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目的探讨血浆非高密度蛋白胆固醇水平(non-HDL-C)与外周动脉疾病(PAD)的关系。方法资料来源于2014年贵阳市慢性病流行病学调查数据,共有7 493例居民纳入本研究。根据踝臂指数(ABI)将居民分为外周动脉疾病组及非外周动脉疾病组。通过单、多因素回归分析得出各指标对PAD的影响,最后通过受试者工作特征曲线分布情况讨论non-HDL-C对PAD的预测效能。结果 (1)单因素分析显示两组间的性别、年龄、体质量指数(BMI)、吸烟、患糖尿病、患高血压差异有统计学意义(P<0.05);两组间低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)及非高密度脂蛋白胆固醇(non-HDL-C)的差异有统计学意义(P<0.05);(2)多因素回归分析中显示年龄、性别、BMI、高血压病及吸烟是PAD的独立危险因素,在血脂指标中LDL(OR=1.912)、TG(OR=1.197)、TC(OR=1.637)及non-HDL(OR=1.390)均与PAD呈正相关,且为PAD的独立危险因素(P<0.05);(3)经绘制受试者工作特征曲线可得non-HDL-C的曲线下面积最大。结论 non-HDL-C是PAD独立危险因素,可作为评价PAD患病风险的指标之一,并可能对预测并辅助诊断PAD有一定的临床价值。
Objective To investigate the relationship between plasma non-HDL-C and peripheral arterial disease (PAD). Methods The data are from the 2014 epidemiological survey of chronic diseases in Guiyang City. A total of 7 493 residents were included in this study. Residents were divided into peripheral arterial disease group and non-peripheral arterial disease group according to ankle-brachial index (ABI). The influence of each index on PAD was obtained by single and multi-factor regression analysis. Finally, the predictive efficacy of non-HDL-C on PAD was discussed through the distribution of working characteristic curves of subjects. Results (1) Univariate analysis showed that gender, age, body mass index (BMI), smoking, diabetes mellitus and hypertension had significant difference between the two groups (P <0.05). The levels of low density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG) and non-HDL-C were statistically significant (P <0.05); (2) The analysis showed that age, sex, BMI, hypertension and smoking were independent risk factors of PAD. The levels of LDL (OR = 1.197), TC (OR = 1.637) and non-HDL OR = 1.390) were positively correlated with PAD and were independent risk factors for PAD (P <0.05). (3) The area under the curve of non-HDL-C was the largest under the working characteristic curve of the subjects. Conclusion Non-HDL-C is an independent risk factor for PAD, which may be used as one of the indicators to evaluate the risk of PAD and may be of clinical value in predicting and supporting the diagnosis of PAD.