中国中老年人脂质衍生指标与心血管-肾脏代谢综合征进展的相关性：一项纵向研究

摘要(中文译文)

心血管-肾脏-代谢综合征(CKM)凸显了代谢异常、慢性肾脏病(CKD)与心血管疾病(CVD)之间的病理关联。脂质代谢与这些疾病的病理生理学密切相关。本研究旨在探讨八种脂质衍生指标与CKM综合征进展之间的关联。本研究利用2011至2020年中国健康与养老追踪调查(CHARLS)的数据。纳入的脂质衍生指标包括:血浆致动脉粥样硬化指数(AIP)、非高密度脂蛋白胆固醇(Non-HDL-C)、非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值(NHHR)、脂蛋白联合指数(LCI)、残余胆固醇(RC)、脂质蓄积指数(LAP)、内脏脂肪指数(VAI)和甘油三酯-葡萄糖指数(TyG)。采用Cox回归分析和限制性立方样条(RCS)模型评估脂质衍生指标与CKM综合征0-3期人群进展为CVD之间的关联。通过一致性指数(C-index)比较预测性能。采用Logistic回归和RCS模型分析脂质衍生指标与CKM综合征进展之间的关联。在调整潜在混杂因素后,除RC外,所有脂质衍生指标均与CKM综合征0-3期人群的CVD风险呈正相关。Cox回归模型显示,AIP、non-HDL-C、NHHR、LCI、LAP、VAI和TyG与CVD风险呈正相关。RCS模型表明,AIP、NHHR、LCI和TyG与CVD风险呈线性关联,而LAP和VAI与CVD风险呈非线性关联。纳入NHHR的预测模型表现最佳,C-index为0.6322。同样,Logistic回归分析确定,除RC外,所有脂质衍生指标均与CKM综合征的进展呈正相关。七种脂质衍生指标——AIP、non-HDL-C、NHHR、LCI、LAP、VAI和TyG——与诊断为CKM综合征0-3期个体的CVD风险呈正相关。NHHR对CVD风险表现出更强的预测价值。此外,这七种指标与CKM综合征的进展呈正相关,提示这些脂质衍生指标是CKM进展的重要预测因子。

Abstract

The cardiovascular-kidney-metabolic syndrome (CKM) underscores the pathological interconnections between metabolic abnormalities, chronic kidney disease (CKD), and cardiovascular disease (CVD). Lipid metabolism is closely associated with the pathophysiology of these diseases. This study aimed to investigate the associations between eight lipid-derived indices and the progression of CKM syndrome. This study utilized data from the 2011-2020 China Health and Retirement Longitudinal Study (CHARLS). Lipid-derived indices were included: the atherogenic index of plasma (AIP), non-high-density lipoprotein cholesterol (Non-HDL-C), the non-HDL-C to HDL-C ratio (NHHR), the lipoprotein combined index (LCI), the remnant cholesterol (RC), the lipid accumulation product (LAP), the visceral adiposity index (VAI), and the triglyceride-glucose ratio (TyG). Cox regression analysis and restricted cubic spline (RCS) modeling were employed to assess the associations between lipid-derived indices and progression to CVD in the CKM syndrome stage 0-3 population. A comparison of prediction performance was conducted via the concordance index (C-index). Logistic regression and RCS models were used to analyze the associations between lipid-derived indices and the progression of CKM syndrome. After adjusting for potential confounders, all lipid-derived indices, except for RC, exhibited positive associations with the risk of CVD in the CKM syndrome stages 0-3 population. The Cox regression model revealed that the AIP, non-HDL-C, NHHR, LCI, LAP, VAI, and TyG were positively associated with the risk of CVD. The RCS models demonstrated that the AIP, NHHR, LCI, and TyG were linearly associated with CVD risk, whereas the LAP and VAI exhibited nonlinear associations with CVD risk. The predictive model incorporating NHHR demonstrated the highest performance, with a C-index of 0.6322. Similarly, all lipid-derived indices, except RC, were positively correlated with the progression of CKM syndrome, as determined by logistic regression analysis. Seven lipid-derived indices-AIP, non-HDL-C, NHHR, LCI, LAP, VAI, and TyG-were positively associated with the risk of CVD in individuals diagnosed with CKM syndrome across stages 0-3. The NHHR demonstrated a stronger predictive value for CVD risk. Additionally, the seven indices were positively correlated with the progression of CKM syndrome, suggesting that these lipid-derived indices are important predictors of CKM progression.

如何引用

Frontiers in nutrition 的其他文献

• 城市环境中与学童营养有关的父母知识、态度和做法：来自哈萨克斯坦中部的横断面研究
• 从饮食到大脑修复：缺血性卒中后恢复中的天然生物活性化合物
• 使用PHBHHx ZnO生物纳米复合材料的活性生物包装：提高食品安全性和保质期
• 揭示老年牙周炎患者心血管疾病风险的非线性饮食预测因素：横断面分析
• {“_”：“多糖：结构特征、药理潜力和先进递送系统综述。”，“i”：[“地黄”]}
• 山楂对脂质代谢稳态的调节作用：机制、证据和前景
• 基于移动互联网技术和中医体质理论的超重/肥胖综合管理模式的效果：随机对照试验
• 牛磺酸通过eCB-CB1轴减轻脂质积聚：来自HFD喂养小鼠和3D脂肪细胞球体的脂肪代谢组学证据
• CHG指数用于识别代谢功能障碍相关脂肪变性肝病的评估：来自两个独立的亚洲非肥胖人群的证据
• {“_”：“多糖通过调节肠道微生物群和代谢物减轻长期高脂肪饮食小鼠的肥胖。”，“i”：[“马齿苋”]}