是否可以通过致动脉粥样硬化指数预测外周动脉疾病的复杂性？

Is it possible to predict the complexity of peripheral artery disease with atherogenic index?

作者信息

Mesut Engin, Cihan Aydın, Orhan Guvenc

机构信息

Department of Cardiovascular Surgery, University of Health Sciences, Mehmet Akif İnan Training and Research Hospital, Karaköprü/Şanlıurfa, Türkiye.

Department of Cardiology, University of Health Sciences, Ahi Evren Thoracic and Vascular Surgery Training and Research Hospital, Trabzon, Turkey.

出版信息

Vascular. 2020 Oct;28(5):513-519. doi: 10.1177/1708538120923531. Epub 2020 May 9.

DOI:10.1177/1708538120923531

PMID:32390562

Abstract

OBJECTIVES

Lower extremity peripheral artery disease develops mainly due to atherosclerosis and occurs as a result of the systemic atherosclerotic process. Increased triglyceride (TG) and decreased high density lipoprotein cholesterol (HDL-C) values increase atherosclerosis risk. With regard to this information, TG/HDL-C ratio is used as the atherogenic index. The aim of the present study was to evaluate the role of TG/HDL-C ratio to predict the complexity of disease in patients with peripheral artery disease.

METHODS

Patients who were diagnosed with peripheral artery disease and admitted to our clinic between August 2013 and August 2019 were included in this study retrospectively. Patients were divided into two groups based on angiographic evaluations with TransAtlantic Inter-Society Consensus-II classification. Those with TASC A-B lesions were included in Group 1 and those with TASC C-D lesions constituted Group 2.

RESULTS

The mean ages of Group 1 ( = 314) and Group 2 ( = 98) patients were 56.1 ± 9.3 and 58.4.1 ± 8.1 years, respectively. The frequency of male gender and coronary artery disease was significantly higher in Group 2 ( = 0.043, = 0.001, respectively). In Group 2, triglyceride and TG/HDL-C ratios were significantly high, while HDL-C was significantly low ( = 0.022, < 0.001, = 0.010, respectively). The multivariate logistic regression analysis performed to evaluate the parameters in predicting the angiographic complexity of peripheral artery disease showed that coronary artery disease (OR: 1.009 CI 95%: 1.003-1.021 = 0.016) and TG/HDL-C ratio (OR: 5.385 CI 95%: 2.553-9.357 = 0.001) were independent predictors for complexity. ROC analysis revealed that the cut-off value of TG/HDL-C was 2.9 (AUC = 0.670, < 0.001) with 75.5% sensitivity and 56.7% specificity.

CONCLUSIONS

It is possible to predict the angiographic complexity of peripheral artery disease with TG/HDL-C ratio, also known as atherogenic index, which is easily obtained by routine biochemical parameters.

摘要

目的

下肢外周动脉疾病主要因动脉粥样硬化发展而来，是全身动脉粥样硬化进程的结果。甘油三酯（TG）升高和高密度脂蛋白胆固醇（HDL-C）降低会增加动脉粥样硬化风险。基于此信息，TG/HDL-C比值被用作致动脉粥样硬化指数。本研究的目的是评估TG/HDL-C比值在预测外周动脉疾病患者疾病复杂性方面的作用。

方法

回顾性纳入2013年8月至2019年8月期间在我院门诊确诊为外周动脉疾病的患者。根据跨大西洋协作组共识-II分类的血管造影评估将患者分为两组。TASC A - B级病变患者纳入第1组，TASC C - D级病变患者构成第2组。

结果

第1组（n = 314）和第2组（n = 98）患者的平均年龄分别为56.1±9.3岁和58.4±8.1岁。第2组男性和冠状动脉疾病的发生率显著更高（分别为P = 0.043，P = 0.001）。在第2组中，甘油三酯和TG/HDL-C比值显著升高，而HDL-C显著降低（分别为P = 0.022，P < 0.001，P = 0.010）。为评估预测外周动脉疾病血管造影复杂性的参数而进行的多因素逻辑回归分析表明，冠状动脉疾病（OR：1.009，95%CI：1.003 - 1.021，P = 0.016）和TG/HDL-C比值（OR：5.385，95%CI：2.553 - 9.357，P = 0.001）是复杂性的独立预测因素。ROC分析显示，TG/HDL-C的截断值为2.9（AUC = 0.670，P < 0.001），敏感性为75.5%，特异性为56.7%。