Association between the triglyceride to high-density lipoprotein cholesterol ratio and cardiovascular diseases in people living with human immunodeficiency virus:Evidence from a retrospectively cohort study 2005-2022  

作　　者：Liqin Sun Yinsong Luo Xinyun Jia Hui Wang Fang Zhao Lukun Zhang Bin Ju Haiyan Wang Duo Shan Yun He Hongzhou Lu Jiaye Liu 

机构地区：[1]Department of Infectious Diseases,National Clinical Research Center for Infectious Diseases,Shenzhen Third People’s Hospital,Shenzhen,Guangdong 518010,China [2]School of Public Health,Shenzhen University Medical School,Shenzhen,Guangdong 518060,China [3]National Center for AIDS/STD Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China

出　　处：《Chinese Medical Journal》2024年第22期2712-2719,共8页中华医学杂志(英文版)

基　　金：supported by the Science and Technology Innovation Committee of Shenzhen Municipality(No.JCYJ20220531102202005);the Natural Science Foundation of Guangdong Province(No.2024A1515012118);the Shenzhen High-level Hospital Construction Fund(No.G2022153);the Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties(No.SZGSP011);the Shenzhen Health Economics Association Project(No.202485).

摘　　要：Introduction:The triglyceride to high-density lipoprotein cholesterol(TG/HDL-C)ratio,a novel biomarker for metabolic syndrome(MetS),has been validated in the general population as being significantly correlated with cardiovascular disease(CVD)risk.However,its capabilities to predict CVD in people living with human immunodeficiency virus(HIV;PLWH)remain underexplored.Methods:We conducted a retrospective cohort study of 16,081 PLWH who initiated antiretroviral therapy(ART)at the Third People’s Hospital of Shenzhen(China)from 2005 to 2022.The baseline TG/HDL-C ratio was calculated as TG(mmol/L)divided by HDL-C(mmol/L).We employed a multivariate Cox proportional hazards model to assess the association between the TG/HDL-C ratio and CVD occurrence,using Kaplan-Meier curves and log-rank tests to compare survival distributions.The increase in prediction risk upon the addition of the biomarker to the conventional risk model was examined through the assessment of changes in net reclassification improvement(NRI)and integrated discrimination improvement(IDI).Nonlinear relationships were investigated using a restricted cubic spline plot,complemented by a two-piecewise Cox proportional hazards model to analyze threshold effects.Results:At the median follow-up of 70 months,213 PLWH developed CVD.Kaplan-Meier curves demonstrated a significant association between the increased risk of CVD and a higher TG/HDL-C ratio(log-rank P<0.001).The multivariate-adjusted Cox proportional hazards regression model indicated that the CVD hazard ratios(HR)(95%confidence intervals[95%CIs])for Q2,Q3,and Q4 versus Q1 of the TG/HDL-C ratio were 2.07(1.24,3.45),2.17(1.32,3.57),and 2.20(1.35,3.58),respectively(P<0.05).The consideration of the TG/HDL-C ratio in the model,which included all significant factors for CVD incidence,improved the predictive risk,as indicated by the reclassification metrics(NRI 16.43%,95%CI 3.35%-29.52%,P=0.014).The restriction cubic spline plot demonstrated an upward trend between the TG/HDL-C ratio and the CVD occurrence(

关 键 词：TRIGLYCERIDES Cholesterol HDL Human immunodeficiency virus HIV Cardiovascular disease INCIDENCE 

分 类 号：R54[医药卫生—心血管疾病]