中国血液净化

中国血液净化 ›› 2023, Vol. 22 ›› Issue (1): 17-21.doi: 10.3969/j.issn.1671-4091.2023.01.004

• 临床研究 • 上一篇    下一篇

三酰甘油葡萄糖乘积指数对维持性血液透析患者腹主动脉钙化的评估价值

李新玉   王雪荣   袁 亮   包 婷   王德光   

  1. 230601合肥，安徽医科大学第二附属医院1肾脏内科 2肾病与炎症免疫性疾病研究所
  • 收稿日期:2022-09-06 修回日期:2022-10-17 出版日期:2023-01-12 发布日期:2023-01-12
  • 通讯作者: 王德光 E-mail:wangdeguang@ahmu.edu.cn
  • 基金资助:
    安徽省自然科学基金面上项目(2008085MH244)；安医大二附院临床研究培育计划项目(2020LCZD01)

The value of triglycerides-glucose index in the evaluation of abdominal aortic calcification in maintenance hemodialysis patients

LI Xin-yu, WANG Xue-rong, YUAN Liang, BAO Ting, WANG De-guang   

  1. Department of Nephrology and 2Institute of Kidney Disease, Inflammation & Immunity Mediated Diseases, The Second Hospital of Anhui Medical University, Hefei 230601, China
  • Received:2022-09-06 Revised:2022-10-17 Online:2023-01-12 Published:2023-01-12
  • Contact: 230601合肥，安徽医科大学第二附属医院1肾脏内科 2肾病与炎症免疫性疾病研究所 E-mail:wangdeguang@ahmu.edu.cn

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摘要： 目的  探讨三酰甘油葡萄糖(triglycerides-glucose，TyG)乘积指数对维持性血液透析(maintenance hemodialysis,MHD)患者腹主动脉钙化(abdominal aortic calcification，AAC)的评估价值。方法  纳入在安徽医科大学第二附属医院肾内科住院的MHD患者，收集患者临床资料及生化指标，使用腹部侧位平片检测腹主动脉钙化情况，根据钙化评分分成腹主动脉钙化组及非钙化组。分析AAC评分与各指标的相关性，进一步探讨TyG指数对AAC的评估价值。 结果 共纳入130例MHD患者,67例(51.5%)患者发生腹主动脉钙化，中重度钙化发生率为36.2%。钙化组年龄、透析龄、体质量指数(body mass index,BMI)、中性粒细胞计数、总胆固醇、三酰甘油、C反应蛋白、TyG指数均高于非钙化组(t=-3.642，P＜0.001；t=-2.458，P=0.015；Z=3.776，P＜0.001；Z=2.041，P=0.041；Z=2.364，P=0.018；    Z=6.802，P＜0.001；Z=2.113，P=0.035；Z=7.247，P＜0.001)。AAC评分与年龄、BMI、总胆固醇、三酰甘油、C反应蛋白、TyG指数呈正相关(r=0.299，P=0.001；r=0.274，P=0.002；r=0.223，P=0.013；r=0.640，P＜0.001；r=0.234，P=0.014；r=0.667，P＜0.001)。Logistic回归分析结果显示：年龄(OR=1.060,95% CI：1.001～1.122，P=0.046)、透析龄(OR=1.027，95% CI：1.012～1.042，P＜0.001)、BMI(OR=1.163，95% CI：1.016～1.331，P=0.028)及TyG指数(OR=133.874，95% CI：18.833～951.649，P＜0.001)是MHD患者发生腹主动脉钙化的独立危险因素。TyG指数诊断AAC的受试者工作特征(receiver operating characteristic,ROC)曲线下面积为0.871(截点8.58，敏感度为80.0%，特异度为84.1%，95% CI：0.812～0.931，P＜0.001)。 结论 MHD患者腹主动脉钙化发生率较高，TyG指数与腹主动脉钙化相关，对腹主动脉钙化的发生有较好的预测价值。

关键词: 维持性血液透析, 三酰甘油葡萄糖乘积指数, 腹主动脉钙化, 胰岛素抵抗

Abstract: Objective  To explore the value of triglycerides-glucose (TyG) index in the evaluation of abdominal aortic calcification (AAC) in maintenance hemodialysis (MHD) patients.  Method  The MHD patients hospitalized in the Nephrology Department of the Second Affiliated Hospital of Anhui Medical University were enrolled in this study. Their clinical data and biochemical parameters were recruited and the AAC scores was evaluated by abdominal lateral X-ray film. Based on AAC score, the patients were divided into non-AAC group and AAC group. The correlation between AAC score and clinical parameters were analyzed to explore the value of TyG index in the evaluation of AAC.   Results  In the 130 MHD patients enrolled in this study, AAC was found in 67 patients (51.5%), in which 36.2% had moderate to severe AAC. Compared with non-AAC group, age (t= -3.642, P<0.001), dialysis age  (t= -2.458,  P=0.015), BMI (Z=3.776, P<0.001), neutrophil count (Z=2.041, P=0.041), total cholesterol (Z=2.364, P=0.018), triglyceride (Z=6.802, P<0.001), C-reative protein (Z=2.113, P=0.035) and TyG index (Z=7.247, P<0.001) were higher in AAC group. AAC score was positively correlated with age, BMI, total cholesterol, triglyceride, C-creative protein and TyG index (r=0.299, 0.274, 0.223, 0.640, 0.234 and 0.667 respectively;  P=0.001,  0.002,  0.013, <0.001,
0.014 and <0.001 respectively). Logistic regression analysis showed that age (OR=1.060, 95% CI : 1.001～1.122, P=0.046), dialysis age (OR=1.027, 95% CI:1.012～1.042, P<.001), BMI (OR=0.163, 95% CI: 11.016～1.331, P=0.028),  and TyG index (OR=133.874, 95% CI: 18.833 ～ 951.649,  P<0.001)  were the independent risk factors for AAC in MHD patients. The area under receiver operating characteristic (ROC) curve of TyG index for AAC was 0.871,with the cutoff point of 8.58, sensitivity of 80.0%,   and specificity of 84.1% (95% CI: 
0.812~0.931, P<0.001).   Conclusion  The incidence of AAC is high in MHD patients. TyG index is correlated with AAC, and has a better predictive value for AAC in MHD patients.

Key words: Maintenance hemodialysis, Triglycerides-glucose index, Abdominal aortic calcification; , Insulin resistance

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