新型肥胖指标体质量调整的腰围指数对老年冠心病患者主要不良心血管事件的预测价值  

Weight-adjusted waist index,a novel obesity indicator:Its predictive value for major adverse cardiovascular events in elderly patients with coronary heart disease

作　　者：卢树苹 邢园园 许鹏 LU Shuping;XING Yuanyuan;XU Peng(Department of Cardiology,The First Hospital of Zhangjiakou,Zhangjiakou 075000,China)

机构地区：[1]张家口市第一医院心内科,075000

出　　处：《心肺血管病杂志》2025年第3期252-258,共7页Journal of Cardiovascular and Pulmonary Diseases

基　　金：2018年河北省医学科学研究重点课题计划(20181174)。

摘　　要：目的:探讨体质量调整的腰围指数(weight-adjusted-waist index,WWI)与老年冠心病患者主要不良心血管事件(major adverse cardiovascular events,MACE)风险的相关性及其预测价值。方法:本研究回顾性纳入2018年1月至2020年12月期间,在张家口市第一医院住院的598例60岁以上冠心病患者。根据WWI四分位数将患者分为Q1~Q4四组,随访36个月。主要终点为MACE事件,包括心血管死亡、心肌梗死和血运重建。采用Kaplan-Meier生存分析评估不同WWI组间生存差异,应用多因素COX回归分析评估WWI与MACE风险的关联强度,并通过限制性立方样条(restricted cubic splines,RCS)分析确定其关联模式。结果:随访期间,MACE总体发生率随WWI水平升高而增加,从Q1组的8.2%逐步上升至Q4组的20.0%(P=0.037)。Kaplan-Meier分析显示各组间无事件生存率存在显著差异(Log-rank P=0.034)。经多因素COX回归分析调整混杂因素后显示,WWI每增加1个单位,MACE风险增加约170%(HR=2.70,95%CI:2.13~3.43,P<0.001)。RCS分析进一步证实WWI与MACE风险呈现显著的线性正相关。结论:WWI水平与老年冠心病患者MACE风险呈显著正相关,且具有良好的预测价值。这一简便易行的指标可为临床识别高危患者提供新的评估工具,对指导老年冠心病患者的个体化预防和管理具有重要意义。Objective:To investigate the correlation and predictive value of weight-adjusted-waist index(WWI)for major adverse cardiovascular events(MACE)risk in elderly patients with coronary heart disease(CHD).Methods:This retrospective study included 598 CHD patients aged over 60 years who were hospitalized at the First Hospital of Zhangjiakou from January 2018 to December 2020.Patients were divided into four groups(Q1-Q4)according to WWI quartiles and followed up for 36 months.The primary endpoint was MACE,including cardiovascular death,myocardial infarction,and revascularization.Kaplan-Meier survival analysis was used to evaluate survival differences among WWI groups,multivariate COX regression analysis was employed to assess the association strength between WWI and MACE risk,and restricted cubic splines(RCS)analysis was performed to determine their relationship pattern.Results:During the follow-up period,the overall incidence of MACE increased with rising WWI levels,progressively increasing from 8.2%in the Q1 group to 20.0%in the Q4 group(P=0.037).Kaplan-Meier analysis revealed significant differences in event-free survival rates among groups(Log-rank P=0.034).After adjusting for confounding factors in multivariate COX regression analysis,each unit increase in WWI was associated with approximately 170%increased risk of MACE(HR=2.70,95%CI:2.13-3.43,P<0.001).RCS analysis further confirmed a significant linear positive correlation between WWI and MACE risk.Conclusions:WWI levels show a significant positive correlation with MACE risk in elderly CHD patients and demonstrate good predictive value.This simple and practical indicator provides a new assessment tool for identifying high-risk patients clinically,with important implications for guiding individualized prevention and management of elderly CHD patients.

关 键 词：体质量调整的腰围指数 冠心病 老年人 主要不良心血管事件 预后 

分 类 号：R54[医药卫生—心血管疾病]