脂肪蓄积指数、内脏脂肪指数与红细胞计数对冠心病患病风险的联合作用

The combined effect of lipid accumulation product, visceral adiposity index and red blood cell count on the risk of developing coronary heart disease

    摘要
  • 摘要: 目的 探讨成年人红细胞计数(RBC)与脂质蓄积指数(LAP)、内脏脂肪指数(VAI)的联合作用对冠心病患病风险的影响。方法 \纳入2019年1月至2021年7月在福建医科大学附属第一医院心血管内科就诊的310例新发冠心病患者作为研究对象,按照年龄、性别1∶1匹配同时期在福建医科大学附属协和医院骨科就诊的310例未患心血管疾病的新入院患者作为对照组。采用多因素logistic回归分析RBC与LAP、VAI对冠心病患病风险的联合作用。结果 \冠心病组的LAP37.95(24.87,57.42)比28.80(17.28,42.92),Z=5.472,P<0.001、VAI2.22(1.47,3.53)比1.61(1.10,2.55),Z=5.165,P<0.001高于对照组,RBC低于对照组4.36(4.02,4.71)×1012/L比4.44(4.16,4.79)×1012/L,Z=-1.980,P=0.048。多因素logistic回归分析发现,RBC (OR=0.717,95%CI 0.541~0.951)、LAP (OR=1.013,95%CI 1.005~1.021)、VAI (OR=1.164,95%CI 1.042~1.301)与冠心病患病风险存在关联(均P<0.05)。RBC与LAP、RBC与VAI对冠心病患病风险存在相乘交互效应OR值分别为0.985(95%CI 0.973~0.998),0.826(95%CI 0.695~0.980)。按RBC、LAP、VAI水平进行四分位数分组,以RBC第4四分位/LAP第1四分位组为参照,RBC第2四分位/LAP第4四分位组、RBC第3四分位/LAP第4四分位组、RBC第1四分位/LAP第4四分位组和RBC第1四分位/LAP第3四分位组冠心病患病风险分别为2.870(95%CI 1.068~7.717)、3.047(95%CI 1.053~8.812)、5.126(95%CI 1.930~13.614)和5.183(95%CI 1.821~14.753)倍,以RBC第4四分位/VAI第1四分位组为参照,RBC第1四分位/VAI第4四分位组冠心病患病风险为7.753(95%CI 2.65~22.654)倍。结论 \RBC是冠心病患病的保护因素,而LAP、VAI是冠心病患病的危险因素。RBC与LAP或VAI对冠心病患病风险存在联合作用。

     

    Abstract: Objective To investigate the effect of the combination of red blood cell count (RBC) with lipid accumulation product (LAP) and visceral adiposity index (VAI) on the risk of coronary heart disease in adults. Methods A total of 310 newly diagnosed patients with coronary heart disease who were admitted to the department of cardiovascular medicine at the First Affiliated Hospital of Fujian Medical University from January 2019 to July 2021 were recruited (the case group), and 310 newly admitted patients without cardiovascular related diseases who were admitted to the orthopedics department of Fujian Medical University Union Medical College Hospital during the same period were matched 1∶1 by age and gender (the control group). Logistic regression analysis was used to analyze the joint effect of RBC with LAP and VAI on the risk of coronary heart disease. Results LAP 37.95 (24.87, 57.42) vs 28.80 (17.28, 42.92), Z=5.472, P<0.001 and VAI 2.22 (1.47, 3.53) vs 1.61 (1.10, 2.55), Z=5.165, P<0.001 in the case group were higher than those in the control group, while the RBC count 4.36 (4.02, 4.71) × 1012/L vs 4.44 (4.16, 4.79)×1012/L, Z=-1.980, P=0.048 was lower than that in the control group. Multifactorial logistic regression analysis revealed that RBC (OR: 0.717, 95%CI: 0.541-0.951), LAP (OR: 1.013, 95%CI: 1.005-1.021), and VAI (OR: 1.164, 95%CI: 1.042-1.301) were associated with the risk of coronary heart disease (P<0.05). The multiplicative interaction effects of RBC with LAP (OR: 0.985, 95%CI:0.973-0.998) and RBC with VAI (OR: 0.826, 95%CI:0.695-0.980) on the risk of coronary heart disease were statistically significant. The risk of coronary heart disease was 2.870 (95%CI 1.068-7.717), 3.047 (95%CI 1.053-8.812), 5.126 (95%CI 1.930-13.614) and 5.183 (95%CI 1.821-14.753) times higher in the RBC Q2/LAP Q4, RBC Q3/LAP Q4, RBC Q1/LAP Q4, RBC Q1/LAP Q4 and RBC Q1/LAP Q3 groups, respectively, with RBC Q4/LAP Q1 as the reference group and RBC Q2/LAP Q4, RBC Q3/LAP Q4, RBC Q1/LAP Q4 and RBC Q1/LAP Q3, respectively.The risk of coronary heart disease in the RBC Q1 group/VAI Q1 group was 7.753 (95%CI 2.65-22.654) times higher than that in the RBC Q1 group/VAI Q4 group, using the RBC Q4/VAI Q1 group as a reference. Conclusion RBC is a protective factor, while LAP and VAI are risk factors of coronary heart disease, and the combination of RBC and LAP or VAI has a combined effect on the risk of coronary heart disease.

     

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