CRP联合TyG指数对类风湿关节炎患者发生冠心病风险的预测价值

doi:10.3969/j.issn.1004-583X.2024.06.004

摘要/Abstract

摘要：

目的探讨C-反应蛋白(C-reactive protein CRP)和甘油三酯-葡萄糖(triglyceride glucose TyG)指数对类风湿关节炎(Rheumatoid arthritis RA)人群发生冠心病(coronary heart disease CHD)风险的预测价值。方法纳入2019年1月至2022年12月于济宁医学院附属医院风湿免疫科住院的确诊为RA的患者,经过纳入和排除后筛选至300例,根据受试者是否患有CHD分为CHD组(102例)与非CHD组(198例),收集相关一般资料及实验室数据,分析其差异性后将差异具有统计学意义的指标纳入logistic回归分析,构建回归模型,观察CRP和TyG指数与RA患者中CHD发生风险的相关性,绘制CRP、TyG指数、CRP联合TyG指数的ROC曲线,报告曲线下面积, 以此评价CRP、TyG指数对RA患者发生CHD的预测价值。结果两组间CRP、空腹血糖、TyG指数、RA患者年龄、高血压史、糖尿病史差异有统计学意义,logistic回归分析示CRP、TyG指数、高血压史、年龄是RA患者发生CHD的独立危险因素,CRP、TyG指数、二者联合系数的ROC曲线下面积分别为0.608、0.602、0.656。结论 CRP、TyG指数对RA患者发生CHD的风险有良好的预测价值。

关键词: 关节炎, 类风湿, 冠心病, C-反应蛋白, 甘油三酯-葡萄糖指数

Abstract:

Objective To explore the predictive value of C-reactive protein (CRP) and triglyceride glucose (TyG) index for coronary heart disease (CHD) risk in patients with rheumatoid arthritis. Methods Totally 300 eligible patients diagnosed with RA admitted to the Department of Rheumatology and Immunology of the Affiliated Hospital of Jining Medical University from January 2019 to December 2022 were included and screened. The subjects were divided into CHD group (102 cases) and non-CHD group (198 cases) based on the performance of CHD or not. The baseline information and laboratory data were collected. After analyzing their differences, statistically significant indicators were included in logistic regression analysis, a regression model was built to observe the correlation between CRP and TyG index with the risk of CHD in RA patients, and receiver operating characteristic (ROC) curves of CRP, TyG index and CRP combined with TyG index were plotted. Area under the curve (AUC) was reported to evaluate the predictive value of CRP and TyG index for CHD in RA patients. Results Correlation analysis showed that CRP, fasting blood glucose (FBG), TyG index, age, history of hypertension and history of diabetes were significantly different between the two groups. Logistic regression analysis showed that CRP, TyG index, history of hypertension and age were independent risk factors for CHD in RA patients. The AUC of CRP, TyG index and their combined coefficient was 0.608, 0.602 and 0.656, respectively. Conclusion The combination of CRP and TyG index has good predictive value for the risk of CHD in RA patients.

Key words: arthritis, rheumatoid, coronary disease, C-reactive protein, triglyceride-glucose index

中图分类号:

R593.22

宋怡静, 李健, 宋芹, 邵莉. CRP联合TyG指数对类风湿关节炎患者发生冠心病风险的预测价值[J]. 临床荟萃, 2024, 39(6): 506-511.

Song Yijing, Li Jian, Song Qin, Shao Li. Predictive value of C-reactive protein combined with triglyceride glucose index for coronary heart disease risk in patients with rheumatoid arthritis[J]. Clinical Focus, 2024, 39(6): 506-511.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2024.06.004

https://huicui.hebmu.edu.cn/CN/Y2024/V39/I6/506

图/表 7

参考文献 28

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组别	例数		性别[例(%)]			吸烟史[例(%)]				年龄 (岁)		BMI (kg/m²)
组别	例数		男		女	有		无		年龄 (岁)		BMI (kg/m²)
非CHD组	198		67(33.8)		131(66.2)	49(24.7)		149(75.3)		57.98±11.16		22.41(20.55, 24.97)
CHD组	102		26(25.5)		76(74.5)	26(25.5)		76(74.5)		68.26±8.73		23.71(20.59, 26.51)
统计值			χ²=2.193			χ²=0.020				t=8.760		Z=-1.606
P值			0.139			0.888				<0.01		0.108
组别		饮酒史[例(%)]					高血压史[例(%)]				糖尿病史[例(%)]
组别		有		无			有		无		有		无
非CHD组		39(19.7)		159(80.3)			37(18.7)		161(81.3)		14(7.1)		184(92.9)
CHD组		15(14.7)		87(85.3)			53(52.0)		49(48.0)		24(23.5)		78(76.5)
统计值		χ²=1.136					χ²=35.492				χ²=16.485
P值		0.286					<0.01				<0.01

