摘要
目的 探讨高尿酸血症人群中红细胞分布宽度与白蛋白比值(ratio of red blood cell distribution width to albumin level, RAR)和非瓣膜性心房颤动风险的关联。方法 选取2021年1月至2024年6月在江苏省苏北人民医院内科体检中心接受体检的高尿酸血症患者8277例,其中将心房颤动患者185例纳入病例组,采用了倾向性评分匹配法,以1:4的比例将非心房颤动患者740例纳入对照组。采用logistic回归分析、限制性三次样条分析、分层分析高尿酸血症人群RAR与非瓣膜性心房颤动风险的相关性。结果 病例组吸烟、红细胞分布宽度、总胆红素、红细胞压积、RAR水平显著高于对照组,白蛋白、低密度脂蛋白胆固醇、三酰甘油水平及脂肪肝比例显著低于对照组,差异有统计学意义(P<0.01)。多元logistic回归分析显示,RAR在四分位Q2,Q3,Q4患者心房颤动患病风险明显高于Q1患者(OR=2.843,OR=4.263,OR=7.801,P<0.01)。RAR在折点2.85以下的效应显著(OR=1.492,95%CI:1.151~1.993,P=0.004)。分层分析显示,RAR与年龄和吸烟之间存在显著交互作用(P_(交互)<0.05)。RAR预测男性高尿酸血症患者非瓣膜性心房颤动患病率的曲线下面积为0.679(95%CI:0.632~0.725)。结论 在高尿酸血症人群中,RAR越高,患有非瓣膜性心房颤动的概率越高,且对诊断高尿酸血症合并心房颤动的男性患者,具有指导意义。
Objective To explore the association between the ratio of red blood cell distribution width to albumin level(RAR)and the risk of non-valvular atrial fibrillation(NVAF)in patients with hyperuricemia.Methods A total of 8277 patients with hyperuricemia who underwent physi-cal examinations at the Physical Examination Center of Northern Jiangsu People's Hospital from January 2021 to June 2024 were enrolled.From them,185 patients with AF were assigned into a case group,and 740 patients without AF were into a control group in a ratio of 1:4 with propen-sity score matching(PSM).Logistic regression analysis,restricted cubic spline analysis,and sub-group analysis were employed to investigate the association between RAR and the risk of NVAF in hyperuricemic patients.Results The case group had significantly larger ratio of smoking,high-er levels of red blood cell distribution width,total bilirubin,hematoerit,and RAR index,but lower albumin,low-density lipoprotein cholesterol(LDL-C)and triglyceride(TG)levels,and smaller ra-tio of fatty liver than the control group(P<0.01).Multivariate logistic regression analysis showed that the patients at Q2,Q3,and Q4 quartiles of RAR index have higher risk for AF than those at Q1 quartile(OR=2.843,0R=4.263,OR=7.801,P<0.01).The effect of RAR index was significant when below the breakpoint of 2.85(OR=1.492,95%CI:1.151-1.993,P=0.004).Subgroup analysis indicated significant interactions between RAR index and age as well as smok-ing(P ieretono<0.05).The area under curve value of RAR index in predicting NVAF occurrence in male hyperuricemic patients was 0.679(95%CI:0.632-0.725).Conclusion In patients with hyperuricemia,a higher RAR index is associated with an increased risk of NVAF.RAR index has guiding significance for diagnosing male hyperuricemic patients complicated with AF.
作者
章帅
梁好
鲍正宇
谢勇
朱业
Zhang Shuai;Liang Hao;Bao Zhengyu;Xie Yong;Zhu Ye(Medical College of Yangzhou University,Yangzhou 225001,Jiangsu Province,China)
出处
《中华老年心脑血管病杂志》
北大核心
2025年第6期727-731,共5页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
国家自然基金项目(81800250)
中国博士后科学基金第71批次面上资助项目(2022M711417)
江苏省中医药科技发展计划项目(MS2023137)
扬州市科技计划项目(YZ2023096)
江苏省苏北人民医院科研项目(SBLC23002)。
关键词
高尿酸血症
心房颤动
红细胞
血清白蛋白
hyperuricacideria
atrial fibrillation
erythrocytes
serum albumin
