| Objective To analyze the risk factors of cardiovascular disease(CVD)in patients with chronic kidney disease(CKD)and evaluate the value of triglyceride/high density lipoprotein cholesterol(TG/HDL-C)in evaluating the risk of CVD in patients with CKD.Methods The study collected inpatients with CKD admitted to the Department of Nephrology,the first people’s Hospital of Yichang City from July 2016 to January 2017.Record the general information of the patient,including age,sex,height,weight,blood pressure,personal history,current medical history,past history,etc.Clinical data included serum creatinine(Scr),blood urea nitrogen(BUN),uric acid(UA),carbon dioxide(CO2),glomerular filtration(GFR),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),triglyceride/high density lipoprotein cholesterol(TG/HDL-C),low density lipoprotein cholesterol(LDL-C),lactate dehydrogenase(LDH),α-hydroxybutyrate dehydrogenase(α-HBDE),creatine kinase(CK),creatine kinase-MB(CK-MB),troponin I(Tn I),brain natriuretic peptide(BNP),electrocardiogram,cardiac color doppler ultrasound,vascular color doppler ultrasound and other indicators and auxiliary examination.Body mass index(BMI)was calculated according to height and weight,and TG/HDL-C was calculated by serum TG and HDL-C.GFR was estimated according to the MDRD equation.Follow-up for 2 years,the selected CKD patients will be selected based on the occurrence of CVD,it mainly includes coronary artery disease(CAD),left ventricular hypertrophy(LVH),congestive heart failure(CHF),macrovascular atherosclerotic disease(LAD),divided into occurrence group(CKD patients with CVD group)and non-occurrence group(CKD patients without CVD group).The data of the two groups were sorted out,and the risk factors were screened by Logistic regression analysis,the diagnostic value of TG/HDL-C in the risk of CVD in CKD patients was evaluated by ROC curve,sensitivity and specificity analysis.Results(1)Comparison of general data of CKD patients:The average age of the patients in the occurrence group was 66.48±11.86 years old,and the average age of the patients in the non-occurrence group was48.93±14.01years old,the difference was statistically significant(P<0.001).There was no significant difference in sex,BMI and blood pressure between the two groups(P>0.05).(2)Comparison of Laboratory Indexes in patients with CKD:Scr was 156.43±103.66umol/L in the occurrence group and 112.08±83.04 umol/L in the non-occurrence group,the difference was statistically significant(P<0.05).BUN was 11.86±7.94 mmol/L in the occurrence group and 8.37±6.23mmol/L in the non-occurrence group,the difference was statistically significant(P<0.05).GFR was 51.28±27.39 ml/(min·1.73m~2)in the occurrence group and 76.09±31.81 ml/(min·1.73m~2)in the non-occurrence group,the difference was statistically significant(P<0.05).HDL-C was 1.27±0.28 mmol/L in the occurrence group and 1.48±0.42 mmol/L in the non-occurrence group,the difference was statistically significant(P<0.05).TG/HDL-C was 1.05±0.41 in the occurrence group and 0.86±0.34 in the non-occurrence group,the difference was statistically significant(P<0.05).However,there was no significant difference in CO2,UA,TC,TG,LDL-C,LDH,α-HBDE,CK and CK-MB between the occurrence group and the non-occurrence group(P>0.05).(3)Regression analysis of risk factors:TG/HDL-C(P=0.012,OR=4.468,95%CI=1.382-14.445)and age(P=0.000,OR=1.113,95%CI=1.069-1.159)were risk factors for CVD in CKD patients.(4)ROC curve analysis:The area under the ROC curve of TG/HDL-C was 0.714,and the confidence interval of 95%was(0.618-0.809),P<0.001.The area under the ROC curve was 0.807,and the 95%confidence interval was(0.762-0.84),P<0.001.(5)Sensitivity and specificity analysis:in the risk of CVD in CKD patients,the optimal threshold of TG/HDL-C was 0.885,the corresponding sensitivity was 77.3%,and the specificity was 62.4%.The critical age of CVD in CKD patients was 57.50 years old,the corresponding sensitivity was 86.4%,and the specificity was 72.8%.Conclusion(1)Age and TG/HDL-C are the risk factors of CVD in CKD patients.(2)CKD patients aged 57.5 years and over should be highly alert to the occurrence of CVD.(3)TG/HDL-C can be used as a reference index for the early assessment of CVD in CKD patients.When TG/HDL-C is 0.885,it is significant for the diagnosis of CVD in CKD patients. |
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