.144)、2.847(1.468~5.520);TG位于第3、4四分位数组的人群发生冠心病的OR(95%CI)分别为3.043(1.520~6.092)、3.520(1.811~6.842)。限制性立方样条图显示,RLP-C、TG与冠心病呈正非线性相关关系(P_(总体)均<0.001,P_(非线性)=0.002、0.001)。亚组分析显示,女性人群RLP-C、TG与冠心病的关系较男性人群更为显著。ROC曲线分析显示,RLP-C、TG预测总体人群发生冠心病的曲线下面�Aim To investigate the correlation between serum remnant lipoprotein cholesterol(RLP-C),triglyc-eride levels(TG)and coronary heart disease(CHD)in middle-aged people.Methods A total of 439 middle-aged in-dividuals who were hospitalized in the Department of Cardiology of Liuzhou Peoples Hospital from January 2015 to Decem-ber 2022 and underwent coronary angiography were selected as the research subjects.They were divided into CHD group(190 cases)and control group(249 cases)according to the results of coronary angiography.The general clinical data and laboratory tests of the subjects were collected,and RLP-C was calculated based on blood lipid profile.Bivariate Spearman correlation,multivariate Logistic regression,and restricted cubic spline graph were used to analyze the correlation between RLP-C,TG,and CHD in these middle-aged participants.Receiver operating characteristic(ROC)curve was used to evaluate the value of RLP-C and TG in predicting CHD.Results The age in CHD group was older than that in control group,proportion of male,proportion of smoking history,incidence of hypertension,incidence of diabetes,inci-dence of hyperlipidemia,body mass index(BMI),systolic blood pressure(SBP),fasting blood glucose(FBG),glycosy-lated hemoglobin(HbA1c),TG,low density lipoprotein cholesterol(LDLC),RLP-C were higher than those in control group,while high density lipoprotein cholesterol(HDLC)was lower than that in control group(P<0.05).The Spearman correlation analysis results showed positive correlation between RLP-C,TG,LDLC and CHD(r=0.227,0.279,and 0.105,respectively,P<0.05),and negative correlation between HDLC and CHD(r=-0.340,P<0.001)in these stud-ied population.Multivariate Logistic regression analysis showed that whether as continuous or categorical variables,RLP-C and TG were independent risk factors for CHD(P<0.05),HDLC was independent protective factor for CHD(P<0.05).Compared with lowest quartile group,The OR(95%CI)of CHD incidence in 3rd and 4th quartile group of RLP-C were 2.648(1.364~5.144)and 2.847(1.468~5.520)r

关 键 词：残粒脂蛋白胆固醇 甘油三酯 中年人群 冠心病 

分 类 号：R5[医药卫生—内科学]