非糖尿病人群致动脉粥样硬化指数和心肌梗死风险的相关性分析  

Association between atherogenic index of plasma and myocardial infarction risk in non-diabetic population

作　　者：董立平[1] 张怡君 吴寿岭[3] 刘芬 王安心 Dong Liping;Zhang Yijun;Wu Shouling;Liu Fen;Wang Anxin(Department of Neurology,Beijing Daxing District People’s Hospital,Beijing 102600,China)

机构地区：[1]北京市大兴区人民医院神经中心,102600 [2]首都医科大学公共卫生学院流行病与卫生统计学系 [3]开滦总医院心内科 [4]首都医科大学附属北京天坛医院,北京市神经外科研究所流行病学研究室

出　　处：《北京医学》2024年第12期1019-1025,共7页Beijing Medical Journal

基　　金：国家重点研发计划(2022YFC3600600)。

摘　　要：目的探讨非糖尿病人群中基线与长期血浆致动脉粥样硬化指数(atherogenic index of plasma,AIP)与心肌梗死(myocardial infarction,MI)发生风险的相关性。方法选取2006年6月至2007年10月唐山开滦社区开展的开滦研究受试者。根据基线和长期AIP四分位数分为4组,即Q1~Q4组。AIP计算方式为log(TG/HDL-C)。长期AIP定义为自基线至首次发生MI或随访结束时AIP的平均水平。采用限制性立方样条(restricted cubic spline,RCS)分析基线和长期AIP作为连续变量对MI发生风险的影响,采用Cox比例风险模型评估基线和长期AIP与MI发生风险之间的关联性。结果共纳入受试者95828名,其中男76528名,女19300名,年龄18~97岁,平均(51.5±12.6)岁,基线AIP平均水平为(-0.11±0.67)。在中位随访12.18年期间,1903名受试者发生MI,发生率为1.99%。1903例MI患者中,男1752例、女151例,年龄22~92岁,平均(58.6±10.6)岁。多变量校正的RCS结果显示,MI的发生风险随着基线和长期AIP水平的升高而增加。多因素Cox比例风险模型分析结果显示,基线和长期AIP水平升高均增加了MI的发生风险。与最低基线AIP组相比,最高四分位组发生MI的风险增加了0.69倍(HR=1.69,95%CI:1.47~1.94)。最高长期AIP组发生MI是最低组的1.64倍(95%CI:1.42~1.89)。结论非糖尿病人群基线和长期AIP水平与MI的发生风险呈正相关。Objective To explore the associations between baseline and long-term atherogenic index of plasma(AIP)and the risk of myocardial infarction(MI)in non-diabetic population.Methods The participants in the Kailuan study,which was conducted in the Kailuan community from June 2006 to October 2007 in Tangshan City,China were selected and were divided into four groups based on baseline and long-term AIP quartiles,group Q1 to Q4.The AIP was calculated as log(TG/HDL-C).The long-term AIP was defined as updated mean AIP which was calculated as the mean of AIP from baseline to the first occurrence of MI or to the end of follow-up.The effect of baseline and long-term AIP on MI risk as continuous variables was analyzed by the restricted cubic splines(RCS).The associations between baseline and long-term AIP on MI risk was analyzed by the Cox proportional hazard models.Results A total of 95828 participants were included,including 76528 males and 19300 females,aged from 18 to 97 years,with an average of(51.5±12.6)years.The average level of baseline AIP was(-0.11±0.67).During a median follow-up of 12.18 years,1903 participants developed MI,with an incidence of 1.99%.Among the 1903 MI patients,there were 1752 males and 151 females,aged from 22 to 92 years,with an average of(58.6±10.6)years.The multivariable RCS result showed that the MI risk was higher with elevated levels of baseline and long-term AIP.The multivariable Cox proportional hazard models result showed that elevated levels of baseline and long-term AIP increased the risk of MI.Compared with participants in baseline AIP Q1 group,the risk of MI in Q4 group increased 0.69-fold(HR=1.69;95%CI:1.47-1.94).The risk of MI in long-term AIP Q4 group increased 1.64-fold(95%CI:1.42-1.89),compared with that in long-term AIP Q1 group.Conclusions Baseline and long-term AIP levels in nondiabetic population are positively correlated with the risk of MI.

关 键 词：血浆致动脉粥样硬化指数 非糖尿病人群 心肌梗死 纵向数据 相关性 

分 类 号：R57[医药卫生—消化系统]