血清白蛋白联合高密度脂蛋白胆固醇作为预测冠心病的新型标志物：它们的关联是相乘的还是可分级的？

Serum albumin combined with high-density lipoprotein cholesterol as a novel marker to predict coronary heart disease: are their associations multiplicative or rateable?

作者信息

He Li, Chen Sisi, Zhu Xuan, He Fang

机构信息

Department of Emergency, Wuhan Fourth Hospital, Wuhan, Hubei, China.

出版信息

Front Cardiovasc Med. 2025 Jul 30;12:1508972. doi: 10.3389/fcvm.2025.1508972. eCollection 2025.

DOI:10.3389/fcvm.2025.1508972

PMID:40809897

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12343592/

Abstract

BACKGROUND

Coronary heart disease (CHD) is a leading cause of death and disability worldwide. Albumin (ALB) and high-density lipoprotein cholesterol (HDL-c) possess potential clinical application values. However, the relationship between ALB*HDL-c (AHM) and CHD in the general population has not been studied yet. Therefore, this study aims to investigate the association between the AHM and CHD.

METHODS

We conducted a retrospective study using data from 2,568 patients with a diagnosis of CHD from Wuhan Fourth Hospital. Patients with one or more major coronary artery or branch vessel stenosis ≥ 50% were included in the CHD group, while patients without CHD were enrolled in the control group. Logistic regression analysis was performed to determine the influence of AHM on CHD. The receiver operating characteristic (ROC) curve was constructed to analyze the predictive value of AHM for CHD.

RESULTS

A total of 1,824 enrolled patients (71.0%) were diagnosed with CHD. The mean age was 64.56 ± 10.08 years. Notably, the CHD group had a substantially lower median AHM than that of the control group (36.94 vs. 52.63), with a statistically significant difference ( < 0.05). Specifically, logistic regression demonstrated that AHM was an independent risk factor for CHD (OR = 0.903, 95% CI: 0.888-0.918) in identifying CHD. In ROC analysis, the area under the ROC curve (AUC) for AHM [0.808 (95% CI: 0.791-0.825, < 0.001)] was larger than that for ALB, HDL-c, and ALB-HDL-c ratio (AHR), and the differences were statistically significant ( < 0.05). Additionally, the Gensini (GS) score was negatively correlated with AHM ( = -0.150, < 0.001). AHM was significantly associated with multivessel CHD (OR = 0.903, 95% CI: 0.888-0.918), and ROC analysis showed an AUC of 0.639 for AHM in predicting multivessel CHD.

CONCLUSION

AHM was significantly linked to an elevated risk of CHD. The lower the AHM level, the greater the CHD occurrence rate. AHM is associated not only with the occurrence of CHD but also with the severity of coronary artery stenosis. This underscores the crucial value of AHM in the discrimination and management of CHD.

摘要

背景

冠心病（CHD）是全球死亡和残疾的主要原因。白蛋白（ALB）和高密度脂蛋白胆固醇（HDL-c）具有潜在的临床应用价值。然而，一般人群中ALB*HDL-c（AHM）与冠心病之间的关系尚未得到研究。因此，本研究旨在探讨AHM与冠心病之间的关联。

方法

我们进行了一项回顾性研究，使用来自武汉第四医院2568例诊断为冠心病患者的数据。冠心病组纳入有一条或多条主要冠状动脉或分支血管狭窄≥50%的患者，而无冠心病的患者纳入对照组。进行逻辑回归分析以确定AHM对冠心病的影响。构建受试者工作特征（ROC）曲线以分析AHM对冠心病的预测价值。

结果

共纳入1824例患者（71.0%）被诊断为冠心病。平均年龄为64.56±10.08岁。值得注意的是，冠心病组的AHM中位数显著低于对照组（36.94对52.63），差异有统计学意义（<0.05）。具体而言，逻辑回归表明AHM是识别冠心病时冠心病的独立危险因素（OR = 0.903，95%CI：0.888 - 0.918）。在ROC分析中，AHM的ROC曲线下面积（AUC）[0.808（95%CI：0.791 - 0.825，<0.001）]大于ALB、HDL-c和ALB-HDL-c比值（AHR），差异有统计学意义（<0.05）。此外，Gensini（GS）评分与AHM呈负相关（= -0.150，<0.001）。AHM与多支血管冠心病显著相关（OR = 0.903，95%CI：0.888 - 0.918），ROC分析显示AHM预测多支血管冠心病的AUC为0.639。