摘要
目的 探究胆红素血脂综合指数与原发性高血压(essential hypertension,EH)的相关性.方法 选取2022年6月至2023年6月于新疆医科大学第一附属医院综合内三科就诊的2795例患者,根据是否患有原发性高血压分为EH组(n=1163)和非EH组(n=1213).采用多因素Logistic回归分析影响EH发病风险的因素,依此构建EH发病的预测模型并绘制列线图,并对胆红素血脂综合指数进行亚组分析.结果 EH组与非EH组在年龄、族别、体质指数(BMI)、血红蛋白(HGB)、血小板(PLT)、纤维蛋白原(FIB)、血肌酐(Scr)、尿酸(UA)、空腹血糖(FBG)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白B(ApoB)、总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)、Index1[TC/(HDL-C+TBIL)]、Index2[LDL/(HDL-C+TBIL)]水平均具有统计学差异(P均＜0.05).Logistic分析显示,年龄、BMI、HGB、FIB、TG、DBIL、Index1、Index2是EH发生的危险因素.将其纳入构建预测模型,并绘制模型ROC曲线,曲线下面积为0.780(95％CI:0.762～0.799,P＜0.05),预测性能良好.在BMI 24～28 kg/m2分层下,在模型1、模型2、模型3中,Index2每增加1个标准差,EH风险分别增加43％、41.9％、61.2％.在BMI＞28 kg/m2分层下,Index1每增加1个标准差,在模型1、模型2、模型3中EH的发生风险分别为2.239倍、2.263倍、1.931倍.结论 胆红素血脂综合指数与EH的发生密切相关,且本研究构建的预测EH发病风险的列线图模型,具有较好的临床预测能力.
Abstract
Objective To discuss the correlation between bilirubin and lipid composite indexes and essential hypertension(EH).Methods A total of 2795 patients were chosen from the Third Departments of Comprehensive Internal Medicine in the First Affiliated Hospital of Xinjiang Medical University from June 2022 to June 2023.All patients were divided,according to EH occurrence status,into EH group(n=1163)and non-EH group(n=1213).The risk factors of EH were analyzed by using multi-factor Logistic regression analysis.On the above base,a predictive model of EH onset was established and a column chart was drawn.The bilirubin and lipid composite indexes were analyzed in subgroups.Results Between EH group and non-EH group,age,nationality,ethnicity,body mass index(BMI),hemoglobin(HGB),platelet(PLT),fibrinogen(FIB),serum creatinine(SCr),uric acid(UA),density lipoproteincholesterol,HDL-C)、fasting blood sugar(FBG),triglyceride(TG),total cholesterol(TC),low-density lipoproteincholesterol(LDL-C),high-density lipoproteincholesterol(HDL-C),apolipoprotein B(ApoB),total bilirubin(TBIL),direct bilirubin(DBIL),indirect bilirubin(IBIL),Index1[TC/(HDL-C+TBIL)]and Index2[LDL/(HDL-C+TBIL)]had statistical differences(all P＜0.05).The results of Logistic analysis showed that age,BMI,HGB,FIB,TG,DBIL,Index1 and Index2 were risk factors for EH occurrence.All risk factors were imported to predictive model and ROC curve of the model was drawn,and AUC of the model was 0.780(95％CI:0.762-0.799,P＜0.05).Under a stratificationof 24-28 kg/m2ofBMI,for each SD increase in Index2,the risk of EH occurrence increased by 43％,41.9％,and 61.2％,respectively,in model 1,model 2,and model 3.Under a stratification＞28 kg/m2 of BMI,for each SD increase in Index1,the risk of EH occurrence was 2.239 times,2.263 times and 1.931 times,respectively,in model 1,model 2,and model 3.Conclusion The bilirubin and lipid composite indexes is closely correlated to EH occurrence,and the column chart model for predicting EH risk has a higher efficacy in clinical practice.
基金项目
天山英才科技创新领军人才项目(2022TSYCLJ0023)
维普
万方数据