Department of Cardiovascular Medicine, 521 Hospital of Norinco Group, Xi'an 710065.
Department of Cardiovascular Medicine, Shaanxi Provincial People's Hospital, Xi'an 710068, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2023 Jan 28;48(1):34-39. doi: 10.11817/j.issn.1672-7347.2023.220025.
Serum cystatin C (Cys C) and blood lipid levels are related to the occurrence and development of chronic heart failure (CHF). However, there are few reports on the correlation between blood lipid level and serum Cys C level in patients with CHF. The aim of this study is to explore the correlation between serum Cys C level and blood lipid level in patients with CHF, and to provide valuable reference for clinical diagnosis and treatment of CHF.
A total of 336 CHF patients who were hospitalized in the Department of Cardiovascular Medicine of Shaanxi Provincial People's Hospital from October 2017 to July 2018 were included and they were divided into a Cys C normal group (n=180) and a Cys C abnormal group (n=156) according to serum Cys C level of the patients. The general data, laboratory indicators, and cardiac ultrasound results were compared between the 2 groups. Pearson correlation analysis was used to detect the correlation between serum Cys C level and blood lipid level and other factors, and the data related to Cys C were further analyzed by multivariate logistic regression.
Compared with the Cys C normal group, patients in the Cys C abnormal group had lower left ventricular ejection fraction (LVEF) (P<0.001), older age (P=0.030), higher incidence rate of diabetes and smoking index (P=0.002 and P=0.003, respectively). The levels of serum creatinine (SCr), blood urea nitrogen (BUN), and total bilirubin (TBIL) were higher (all P<0.001), while the levels of high density lipoprotein (HDL), apolipoprotein (Apo) A, and albumin (ALB) were lower (P<0.001, P=0.001, and P=0.003, respectively) in the Cys C abnormal group. Pearson correlation analysis showed that serum Cys C level was negatively correlated with platelet count, HDL, Apo A, ALB, and LVEF. It was positively correlated with smoking index, mean platelet volume, neutrophil ratio, BUN, and TBIL (all P<0.05). The results of multivariate logistic regression analysis showed that the decreased HDL level was a risk factor for the abnormality of serum Cys C in patients with CHF (OR=0.119, P=0.003), while Apo A was not a risk factor for its abnormality (P=0.337).
HDL might be the only blood lipid index associated with abnormal serum Cys C in patients with CHF.
血清胱抑素 C（Cys C）和血脂水平与慢性心力衰竭（CHF）的发生和发展有关。然而，关于 CHF 患者血脂水平与血清 Cys C 水平之间的相关性的报道较少。本研究旨在探讨 CHF 患者血清 Cys C 水平与血脂水平之间的相关性，为 CHF 的临床诊断和治疗提供有价值的参考。
选取 2017 年 10 月至 2018 年 7 月在陕西省人民医院心血管内科住院的 336 例 CHF 患者，根据患者血清 Cys C 水平分为 Cys C 正常组（n=180）和 Cys C 异常组（n=156）。比较两组患者的一般资料、实验室指标和心脏超声结果。采用 Pearson 相关分析检测血清 Cys C 水平与血脂水平及其他因素的相关性，对与 Cys C 相关的数据进行多元逻辑回归分析。
与 Cys C 正常组相比，Cys C 异常组患者的左心室射血分数（LVEF）较低（P<0.001），年龄较大（P=0.030），糖尿病和吸烟指数的发生率较高（P=0.002 和 P=0.003）。血清肌酐（SCr）、血尿素氮（BUN）和总胆红素（TBIL）水平较高（均 P<0.001），而高密度脂蛋白（HDL）、载脂蛋白（Apo）A 和白蛋白（ALB）水平较低（P<0.001、P=0.001 和 P=0.003）。Pearson 相关分析显示，血清 Cys C 水平与血小板计数、HDL、Apo A、ALB 和 LVEF 呈负相关，与吸烟指数、平均血小板体积、中性粒细胞比例、BUN 和 TBIL 呈正相关（均 P<0.05）。多元逻辑回归分析结果显示，HDL 水平降低是 CHF 患者血清 Cys C 异常的危险因素（OR=0.119，P=0.003），而 Apo A 不是其异常的危险因素（P=0.337）。
HDL 可能是 CHF 患者血清 Cys C 异常的唯一血脂指标。