组别	例数		性别[例(%)]			吸烟史[例(%)]				年龄 (岁)		BMI (kg/m²)
组别	例数		男		女	有		无		年龄 (岁)		BMI (kg/m²)
非CHD组	198		67(33.8)		131(66.2)	49(24.7)		149(75.3)		57.98±11.16		22.41(20.55, 24.97)
CHD组	102		26(25.5)		76(74.5)	26(25.5)		76(74.5)		68.26±8.73		23.71(20.59, 26.51)
统计值			χ²=2.193			χ²=0.020				t=8.760		Z=-1.606
P值			0.139			0.888				<0.01		0.108
组别		饮酒史[例(%)]					高血压史[例(%)]				糖尿病史[例(%)]
组别		有		无			有		无		有		无
非CHD组		39(19.7)		159(80.3)			37(18.7)		161(81.3)		14(7.1)		184(92.9)
CHD组		15(14.7)		87(85.3)			53(52.0)		49(48.0)		24(23.5)		78(76.5)
统计值		χ²=1.136					χ²=35.492				χ²=16.485
P值		0.286					<0.01				<0.01

组别	例数	CRP(mg/L)		ESR(mm/H)	RF(IU/ml)		TG(mmol/L)		TC(mmol/L)
非CHD组	198	18.35(5.50, 45.16)		55.00(27.50, 84.00)	120.50(44.95, 230.25)		0.90(0.70,1.23)		3.92(3.41,4.48)
CHD组	102	33.64(11.30, 72.70)		50.50(29.00, 87.25)	146.60(51.53, 293.38)		0.95(0.71,1.46)		3.95(3.21,4.68)
统计值		Z=-3.050		Z=-0.474	Z=-1.231		Z=-1.614		Z=-0.414
P值		0.002		0.636	0.128		0.106		0.679
组别	HDL-C(mmol/L)		LDL-C(mmol/L)			FBG(mg/dL)		TyG指数
非CHD组	1.08(0.92, 1.29)		2.35(1.97, 2.91)			88.30(81.09, 101.63)		8.20(7.94, 8.49)
CHD组	1.15(0.95, 1.31)		2.42(1.83, 2.81)			99.11(84.69, 117.13)		8.37(7.99, 8.82)
统计值	Z=-1.175		Z=-0.525			Z=-3.304		Z=-2.895
P值	0.240		0.599			<0.01		0.004

组别	例数	CRP(mg/L)		ESR(mm/H)	RF(IU/ml)		TG(mmol/L)		TC(mmol/L)
非CHD组	198	18.35(5.50, 45.16)		55.00(27.50, 84.00)	120.50(44.95, 230.25)		0.90(0.70,1.23)		3.92(3.41,4.48)
CHD组	102	33.64(11.30, 72.70)		50.50(29.00, 87.25)	146.60(51.53, 293.38)		0.95(0.71,1.46)		3.95(3.21,4.68)
统计值		Z=-3.050		Z=-0.474	Z=-1.231		Z=-1.614		Z=-0.414
P值		0.002		0.636	0.128		0.106		0.679
组别	HDL-C(mmol/L)		LDL-C(mmol/L)			FBG(mg/dL)		TyG指数
非CHD组	1.08(0.92, 1.29)		2.35(1.97, 2.91)			88.30(81.09, 101.63)		8.20(7.94, 8.49)
CHD组	1.15(0.95, 1.31)		2.42(1.83, 2.81)			99.11(84.69, 117.13)		8.37(7.99, 8.82)
统计值	Z=-1.175		Z=-0.525			Z=-3.304		Z=-2.895
P值	0.240		0.599			<0.01		0.004

因素	回归系数	标准误	Wald χ²值	P值	OR值	95%CI
因素	回归系数	标准误	Wald χ²值	P值	OR值	下限	上限
高血压史(有/无)	0.867	0.306	8.051	0.005	2.380	1.308	4.333
糖尿病史(有/无)	0.614	0.445	1.906	0.167	1.847	0.773	4.415
CRP(mg/L)	0.009	0.004	5.526	0.019	1.009	1.001	1.016
FBG(mg/dL)	0.001	0.007	0.038	0.846	1.001	0.988	1.015
TyG指数	0.827	0.363	5.178	0.023	2.286	1.122	4.660
年龄(岁)	0.087	0.016	29.144	<0.01	1.091	1.057	1.126
常量	-13.966	3.284	18.085	<0.01	0.000