HBV 感染与美国人群冠心病患病率的相关性。
Association between HBV Infection and the Prevalence of Coronary Artery Disease in the US Population.
机构信息
Department of Geriatrics, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China.
Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
出版信息
Comput Math Methods Med. 2022 Aug 8;2022:5062798. doi: 10.1155/2022/5062798. eCollection 2022.
AIMS
This study aims to investigate the association between HBV infection and coronary artery disease (CAD) prevalence in the US population. A nomogram was proposed to predict CAD based on HBV infection.
METHODS
25,749 individuals were collected from the 2001-2014 National Health and Nutrition Examination Survey. Participants with hepatitis B core antibody seropositivity were identified with HBV infection, including current and previous HBV infection status. We used adjusted logistic regression and performed sensitivity analysis to investigate the association between HBV infection and the prevalence of CAD. The effect size was evaluated by odds ratio (OR) with a 95% confidence interval (CI). Then, we created a nomogram to predict coronary artery disease. Additionally, we applied the Cox regression model to assess the association between HBV infection and all-cause mortality in those with baseline CAD.
RESULTS
1790 (6.95%) individuals were with HBV infection. In the adjusted model, individuals with HBV showed a decreased CAD risk than those without (OR, 0.81; 95% CI, 0.67-0.98). Consistently, reduced risk in self-reported angina (OR, 0.72; 95% CI, 0.52-0.98) and coronary heart disease (OR, 0.76; 95% CI, 0.58-0.98) was observed in the hepatitis B core antibody seropositivity group. The subgroup analysis showed a consistent trend in the subgroups of age (<45 or ≥45), gender (male or female), hypertension (no or yes), and diabetes (no or yes). In the testing set, the proposed predictive model showed good performance with an area under the curve of 0.85 (95% CI, 0.83-0.86). There was no significant association between HBV infection and all-cause mortality in CAD patients (adjusted = 0.202).
CONCLUSION
Our study suggests that HBV infection was associated with lower CAD risk. The proposed nomogram showed good performance in predicting CAD. However, no significant association was observed between HBV and all-cause mortality in CAD patients.
目的
本研究旨在探讨乙型肝炎病毒（HBV）感染与美国人群冠心病（CAD）患病率之间的关系。提出了一种基于 HBV 感染预测 CAD 的列线图。
方法
从 2001 年至 2014 年的全国健康与营养调查中收集了 25749 名个体。通过乙型肝炎核心抗体阳性来确定 HBV 感染，包括当前和既往 HBV 感染状态。我们使用调整后的 logistic 回归进行敏感性分析，以调查 HBV 感染与 CAD 患病率之间的关系。使用比值比（OR）及其 95%置信区间（CI）评估效应大小。然后，我们创建了一个列线图来预测冠心病。此外，我们应用 Cox 回归模型评估基线 CAD 患者中 HBV 感染与全因死亡率之间的关系。
结果
1790 人（6.95%）存在 HBV 感染。在调整后的模型中，HBV 感染者 CAD 的风险低于无 HBV 感染者（OR，0.81；95%CI，0.67-0.98）。同样，在乙型肝炎核心抗体阳性组中，自述心绞痛（OR，0.72；95%CI，0.52-0.98）和冠心病（OR，0.76；95%CI，0.58-0.98）的风险也降低。亚组分析显示，在年龄（<45 岁或≥45 岁）、性别（男性或女性）、高血压（无或有）和糖尿病（无或有）亚组中均存在一致的趋势。在验证集中，所提出的预测模型具有良好的性能，曲线下面积为 0.85（95%CI，0.83-0.86）。在 CAD 患者中，HBV 感染与全因死亡率之间无显著关联（调整后的 HR=0.202）。
结论
本研究表明，HBV 感染与 CAD 风险降低相关。所提出的列线图在预测 CAD 方面具有良好的性能。然而，在 CAD 患者中，HBV 与全因死亡率之间无显著关联。
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