摘要
目的 分析单核细胞与高密度脂蛋白比值(MHR)在慢性精神分裂症代谢综合征(MS)评估中的价值.方法 选取慢性精神分裂症患者100例作为研究组,另选择同期在医院体检健康体检者100例作为对照组,收集两组入选者的一般人口学资料[性别、年龄、体质量指数(BMI)]和实验室检查资料[单核细胞计数(M)、血糖(GLU)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、MHR等];依据慢性精神分裂症患者是否伴发MS分为MS组和非MS组,根据患者MHR采用四分位法分为A组(n=25)、B组(n=25)、C组(n=25)及D组(n=25);比较MS组与非MS组患者一般资料及糖脂代谢水平,分析MHR四分位法的4个亚组糖脂代谢水平及MS的发生率;采用Pearson相关性分析MHR与BMI及糖脂代谢指标的相关性、二元logistic回归分析慢性精神分裂症伴发MS的影响因素,采用受试者工作特征(ROC)曲线下面积(AUC)评估MHR在慢性精神分裂症伴发MS的诊断价值.结果 与对照组比较,研究组BMI、M、TG、GLU、MHR水平升高,HDL水平降低,差异有统计学意义(P＜0.05);与非MS组比较,MS组病程、年龄、BMI、GLU、TG、MHR水平增加,HDL水平降低,差异有统计学意义(P＜0.05);与A组比较,B组、C组、D组BMI增加,HDL水平降低,P＜0.05;与A组(8％)比较,B组(12％)、C组(28％)、D组(40％)MS发生率均升高,差异有统计学意义(P＜0.05);研究组的MHR与BMI、TG呈正相关(P＜0.05);与HDL水平呈负相关(P＜0.05);年龄、BMI、TG、MHR均是慢性精神分裂症伴发MS的独立危险因素(P＜0.05);ROC曲线分析结果显示,MHR诊断慢性精神分裂症伴发MS的AUC为0.721,95％CI为0.592～0.849,敏感度和特异度分别为77.3％、61.5％.结论 MHR与慢性精神分裂症伴发MS有关,对慢性精神分裂症患者伴发MS方面具有良好的预测价值.
Abstract
Objective To analyze the value of the ratio of monocyte to high density lipoprotein(MHR)in evaluating chronic schizophrenia comorbid with metabolic syndrome(MS).Methods A total of 100 patients with chronic schizophrenia were selected as research group,and another 100 healthy subjects who underwent physical examination in the hospital during the same period were selected as control group.General demographic data of two groups were collected,including gender,age,body mass index(BMI)and laboratory examination data[monocyte count(M),blood glucose(GLU),total cholesterol(TC),triglycerides(TG),high-density lipoprotein(HDL),low-density lipoprotein(LDL),and MHR,etc.].According to whether chronic schizophrenia patients had MS,they were divided into MS and non-MS groups.According to the patient's MHR,the patients were divided into quartiles:group A(n=25),group B(n=25),group C(n=25),and group D(n=25).General data,glucose & lipid metabolism levels of the patients were compared between MS and non-MS groups.Glucose & lipid metabolism levels and the incidence of MS were analyzed in A-D subgroups.Pearson correlation was used to analyze the correlation between MHR and BMI,MHR and glucose & lipid metabolism indexes.Binary Logistic regression was used to analyze the influencing factors of chronic schizophrenia comorbid with MS.Area under the receiver operating characteristic(ROC)curve(AUC)was used to evaluate the diagnostic value of MHR in chronic schizophrenia comorbid with MS.Result When compared to control group,research group showed the increased BMI,M,TG,GLU and MHR,decreased HDL(P＜0.05).When compared to non-MS group,MS group exhibited increased disease duration,age,BMI,GLU,TG and MHR,along with decreased HDL levels(P＜0.05).When compared to group A,groups B,C,and D had increased BMIs and decreased HDL levels(P＜0.05).When compared to group A(8％),the incidences of MS were increased in groups B(12％),C(28％),and D(40％,P＜0.05).MHR in research group was positively correlated with BMI and TG(P＜0.05)and negatively correlated with HDL level(P＜0.05).Age,BMI,TG,and MHR were all independent risk factors of chronic schizophrenia comorbid with MS(P＜0.05).ROC curve analysis showed that the AUC of MHR in diagnosing chronic schizophrenia comorbid with MS was 0.721,with 95％CI of 0.592-0.849,the sensitivity of 77.3％and the specificity of 61.5％,respectively.Conclusion MHR is associated with the co-occurrence of MS in patients with chronic schizophrenia.MHR is of good predictive value in assessing the coexistence of MS in these patients.
基金项目
安徽省自然科学基金项目(2208064MH163)
2023年安徽医科大学校科研基金立项资助项目(2023xkj187)
NETL
NSTL
万方数据