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血浆致动脉粥样硬化指数或低密度脂蛋白/高密度脂蛋白比值,哪一个对周围动脉疾病复杂性的预测性更强?

Is plasma atherogenic index or LDL/HDL ratio more predictive of peripheral arterial disease complexity?

作者信息

Evsen Ali, Aktan Adem, Altunova Mehmet, Özbek Mehmet

机构信息

Department of Cardiology, Dağkapı State Hospital, Diyarbakır, Turkey.

Department of Cardiology, Mardin Artuklu University Faculty of Medicine, Mardin, Turkey.

出版信息

Vascular. 2025 Jun;33(3):648-653. doi: 10.1177/17085381241260203. Epub 2024 Jun 11.

Abstract

IntroductionThe most basic and well-known cause of peripheral arterial disease (PAD) is atherosclerosis. One of the main factors causing atherosclerosis is dyslipidemia. We will evaluate whether specific ratios of dyslipidemia, such as the atherogenic plasma index (AIP) and LDL/HDL ratio, which have recently been used in practice, can help us to predict the complexity of PAD in the clinic.MethodsA total of 305 patients with PAD admitted to our clinic were retrospectively included in this study. After evaluation according to angiography images using TASC-II classification, patients were divided into TASC A-B and TASC C-D. AIP was evaluated with the following formula: Log (TG/HDL). Cut-off values for AIP and LDL/HDL were determined on the ROC (receiver operating characteristic) curve. Logistic regression analysis were conducted to predict peripheral arterial disease complexity.ResultsThe mean ages of Group 1 (:180, 68.3% male) and Group 2 (:125, 77.6% male) patients were 64.10 ± 12.39 and 64.94 ± 11.12 years, respectively. The prevalence of diabetes mellitus (DM, < 0.016) and coronary artery disease (CAD, < 0.001) was higher in group 2. Group 2 had higher TG ( = 0.045), LDL-C ( = 0.004), AIP ( = 0.010), LDL/HDL ( < 0.001), and lower HDL-C ( = 0.015). In multivariate logistic regression analysis evaluating parameters in predicting PAD complexity, DM (OR: 1.66 Cl 95%: 1.01-2.73 = 0.045), CAD (OR: 2.86 Cl 95%: 1.75-4.69 < 0.001) and LDL/HDL (OR: 1.47 Cl 95%: 1.10-1.96 p = 0.008) were independent variables.ConclusionIn our study, we compared LDL/HDL ratio and AIP in PAD for the first time in the literature and showed that LDL/HDL ratio is a more valuable ratio and an independent predictor of PAD complexity.

摘要

引言

外周动脉疾病(PAD)最基本且广为人知的病因是动脉粥样硬化。导致动脉粥样硬化的主要因素之一是血脂异常。我们将评估血脂异常的特定比率,如近期临床实践中使用的致动脉粥样硬化血浆指数(AIP)和低密度脂蛋白/高密度脂蛋白比率,是否有助于我们在临床上预测PAD的复杂性。

方法

本研究回顾性纳入了我院收治的305例PAD患者。根据血管造影图像采用TASC-II分类法进行评估后,患者被分为TASC A-B组和TASC C-D组。AIP采用以下公式评估:Log(甘油三酯/高密度脂蛋白)。通过ROC(受试者工作特征)曲线确定AIP和低密度脂蛋白/高密度脂蛋白的临界值。进行逻辑回归分析以预测外周动脉疾病的复杂性。

结果

第1组(n = 180,男性占68.3%)和第2组(n = 125,男性占77.6%)患者的平均年龄分别为64.10±12.39岁和64.94±11.12岁。第2组糖尿病(DM,P < 0.016)和冠状动脉疾病(CAD,P < 0.001)的患病率更高。第2组的甘油三酯(P = 0.045)、低密度脂蛋白胆固醇(P = 0.004)、AIP(P = 0.010)、低密度脂蛋白/高密度脂蛋白(P < 0.001)更高,而高密度脂蛋白胆固醇(P = 0.015)更低。在评估预测PAD复杂性参数的多因素逻辑回归分析中,DM(OR:1.66,95%CI:1.01 - 2.73,P = 0.045)、CAD(OR:2.86,95%CI:1.75 - 4.69,P < 0.001)和低密度脂蛋白/高密度脂蛋白(OR:1.47,95%CI:1.10 - 1.96,P = 0.008)为独立变量。

结论

在我们的研究中,我们在文献中首次比较了PAD患者的低密度脂蛋白/高密度脂蛋白比率和AIP,并表明低密度脂蛋白/高密度脂蛋白比率是一个更有价值的比率,是PAD复杂性的独立预测指标。

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