血小板与高密度脂蛋白胆固醇比率与虚弱和全因死亡率的关系。

IF 3.9 2区 医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY
Jianqiang Zhang, Lele Chen, Huifeng Zhang
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引用次数: 0

摘要

背景:体弱患者通常需要重症监护,而入院后的治疗效果往往不佳。然而,由于缺乏可靠的诊断指标,快速识别虚弱具有挑战性。本研究旨在探讨血小板/高密度脂蛋白胆固醇比值(PHR,一种新型炎症指标)与虚弱和全因死亡率的关系:本研究分析了2005年至2018年美国国家健康与营养调查(NHANES)的数据。虚弱程度根据 49 项虚弱指数进行评估。在对人口统计学因素、生活方式、血脂、用药史和并发症进行调整后,通过加权逻辑回归、加权受限立方样条曲线(RCS)和加权 Cox 回归探讨了 PHR 与虚弱和长期生存预后的关系。此外,还进行了亚组和交互分析。最后,还进行了几项敏感性分析:共纳入 15,615 名成年参与者,其中女性 7,928 人(占 53.63%),平均年龄为 60.76 岁。在对混杂变量进行充分调整后,PHR最高四分位组的虚弱患病率明显高于最低四分位组(OR:1.23,95% CI:1.04-1.47;P = 0.02)。RCS 显示,拐点为 166.7。在拐点之前和之后,PHR 分别与虚弱呈负相关(OR:0.88,95% CI:0.80-0.97,P = 0.01)和正相关(OR:1.10,95% CI:1.02-1.19,P = 0.01)。亚组分析表明,女性 PHR 与虚弱之间的关系要强于男性。共有 5,544 名体弱者被纳入生存分析。研究结果表明,PHR 与体弱参与者的全因死亡风险呈 U 型关系,拐点为 240.4。在拐点前后,PHR 分别下降(HR:0.89,95% CI:0.81-0.97,P = 0.01),全因死亡风险分别上升(HR:1.08,95% CI:1.02-1.14,P = 0.01):本研究表明,在美国成年人群中,PHR 与虚弱之间存在着 J 型关联,女性的 PHR 与虚弱之间的关联性更强。此外,PHR 与体弱患者的全因死亡风险呈 U 型关系。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association of platelet-to-HDL cholesterol ratio with frailty and all-cause mortality.

Background: Frailty often requires intensive care, and the admission outcomes of frail patients are often poor. However, owing to the lack of reliable diagnostic indicators, quickly identifying frailty is challenging. The present study aimed to explore the associations of the platelet/high-density lipoprotein cholesterol ratio (PHR; a novel inflammatory indicator) with frailty and all-cause mortality.

Methods: The present study analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. Frailty was assessed on the basis of the 49-item Frailty Index. The associations of the PHR with frailty and long-term survival prognosis were explored through weighted logistic regression, weighted restricted cubic spline (RCS), and weighted Cox regression, with adjustments for demographic factors, lifestyle, blood lipids, medication history, and complications. In addition, subgroup and interaction analyses were conducted. Finally, several sensitivity analyses were performed.

Results: A total of 15,615 adult participants were included, with 7,928 women (53.63%) and an average age of 60.76 years. After fully adjusting for confounding variables, the prevalence of frailty in the highest PHR quartile group of was significantly greater than that in the lowest quartile group (OR: 1.23, 95% CI: 1.04-1.47; P = 0.02). The RCS showed that the inflection point was 166.7. Before and after the inflection point, the PHR was negatively associated (OR: 0.88, 95% CI: 0.80-0.97, P = 0.01) and positively associated (OR: 1.10, 95% CI: 1.02-1.19, P = 0.01) with frailty, respectively. Subgroup analysis suggested that the association between PHR and frailty was stronger in women than in men. A total of 5,544 frail participants were included in the survival analysis. The RCS revealed that the PHR was associated with the all-cause mortality risk of frail participants in a U-shaped manner, with an inflection point of 240.4. Before and after the inflection point, the PHR decreased (HR: 0.89, 95% CI: 0.81-0.97, P = 0.01) and the all-cause mortality risk increased (HR: 1.08, 95% CI: 1.02-1.14, P = 0.01), respectively.

Conclusion: The present study suggests that there is a J-shaped association between PHR and frailty in the adult population of the United States and that the association between the PHR and frailty is stronger in women. In addition, the PHR has a U-shaped relationship with the all-cause mortality risk of frail patients.

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来源期刊
Lipids in Health and Disease
Lipids in Health and Disease 生物-生化与分子生物学
CiteScore
7.70
自引率
2.20%
发文量
122
审稿时长
3-8 weeks
期刊介绍: Lipids in Health and Disease is an open access, peer-reviewed, journal that publishes articles on all aspects of lipids: their biochemistry, pharmacology, toxicology, role in health and disease, and the synthesis of new lipid compounds. Lipids in Health and Disease is aimed at all scientists, health professionals and physicians interested in the area of lipids. Lipids are defined here in their broadest sense, to include: cholesterol, essential fatty acids, saturated fatty acids, phospholipids, inositol lipids, second messenger lipids, enzymes and synthetic machinery that is involved in the metabolism of various lipids in the cells and tissues, and also various aspects of lipid transport, etc. In addition, the journal also publishes research that investigates and defines the role of lipids in various physiological processes, pathology and disease. In particular, the journal aims to bridge the gap between the bench and the clinic by publishing articles that are particularly relevant to human diseases and the role of lipids in the management of various diseases.
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