目的:探究2型糖尿病(T2DM)合并代谢相关脂肪性肝病(MAFLD)患者的TG/HDL-C与肝脏脂肪变相关性。方法:选取2023年9月至2024年8月于石家庄市人民医院内分泌科住院接受治疗27~75岁T2DM合并MAFLD患者共186例。根据代表肝脏脂肪变性的严重程...目的:探究2型糖尿病(T2DM)合并代谢相关脂肪性肝病(MAFLD)患者的TG/HDL-C与肝脏脂肪变相关性。方法:选取2023年9月至2024年8月于石家庄市人民医院内分泌科住院接受治疗27~75岁T2DM合并MAFLD患者共186例。根据代表肝脏脂肪变性的严重程度的受控衰减参数(CAP)水平(S0: CAP γ-GGT、TG/HDL-C、CAP均高于非重度脂肪变组,差异均有统计学意义(P γ-GGT、BMI、TG/HDL-C等均呈正相关(r值分别为0.407、0.392、0.422、0.547、0.381、0.433、0.368、0.538、0.568)。(3) 行二元Logistic多因素回归分析得出:TG/HDL-C、LDL-C、BMI、ALT是T2DM合并MAFLD患者肝脏脂肪变的独立危险因素(TG/HDL-C 95%置信区间1.726 (1.238, 2.407),P = 0.001)。(4) 将TG/HDL-C、TG、LDL-C、ALT代入ROC曲线分析,曲线下面积分别为:0.753、0.747、0.609、0.695。其中TG/HDL-C敏感度54.7%,特异度86.3%,TG、TG/HDL-C均能预测T2DM合并MAFLD患者的重度肝脏脂肪变性,但TG/HDL-C预测价值更优(P = 0.000),具有统计学意义。Objective: To investigate the correlation between TG/HDL-C and hepatic steatosis in patients with type 2 diabetes mellitus (T2DM) combined with metabolism-associated fatty liver disease (MAFLD). Methods: A total of 186 patients with T2DM combined with MAFLD aged 27-75 years who were hospitalized in the Department of Endocrinology of Shijiazhuang People’s Hospital from September 2023 to August 2024 were selected. The patients were categorized into 80 cases in the non-severe hepatic steatosis group and 106 cases in the severe hepatic steatosis group according to the level of controlled attenuation parameter (CAP), which represents the severity of hepatic steatosis (S0: CAP γ-GGT, TG/HDL-C, and CAP were higher in the severe steatosis group than those in the non-severe steatosis group, and the differences were statistically significant (P γ-GGT, BMI, and TG/HDL-C (r-values of 0.407, 0.392, 0.422, 0.547, 0.381, 0.433, 0.368, 0.538, respectively, 0.568). (3) Binary logistic multifactorial regression analysis was performed to conclude that TG/HDL-C, LDL-C, BMI, and ALT were independent risk factors for hepatic steatosis in patients with T2DM combined with MAFLD (TG/HDL-C 95% confidence interval 1.726 (1.238, 2.407), P = 0.001). (4) Substituting TG/HDL-C, TG, LDL-C, and ALT into the ROC curve analysis, the areas under the curve were 0.753, 0.747, 0.609, and 0.695, respectively of which the sensitivity of TG/HDL-C was 54.7% and specificity 86.3%, both TG and TG/HDL-C could predict severe hepatic steatosis in patients with T2DM combined with MAFLD, but the predictive value of TG/HDL-C was superior (P = 0.000), which was statistically significant.展开更多
目的:探讨急性ST段抬高型心肌梗死(STEMI)患者低密度脂蛋白胆固醇(LDL-C)/高密度脂蛋白胆固醇(HDL-C)比值(LHR)与其院内主要不良心血管事件(MACE)的相关性及其在临床中的应用价值。方法:收集发病12h内就诊的481例STEMI住院患者的临床资...目的:探讨急性ST段抬高型心肌梗死(STEMI)患者低密度脂蛋白胆固醇(LDL-C)/高密度脂蛋白胆固醇(HDL-C)比值(LHR)与其院内主要不良心血管事件(MACE)的相关性及其在临床中的应用价值。方法:收集发病12h内就诊的481例STEMI住院患者的临床资料及MACE发生情况,根据LHR的中位数(2.9)将患者分为低LHR组(LHR≤2.9,n=223)和高LHR组(LHR>2.9,n=258)。分析LHR与STEMI患者院内MACE的相关性。结果:高LHR组患者院内MACE比例均高于低LHR组[恶性室性心律失常:29(11.2%) VS 9(4.0%),P=0.004;高度房室传导阻滞:22(8.5%) VS 6(2.7%),P=0.006;心源性休克+死亡:29(11.2%) VS 7(3.1%),P=0.001]。恶性室性心律失常、心源性休克+死亡患者LHR差异有统计学意义(P均<0.05)。Pearson相关分析显示,除高度房室传导阻滞(r=0.060,P>0.05)外,LHR与恶性室性心律失常(r=0.121)、心源性休克和死亡(r=0.115)均显著相关(P<0.05)。多因素Logistic回归分析显示,LHR、空腹血糖是STEMI患者发生院内MACE的独立危险因素(P均<0.05)。ROC曲线显示LHR预测STEMI患者院内MACE的曲线下面积为0.606(95%CI:0.544~0.668),cut-off值为2.854,敏感度为80.6%,特异度为52.1%;LHR>2.854时STEMI住院患者很可能会发生MACE。结论:STEMI患者LHR升高与恶性室性心律失常、心源性休克及死亡发生呈正相关。LHR是STEMI患者发生MACE的独立危险因素,对恶性室性心律失常、心源性休克及死亡发生有一定的预测价值。展开更多
