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高敏 C 反应蛋白与高密度脂蛋白胆固醇比值。

High-Sensitivity C-Reactive Protein to HDL-C Ratio.

机构信息

School of Medicine, University of Electronic Science and Technology of China.

School of Medicine, Southwest Medical University.

出版信息

Int Heart J. 2021 Nov 30;62(6):1221-1229. doi: 10.1536/ihj.21-246. Epub 2021 Nov 6.

DOI:10.1536/ihj.21-246
PMID:34744148
Abstract

Inflammation and lipid signaling are involved in the pathogenesis and progression of coronary artery disease (CAD). We proposed that high-sensitivity C-reactive proteins, as a marker of the pro-inflammatory state, and high-density lipoprotein cholesterol (HDL-C), as an anti-atherosclerosis component, should be integrated into a single novel biomarker. Our work was conducted to discuss and compare the predictive ability of the high-sensitivity C-reactive protein to high-density lipoprotein cholesterol ratio (CHR) with other existing indices, for example, neutrophil high-density lipoprotein ratio (NHR) and neutrophil lymphocyte ratio (NLR), in the severity of CAD patients.Based on the results of coronary angiography, patients were divided into the CAD group, CAD group, and control group. The relationship between various serum markers and the severity of coronary artery disease was examined via Spearman's correlation analysis. Logistic regression analysis was conducted to identify the influencing factors of the coronary artery disease severity.This study included 420 patients. The Gensini score was positively correlated with CHR. Multiple regression analysis revealed that the CHR was significantly associated with CAD. CHR is an independent predictor of CAD. The receiver operating characteristic (ROC) analysis provided a cut-off value of 1.17 for CHR to predict CAD, with a specificity of 86.7%, Yoden index of 0.264, and area under the ROC curve of 0.662 (95% confidence intervals 0.606-0.719, P < 0.001). At the same time, the area under the ROC curve of the NHR was 0.652, and that of the NLR was 0.579. The results of the DeLong test indicated that the area under the ROC curve of the CHR was larger than that of the NLR (P = 0.0306). This suggests that the CHR as a predictor of CAD has better diagnostic performance than the NLR.CHR was not only closely related to the presence and severity of CAD but also an independent predictor of severe CAD.

摘要

炎症和脂质信号参与冠状动脉疾病 (CAD) 的发病机制和进展。我们提出,高敏 C 反应蛋白作为炎症状态的标志物,高密度脂蛋白胆固醇 (HDL-C) 作为抗动脉粥样硬化成分,应该整合到一个单一的新型生物标志物中。我们的工作旨在讨论和比较高敏 C 反应蛋白与高密度脂蛋白胆固醇比值 (CHR) 与其他现有指标(如中性粒细胞高密度脂蛋白比值 (NHR) 和中性粒细胞淋巴细胞比值 (NLR))在 CAD 患者严重程度中的预测能力。

根据冠状动脉造影结果,患者分为 CAD 组、非 CAD 组和对照组。通过 Spearman 相关分析研究了各种血清标志物与冠状动脉疾病严重程度的关系。通过逻辑回归分析确定了冠状动脉疾病严重程度的影响因素。

本研究共纳入 420 例患者。Gensini 评分与 CHR 呈正相关。多因素回归分析显示,CHR 与 CAD 显著相关。CHR 是 CAD 的独立预测因子。ROC 分析提供了 CHR 预测 CAD 的截断值为 1.17,特异性为 86.7%,Yoden 指数为 0.264,ROC 曲线下面积为 0.662(95%置信区间为 0.606-0.719,P<0.001)。同时,NHR 的 ROC 曲线下面积为 0.652,NLR 的 ROC 曲线下面积为 0.579。DeLong 检验结果表明,CHR 的 ROC 曲线下面积大于 NLR(P=0.0306)。这表明 CHR 作为 CAD 的预测因子具有比 NLR 更好的诊断性能。

CHR 不仅与 CAD 的存在和严重程度密切相关,而且是严重 CAD 的独立预测因子。

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