non-HDL-C/HDL-C对老年2型糖尿病患者冠状动脉钙化的预测价值

doi:10.3969/j.issn.1003-9198.2026.01.005

摘要/Abstract

摘要： 目的探讨非高密度脂蛋白胆固醇(non-HDL-C)与HDL-C比值(NHHR)对老年T2DM患者冠状动脉钙化(CAC)的预测价值。方法回顾性选取2023年1—12月于淮安市第一人民医院收治的249例老年T2DM患者,根据胸部CT结果,采用Shemesh视觉钙化积分法分为钙化组与无钙化组。收集临床资料并计算NHHR。采用多因素logistic回归分析CAC的独立危险因素,并应用限制性立方样条(RCS)分析NHHR与CAC的非线性关系。采用ROC曲线评估NHHR的预测效能。结果多因素logistic回归分析显示,NHHR(OR=1.53, 95%CI: 1.05~2.21)和年龄(OR=1.07, 95%CI: 1.01~1.13)是CAC的独立危险因素(均P<0.05),且NHHR与CAC风险呈线性剂量-反应关系(P<0.05)。ROC曲线分析表明,NHHR预测CAC的AUC为0.650(95%CI: 0.563~0.736),最佳截断值为2.28时,其敏感度和特异度分别为57.0%和72.0%。结论 NHHR是老年T2DM患者发生CAC的独立危险因素,对其具有一定的预测价值。

关键词: 冠状动脉钙化, 2型糖尿病, 非高密度脂蛋白胆固醇, 脂代谢紊乱, 老年人

Abstract: Objective To explore the predictive value of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) for coronary artery calcification (CAC) in elderly patients with type 2 diabetes mellitus (T2DM). Methods A total of 249 elderly patients with T2DM admitted to Huai’an First People’s Hospital from January to December 2023 were selected. Based on chest CT results, all patients were divided into a non-CAC group and a CAC group using the Shemesh visual calcification score method. NHHR was calculated according to the patients’ laboratory test results. Univariate and multivariate logistic regression analysis were employed to determine whether NHHR was an independent risk factor for CAC in patients with T2DM. Restricted Cubic Spline (RCS) analysis was used to analyze potential nonlinear relationships between NHHR and CAC. The predictive value of NHHR for the presence of CAC was assessed using receiver operating characteristic (ROC) curve analysis. Results Multivariate logistic regression combined with RCS analysis identified both NHHR (OR=1.53, 95%CI: 1.05－2.21) and age (OR=1.07, 95%CI: 1.01－1.13) as independent risk factors for CAC in elderly patients with T2DM (P<0.05), with a linear relationship between NHHR and CAC risk observed. Furthermore, the ROC curve analysis showed that the area under the curve (AUC) for predicting CAC using NHHR was 0.650 (95% CI: 0.563-0.736, P<0.05). At the optimal cut-off value of 2.28, the sensitivity and specificity were 57.0% and 72.0%, respectively. Conclusions An elevated NHHR is associated with an increased risk of CAC in elderly patients with T2DM. NHHR demonstrates a certain predictive value for CAC.

Key words: coronary artery calcification, type 2 diabetes mellitus, non-high-density lipoprotein cholesterol, disorders of lipid metabolism, aged

中图分类号:

R 54

刘梦婕, 杜秋瑶, 陈晓晓, 张泽群, 曾杨, 雷时雨, 张清. non-HDL-C/HDL-C对老年2型糖尿病患者冠状动脉钙化的预测价值[J]. 实用老年医学, 2026, 40(1): 21-25.

LIU Mengjie, DU Qiuyao, CHEN Xiaoxiao, ZHANG Zequn, ZENG Yang, LEI Shiyu, ZHANG Qing. Predictive value of non-HDL-C/HDL-C for coronary artery calcification in older patients with type 2 diabetes mellitus[J]. Practical Geriatrics, 2026, 40(1): 21-25.

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