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甘油三酯葡萄糖体质量指数(TyG-BMI)对高脂血症性急性胰腺炎严重程度的预测价值

罗萍萍 刘群 黄丽雯

引用本文:
Citation:

甘油三酯葡萄糖体质量指数(TyG-BMI)对高脂血症性急性胰腺炎严重程度的预测价值

DOI: 10.12449/JCH240824
基金项目: 

湖北省卫生健康委科研项目 (WJ2019M257)

伦理学声明:本研究方案于2023年7月7日经由武汉科技大学附属天佑医院伦理委员会审批,批号:LL-2023-07-07-02。
利益冲突声明:本文不存在任何利益冲突。
作者贡献声明:罗萍萍负责收集数据,资料分析,撰写论文;黄丽雯负责指导文章撰写;刘群负责课题设计,指导论文修改和最后定稿。
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    通信作者:

    刘群, 1926247724@qq.com (ORCID: 0009-0000-4261-0120)

Value of triglyceride glucose-body mass index in evaluating the severity of hyperlipidemic acute pancreatitis

Research funding: 

Scientific Research Project of Hubei Provincial Health Commission (WJ2019M257)

More Information
    Corresponding author: LIU Qun, 1926247724@qq.com (ORCID: 0009-0000-4261-0120)
  • 摘要:   目的  探讨甘油三酯葡萄糖体质量指数(TyG-BMI)对高脂血症性急性胰腺炎(HLAP)严重程度的预测价值。  方法  回顾性分析武汉科技大学附属天佑医院2021年1月—2023年12月收治入院的185例HLAP患者临床资料。根据修订的亚特兰大急性胰腺炎分级标准分为轻症组95例和中重症组90例,比较两组患者的临床特征,分析TyG-BMI与HLAP严重程度的相关性,评估TyG-BMI对于HLAP严重程度的预测效能。计量资料两组间比较采用成组t检验或Mann-Whitney U检验。计数资料两组间比较采用χ2检验。单因素和多因素Logistic回归分析HLAP严重程度的影响因素。应用Spearman相关性分析探讨TyG-BMI与HLAP严重程度的关系。采用受试者工作特征曲线配对比较法对TyG-BMI预测HLAP严重程度的效能进行评估。  结果  轻症组和中重症组患者Cr、GLU、TG、TyG-BMI、BISAP评分比较,差异均有统计学意义(Z值分别为-2.059、-7.217、-7.799、-9.566、-11.386,P值均<0.05)。多因素Logistic回归分析结果显示,BISAP评分(OR=4.221,95%CI:1.421~12.538,P=0.001)、TyG-BMI(OR=1.262,95%CI:1.140~1.396,P=0.010)和GLU(OR=1.316,95%CI:1.040~1.666,P=0.022)是HLAP严重程度的独立危险因素,且均与HLAP的严重程度呈正相关(r值分别为0.839、0.705、0.532,P值均<0.05)。在预测HLAP严重程度的效能比较中,TyG-BMI略低于BISAP评分(Z=-4.368,P<0.001),但优于GLU(Z=2.155,P<0.001),其受试者工作特征曲线下面积为0.891,敏感度为91.10%,特异度为96.80%。  结论  TyG-BMI对HLAP严重程度具有一定的预测价值,临床上可用于HLAP病情的综合评估。

     

  • 表  1  轻症组与中重症组一般资料比较

    Table  1.   Comparison of general clinical data between mild group and moderate severe group

    项目 轻症组(n=95) 中重症组(n=90) 统计值 P
    男性[例(%)] 68(71.6) 66(73.3) χ2=0.071 0.790
    年龄(岁) 41(35~51) 38(33~48) Z=-1.345 0.178
    BMI(kg/m2 25.30±2.83 28.95±3.38 t=-7.976 0.073
    吸烟史[例(%)] 33(34.7) 34(37.8) χ2=0.185 0.667
    饮酒史[例(%)] 32(33.7) 30(33.3) χ2=0.003 0.960
    高血压病史[例(%)] 19(20.0) 22(24.4) χ2=0.529 0.467
    糖尿病史[例(%)] 11(11.6) 16(17.8) χ2=1.425 0.233
    高脂血症病史[例(%)] 25(26.3) 31(34.4) χ2=1.447 0.229
    脂肪肝病史[例(%)] 8(8.4) 9(10.0) χ2=0.138 0.710
    下载: 导出CSV

    表  2  轻症组与中重症组实验室指标比较

    Table  2.   Comparison of group laboratory indicators between mild group and moderate severe group

    项目 轻症组(n=95) 中重症组(n=90) Z P
    NLR 6.63(4.41~10.23) 7.46(4.90~12.36) -1.361 0.173
    PLR 145.61(103.53~211.11) 172.18(115.50~264.78) -1.703 0.089
    AST(U/L) 23.00(19.00~32.00) 26.00(18.00~35.00) -1.163 0.245
    ALT(U/L) 23.00(15.00~36.00) 27.50(19.75~38.00) -1.760 0.078
    TBil(μmol/L) 13.95(10.31~18.90) 15.37(11.14~19.99) -0.581 0.561
    Cr(μmol/L) 65.20(51.13~73.55) 69.60(58.80~79.70) -2.059 0.040
    GLU(mmol/L) 8.50(6.50~11.20) 13.41(10.75~17.23) -7.217 <0.001
    TG(mmol/L) 11.38(9.13~14.82) 18.13(15.41~22.56) -7.799 <0.001
    TC(mmol/L) 7.40(6.10~8.69) 7.81(6.05~9.12) -0.460 0.645
    HDL-C(mmol/L) 0.92(0.71~1.14) 0.88(0.71~1.24) -0.580 0.562
    LDL-C(mmol/L) 1.56(1.17~2.23) 1.47(0.93~2.13) -1.591 0.112
    TyG-BMI 98.06(91.51~104.34) 137.80(131.73~142.64) -9.566 <0.001
    BISAP评分 1(0~1) 2(2~3) -11.386 <0.001
    下载: 导出CSV

    表  3  单因素和多因素Logistic回归分析结果

    Table  3.   Univariate and multivariate Logistic regression analysis results

    因素 单因素分析 多因素分析
    OR(95%CI P OR(95%CI P
    BMI 1.481(1.302~1.686) <0.001 1.080(0.927~1.259) 0.322
    GLU 1.328(1.213~1.454) <0.001 1.316(1.040~1.666) 0.022
    TG 1.285(1.190~1.388) <0.001 1.051(0.917~1.206) 0.473
    TyG-BMI 1.255(1.165~1.352) <0.001 1.262(1.140~1.396) 0.010
    BISAP评分 10.510(5.574~19.817) <0.001 4.221(1.421~12.538) 0.001
    下载: 导出CSV

    表  4  不同指标预测HLAP严重程度的ROC曲线分析

    Table  4.   ROC analysis of HLAP severity predicted by different indexes

    变量 AUC cut-off值 敏感度 特异度 约登指数 95%CI P
    BISAP评分 0.985 1.500 1.000 0.966 0.966 0.972~0.998 <0.001
    TyG-BMI 0.891 119.196 0.911 0.968 0.879 0.845~0.937 <0.001
    GLU 0.807 9.740 0.822 0.674 0.496 0.745~0.869 <0.001
    下载: 导出CSV
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  • 收稿日期:  2023-12-06
  • 录用日期:  2024-02-01
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