血清肌酐/胱抑素C比值与心血管疾病发病率和死亡率之间的关联：来自美国国家健康与营养检查调查（NHANES）的见解
The Association between Serum Creatinine/Cystatin C Ratio and Cardiovascular Morbidity and Mortality: Insights from NHANES.
作者信息
Shi Jianli, Wu Yufeng, Zhu Shiyu, Xie Yao, Xiang Meixiang
机构信息
Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, Zhejiang, China.
出版信息
Rev Cardiovasc Med. 2023 Sep 25;24(9):275. doi: 10.31083/j.rcm2409275. eCollection 2023 Sep.
BACKGROUND
The Serum creatinine/cystatin C ratio (Cr/CysC ratio) is an emerging alternative index for muscle mass loss, a risk factor for cardiovascular diseases (CVDs). However, the association between the Cr/CysC ratio and CVD morbidity and mortality remains unknown.
METHODS
A total of 11,150 participants of the National Health and Nutrition Examination Survey (NHANES) were included in this study. Univariable and multivariable logistic regression models were employed to assess the association between the Cr/CysC ratio and self-reported CVD morbidity. Cox proportional hazard models were used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of the Cr/CysC ratio for CVD mortality.
RESULTS
At baseline, 1181 (7.90%) participants had self-reported CVDs. Lower Cr/CysC ratios were found in participants with CVDs (1.18 0.30 vs. 1.05 0.23, 0.001). In the multivariable logistic regression model, the Cr/CysC ratio was inversely linked to CVD morbidity (odds ratio: 0.65, 95% CI: 0.52-0.81, 0.001, per standard deviation [SD] increase). 997 (8.94%) CVD deaths were documented during a median follow-up of 16.9 years. A higher Cr/CysC ratio was associated with a decreasing risk of CVD mortality (adjusted HR: 0.54, 95% CI: 0.46-0.65, 0.001, per SD increase).
CONCLUSIONS
In NHANES participants, the Cr/CysC ratio had an inverse correlation with CVD morbidity and mortality.
背景
血清肌酐/胱抑素C比值（Cr/CysC比值）是一种新兴的用于评估肌肉量减少的替代指标，而肌肉量减少是心血管疾病（CVD）的一个危险因素。然而，Cr/CysC比值与CVD发病率和死亡率之间的关联尚不清楚。
方法
本研究纳入了美国国家健康与营养检查调查（NHANES）的11150名参与者。采用单变量和多变量逻辑回归模型评估Cr/CysC比值与自我报告的CVD发病率之间的关联。采用Cox比例风险模型估计Cr/CysC比值对CVD死亡率的风险比（HR）和95%置信区间（CI）。
结果
在基线时，1181名（7.90%）参与者自我报告患有CVD。患有CVD的参与者的Cr/CysC比值较低（1.18±0.30 vs. 1.05±0.23，P<0.001）。在多变量逻辑回归模型中，Cr/CysC比值与CVD发病率呈负相关（优势比：0.65，95%CI：0.52 - 0.81，P<0.001，每增加一个标准差[SD]）。在中位随访16.9年期间，记录了997例（8.94%）CVD死亡病例。较高的Cr/CysC比值与CVD死亡率风险降低相关（调整后的HR：0.54，95%CI：0.46 - 0.65，P<0.001，每增加一个SD）。
结论
在NHANES参与者中，Cr/CysC比值与CVD发病率和死亡率呈负相关。
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