实用老年医学

实用老年医学 ›› 2026, Vol. 40 ›› Issue (5): 505-509.doi: 10.3969/j.issn.1003-9198.2026.05.014

• 临床研究 • 上一篇    下一篇

LDL-C/HDL-C比值在老年结直肠腺瘤发病风险中的评估价值及列线图预测模型构建

孙洁, 桑楠, 樊垚, 杨燕, 赵君宁, 王伟   

  1. 210024 江苏省南京市,江苏省省级机关医院消化内科(孙洁,桑楠,杨燕,赵君宁);临床流行病学研究室(樊垚);慢病与健康管理研究中心(王伟)
  • 收稿日期:2025-11-17 发布日期:2026-05-20
  • 通讯作者: 王伟,Email: wangwei16306@163.com
  • 基金资助:
    江苏省老年医学研究所科研项目(L202202)

Pridictive value of LDL-C/HDL-C ratio in elderly patients with colorectal adenoma and construction of a nomogram prediction model

SUN Jie, SANG Nan, FAN Yao, YANG Yan, ZHAO Junning, WANG Wei   

  1. Department of Gastroenterology (SUN Jie, SANG Nan, YANG Yan, ZHAO Junning); Clinical Epidemiology Research Laboratory (FAN Yao); Chronic Disease and Health Management Research Center (WANG Wei), Jiangsu Province Official Hospital, Nanjing 210024, China
  • Received:2025-11-17 Published:2026-05-20
  • Contact: WANG Wei, Email: wangwei16306@163.com

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摘要： 目的 探索LDL-C/HDL-C比值(LHR)与老年结直肠腺瘤(CRA)的相关性,构建一个适用于老年CRA无创风险预测的列线图模型并验证,以弥补结肠镜筛查的局限。 方法 本研究共纳入329名老年受试者,其中腺瘤组194例,非腺瘤组135例,收集其基线人口统计学和临床资料,包括年龄、BMI、HbA1c、幽门螺杆菌感染(Hp+)、LDL-C、HDL-C、TG和TC等。计算LHR、TG/HDL-C比值(THR)和非HDL-C/HDL-C比值(NHHR)。采用二元logistic回归分析筛选CRA的独立危险因素,并通过ROC曲线、净重分类改进指数(NRI)、整体鉴别指数(IDI)和决策曲线分析(DCA)评估模型的预测能力。 结果 腺瘤组与非腺瘤组年龄、BMI、HbA1c、Hp+、脂肪肝、LHR、THR及NHHR等差异均具有统计学意义(P<0.05)。二元logistic回归分析表明,年龄(OR=1.049)、BMI(OR=1.176)、Hp+(OR=1.989)、LHR(OR = 2.689)和HbA1c(OR=1.684)是老年CRA的独立危险因素(均P<0.05)。包含LHR的预测模型的AUC为0.716,显著优于未包含LHR的模型(AUC=0.697)。NRI与IDI进一步证实加入LHR可提升模型的风险预测能力(P=0.006)。 结论 LHR与CRA独立相关,包含LHR的预测模型显著提升了对CRA的风险预测能力。

关键词: 结直肠腺瘤, LDL-C/HDL-C比值, 预测模型, 老年人

Abstract: Objective To explore the association between LDL-C/HDL-C ratio (LHR) and colorectal adenoma (CRA) in the elderly, and to construct and validate a nomogram prediction model suitable for non-invasive risk assessment of CRA in the elderly, thereby mitigating the limitations of colonoscopy screening. Methods A total of 329 elderly individuals were enrolled in this study, comprising 194 participants in the adenoma group and 135 cases in the non-adenoma group. Baseline demographic and clinical data were collected, including age, body mass index (BMI), glycated hemoglobin (HbA1c), Helicobacter pylori infection (Hp+), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and total cholesterol (TC). The lipid ratios LDL-C/HDL-C (LHR) and TG/HDL-C (THR), as well as the derived index (TC-HDL-C)/HDL-C (NHHR), were calculated. Binary logistic regression analysis was performed to identify independent risk factors for CRA. The predictive ability of the model was assessed using receiver operating characteristic (ROC) curve analysis, net reclassification improvement (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA). Results Significant differences between the adenoma and non-adenoma groups were observed in age, BMI, HbA1c, Hp+, presence of fatty liver, LHR, THR, and NHHR (P<0.05). Binary logistic regression analysis revealed that age(OR=1.049)、BMI(OR=1.176)、Hp+(OR=1.989)、LHR(OR=2.689), and HbA1c(OR=1.684) were independent predictors of CRA in the elderly (all P<0.05). The area under the ROC curve (AUC) for the model incorporating LHR was 0.716, which was significantly higher than that of the model without LHR (AUC=0.697). NRI and IDI analyses further demonstrated that inclusion of LHR improved the model’s risk predictive capacity (P=0.006). Conclusions LHR is independently associated with CRA. The prediction model incorporating LHR significantly improves the risk predictive capability for CRA in the elderly.

Key words: colorectal adenoma, LDL-C/HDL-C ratio, predictive model, aged

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