文摘目的:探究2型糖尿病(T2DM)合并代谢相关脂肪性肝病(MAFLD)患者的TG/HDL-C与肝脏脂肪变相关性。方法:选取2023年9月至2024年8月于石家庄市人民医院内分泌科住院接受治疗27~75岁T2DM合并MAFLD患者共186例。根据代表肝脏脂肪变性的严重程度的受控衰减参数(CAP)水平(S0: CAP γ-GGT、TG/HDL-C、CAP均高于非重度脂肪变组,差异均有统计学意义(P γ-GGT、BMI、TG/HDL-C等均呈正相关(r值分别为0.407、0.392、0.422、0.547、0.381、0.433、0.368、0.538、0.568)。(3) 行二元Logistic多因素回归分析得出:TG/HDL-C、LDL-C、BMI、ALT是T2DM合并MAFLD患者肝脏脂肪变的独立危险因素(TG/HDL-C 95%置信区间1.726 (1.238, 2.407),P = 0.001)。(4) 将TG/HDL-C、TG、LDL-C、ALT代入ROC曲线分析,曲线下面积分别为:0.753、0.747、0.609、0.695。其中TG/HDL-C敏感度54.7%,特异度86.3%,TG、TG/HDL-C均能预测T2DM合并MAFLD患者的重度肝脏脂肪变性,但TG/HDL-C预测价值更优(P = 0.000),具有统计学意义。Objective: To investigate the correlation between TG/HDL-C and hepatic steatosis in patients with type 2 diabetes mellitus (T2DM) combined with metabolism-associated fatty liver disease (MAFLD). Methods: A total of 186 patients with T2DM combined with MAFLD aged 27-75 years who were hospitalized in the Department of Endocrinology of Shijiazhuang People’s Hospital from September 2023 to August 2024 were selected. The patients were categorized into 80 cases in the non-severe hepatic steatosis group and 106 cases in the severe hepatic steatosis group according to the level of controlled attenuation parameter (CAP), which represents the severity of hepatic steatosis (S0: CAP γ-GGT, TG/HDL-C, and CAP were higher in the severe steatosis group than those in the non-severe steatosis group, and the differences were statistically significant (P γ-GGT, BMI, and TG/HDL-C (r-values of 0.407, 0.392, 0.422, 0.547, 0.381, 0.433, 0.368, 0.538, respectively, 0.568). (3) Binary logistic multifactorial regression analysis was performed to conclude that TG/HDL-C, LDL-C, BMI, and ALT were independent risk factors for hepatic steatosis in patients with T2DM combined with MAFLD (TG/HDL-C 95% confidence interval 1.726 (1.238, 2.407), P = 0.001). (4) Substituting TG/HDL-C, TG, LDL-C, and ALT into the ROC curve analysis, the areas under the curve were 0.753, 0.747, 0.609, and 0.695, respectively of which the sensitivity of TG/HDL-C was 54.7% and specificity 86.3%, both TG and TG/HDL-C could predict severe hepatic steatosis in patients with T2DM combined with MAFLD, but the predictive value of TG/HDL-C was superior (P = 0.000), which was statistically significant.
文摘目的:探讨急性ST段抬高型心肌梗死(STEMI)患者低密度脂蛋白胆固醇(LDL-C)/高密度脂蛋白胆固醇(HDL-C)比值(LHR)与其院内主要不良心血管事件(MACE)的相关性及其在临床中的应用价值。方法:收集发病12h内就诊的481例STEMI住院患者的临床资料及MACE发生情况,根据LHR的中位数(2.9)将患者分为低LHR组(LHR≤2.9,n=223)和高LHR组(LHR>2.9,n=258)。分析LHR与STEMI患者院内MACE的相关性。结果:高LHR组患者院内MACE比例均高于低LHR组[恶性室性心律失常:29(11.2%) VS 9(4.0%),P=0.004;高度房室传导阻滞:22(8.5%) VS 6(2.7%),P=0.006;心源性休克+死亡:29(11.2%) VS 7(3.1%),P=0.001]。恶性室性心律失常、心源性休克+死亡患者LHR差异有统计学意义(P均<0.05)。Pearson相关分析显示,除高度房室传导阻滞(r=0.060,P>0.05)外,LHR与恶性室性心律失常(r=0.121)、心源性休克和死亡(r=0.115)均显著相关(P<0.05)。多因素Logistic回归分析显示,LHR、空腹血糖是STEMI患者发生院内MACE的独立危险因素(P均<0.05)。ROC曲线显示LHR预测STEMI患者院内MACE的曲线下面积为0.606(95%CI:0.544~0.668),cut-off值为2.854,敏感度为80.6%,特异度为52.1%;LHR>2.854时STEMI住院患者很可能会发生MACE。结论:STEMI患者LHR升高与恶性室性心律失常、心源性休克及死亡发生呈正相关。LHR是STEMI患者发生MACE的独立危险因素,对恶性室性心律失常、心源性休克及死亡发生有一定的预测价值。
