肾功能正常人群中胱抑素C与颈动脉内膜-中膜增厚相关性及预测价值的研究  

Study of the correlation and predictive value of cystatin C and carotid intima-media thickening in a population with normal renal function

作　　者：何沛原 刘玉萍[1] 帅平[1] 邓玲 何昱欣 HE Peiyuan;LIU Yuping;SHUAI Ping;DENG Ling;HE Yuxin(Department of Health Management&Institute of Health Management,Sichuan Provincial People's Hospital,University of Electronic Science and Technology of China,Chengdu,Sichuan Province 610072,China)

机构地区：[1]四川省科学学院·四川省人民医院(电子科技大学附属医院)健康管理中心(健康管理研究所),四川省成都610072

出　　处：《中国慢性病预防与控制》2025年第2期109-114,共6页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：四川省科技厅重点研发计划项目(2022YFS0600);四川省人民医院院基金项目(2021LY15);四川省卫计委干部保健科研课题(2020-226);中国健康促进基金会(2021HX023)。

摘　　要：目的探讨肾功能正常人群中血清胱抑素C(Cys C)与颈动脉内膜-中膜厚度(CIMT)增厚的相关性及其增高对CIMT增厚的预测价值,为心血管疾病的早期预防及管理提供新的研究方向。方法选取2023年1—12月在四川省人民医院健康管理中心接受血管彩色多普勒超声测量CIMT且估算肾小球滤过率(eGFR)≥60 ml/(min·1.73 m2)的31916名体检人群为研究对象。收集研究对象的一般人口学资料和生化检查指标,分为CIMT增厚组(n=19043)和CIMT正常组(n=12873);根据Cys C四分位水平将研究对象分为4组,分别为G_(1)(n=7374),G_(2)(n=8580),G_(3)(n=8344),G_(4)(n=7618)组。采用SPSS 25.0软件进行两组间Mann-Whitney U检验、多组间Kruskal-Wallis H检验和χ^(2)检验;采用Spearman秩相关进行相关性分析;采用多因素logistic回归分析Cys C与CIMT增厚之间的关系。绘制受试者工作特征(ROC)曲线,通过ROC曲线下面积(AUC)评价Cys C对CIMT增厚发生风险的预测价值。结果CIMT增厚组的年龄、体质指数(BMI)、吸烟年限、收缩压(SBP)、舒张压(DBP)、空腹血糖(FPG)、糖化血红蛋白(HbA_(1C))、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、尿素氮(BUN)和Cys C水平均显著高于CIMT正常组,差异均有统计学意义(P<0.01)。CIMT增厚组的高密度脂蛋白胆固醇(HDL-C)和eGFR水平低于CIMT正常组,差异均有统计学意义(P<0.01)。G_(1)~G_(4)组间所有指标的差异均有统计学意义(P<0.01)。Spearman秩相关分析结果显示,Cys C与年龄、BMI、吸烟年限、血尿酸(UA)、TG、FPG、DBP、SBP、腰围(WC)、HbA_(1C)、血肌酐(Scr)、BUN均呈正相关(P<0.01);与TC、HDL-C和eGFR呈负相关(P<0.05,P<0.01)。logistic回归分析结果显示,调整混杂因素后,在Cys C不分组的情况下模型1(OR=2.29,95%CI:1.89~2.77)、模型2(OR=2.13,95%CI:1.76~2.59)、模型3(OR=1.69,95%CI:1.38~2.09)与模型4(OR=1.33,95%CI:1.12~1.79)Cys C增高与CIMT增厚之间的关联均有统计学意义(P<0.0Objective To explore the correlation between serum cystatin C(Cys C)and carotid intima-media thickness(CIMT)thickening in people with normal renal function and the predictive value of its increase in CIMT thickening,and provide the new research direction for early prevention and management of cardiovascular disease.Methods A total of 31916 residents who received vascular color Doppler ultrasound measurement of CIMT and with estimated glomerular filtration rate(eGFR)≥60 ml/(min·1.73 m2)from January to December 2023 as the subjects.The investigation was performed with collecting the general demographic data and biochemical examination indicators of subjects,the subjects were divided into the CIMT thickening group(n=19043)and CIMT normal group(n=12873);the subjects were divided into 4 groups according to the Cys C quartile level,G_(1)(n=7374),G_(2)(n=8580),G_(3)(n=8344),and G_(4)(n=7618)groups.Mann-Whitney U test between two groups,Kruskal-Wallis H test and χ^(2) test between multiple groups were performed;the correlation analysis was performed by Spearman rank correlation;binary logistic regression was used to analyze the relationship between Cys C and CIMT thickening.Subject operating characteristic(ROC)curve was drawn,and the predictive value of Cys C on the risk of CIMT thickening was evaluated by the area under the ROC curve(AUC).The used software was SPSS 25.0.Results The results of the study indicated that the age,body mass index(BMI),smoking years,systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting plasma glucose(FPG),glycated hemoglobin(HbA_(1C)),triglycerides(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),blood urea nitrogen(BUN)and Cys C levels in the CIMT thickening group were significantly higher than those in the CIMT normal group,P<0.01.The HDL-C and eGFR levels in the CIMT thickening group were significantly lower than those in the CIMT normal group,P<0.01.There were significant differences of all indicators between G_(1) and G_(4) groups(P<0.01).Spearman rank

关 键 词：颈动脉内膜-中膜厚度 体检人群 相关性分析 回归分析 预测作用 

分 类 号：R543.4[医药卫生—心血管疾病]