Health Management Center, Deyang People's Hospital, No. 173, Taishan North Road, Deyang City, Sichuan Province, China.
BMC Cardiovasc Disord. 2023 Nov 21;23(1):572. doi: 10.1186/s12872-023-03618-9.
Existing research has established the pepsinogen ratio (PGR) as a complex biomarker, not only as an independent predictor for various gastrointestinal diseases but also in its association with atherosclerotic cardiovascular diseases. However, the precise mechanism linking changes in PGR to cardiovascular pathologies remains unclear. The objective of this study is to quantitatively elucidate the association between PGR and brachial-ankle pulse wave velocity (baPWV) as an indicator of atherosclerotic progression.
We conducted a cross-sectional study that analyzed clinical data from 465 patients who underwent health screenings. One-way Analysis of Variance (ANOVA) identified potential risk factors affecting baPWV. Multiple logistic regression was employed to evaluate if PGR serves as an independent risk factor for elevated baPWV after accounting for these variables. Generalized additive models and smoothed curve fitting were utilized to investigate the possibility of a nonlinear association between PGR and baPWV. When such nonlinearity was found, threshold effect analysis pinpointed the inflection point in this relationship, followed by segmented correlation analyses.
PGR negatively correlated with both right baPWV (RbaPWV) and left baPWV (LbaPWV) after adjusting for confounders. Smoothed curve analyses revealed nonlinear relationships, with inflection points at 22.5 for RbaPWV and 22.3 for LbaPWV. For PGR values below 22.5, a significant negative correlation with RbaPWV was observed (β = - 6.3 cm/s, P < 0.001). Conversely, for PGR values above 22.5, no significant linear relationship was found (P = 0.141). Similarly, when PGR was below 22.3, a strong negative correlation with LbaPWV was detected (β = - 7.0 cm/s, P < 0.001), but such correlation was absent for higher PGR levels (P = 0.273).
The study reveals that PGR is associated with RbaPWV and LbaPWV in a nonlinear manner. Specifically, lower levels of PGR were linearly and inversely correlated with baPWV, but this relationship became nonlinear at higher PGR levels. These findings suggest that modulating PGR levels may offer a therapeutic strategy for managing atherosclerosis.
已有研究将胃蛋白酶原比值（PGR）确立为一种复杂的生物标志物，其不仅可作为各种胃肠道疾病的独立预测因子，还与动脉粥样硬化性心血管疾病相关联。然而，PGR 变化与心血管病理之间的确切机制尚不清楚。本研究旨在定量阐明 PGR 与肱踝脉搏波速度（baPWV）之间的关联，后者作为动脉粥样硬化进展的指标。
我们进行了一项横断面研究，分析了 465 名接受健康筛查患者的临床数据。单因素方差分析（ANOVA）确定了影响 baPWV 的潜在危险因素。采用多因素逻辑回归评估 PGR 是否为校正这些变量后 baPWV 升高的独立危险因素。采用广义加性模型和平滑曲线拟合来研究 PGR 与 baPWV 之间可能存在的非线性关联。当发现非线性关系时，通过阈值效应分析确定该关系的拐点，然后进行分段相关分析。
校正混杂因素后，PGR 与右侧 baPWV（RbaPWV）和左侧 baPWV（LbaPWV）均呈负相关。平滑曲线分析显示存在非线性关系，拐点分别为 22.5 时的 RbaPWV 和 22.3 时的 LbaPWV。在 PGR 值低于 22.5 的情况下，与 RbaPWV 呈显著负相关（β=-6.3cm/s，P<0.001）。相反，在 PGR 值高于 22.5 的情况下，未发现明显的线性关系（P=0.141）。同样，当 PGR 值低于 22.3 时，与 LbaPWV 呈强烈负相关（β=-7.0cm/s，P<0.001），但在较高的 PGR 水平下，这种相关性不存在（P=0.273）。
本研究表明，PGR 与 RbaPWV 和 LbaPWV 呈非线性关联。具体而言，较低水平的 PGR 与 baPWV 呈线性和负相关，但在较高的 PGR 水平下，这种关系变得非线性。这些发现表明，调节 PGR 水平可能为治疗动脉粥样硬化提供一种治疗策略。
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