Relationship Between TG/HDL-C Ratio And Carotid Atherosclerotic Stenosis In Patients

Objective:To explore the relationship between triglyceride/high density lipoprotein cholesterol(TG/HDL-C)ratio in patients with ischemic cerebrovascular disease and carotid atherosclerotic stenosis in patients with low density lipoprotein cholesterol maintained within a safe range after lipid-lowering treatment in hospital.Method:From Jul 2017 to Jul 2021,we selected 208 in-patients of The Affiliated Hospital of Qingdao University,who were diagnosed with ischemic cerebrovascular disease based on head and neck CT or MRI according to 2019 Chinese Guidelines for the Imaging Application in Cerebrovascular Diseases and met natriuretic standard.The general clinical data was collected for retrospective analysis.Professional staff who received uniform training improved the carotid artery CTA examination.According to CTA report,the patients were divided into patients with CAS and patients without CAS.According to the degree of CAS,the patients with CAS were divided into three groups:mild group(degree of CAS:<50%),moderate group(degree of CAS:50%～69%),and severe group(degree of CAS:70%～99%).Besides,The patients’ clinical biochemical indexes were collected,and the specialized physicians from clinical lab improved the biochemical index monitoring.This paper analyzed and compared with SPSS26.0 to see if the patients’ biochemical indexes,general clinical data and TG/HDL-C ratio were correlated to CAS of ICVD patientsResults:1.Comparison of general clinical data:208 patients aged 45～65(average age:56.91±5.06)were analyzed including 110 males(53%),98 females(47%),75 smokers(36%),86 drinkers(41%),144 hypertension patients(69%)and 56 diabetic patients(27%).According to the patients’ carotid artery CTA results,the patients were divided into CAS group(114 patients)and NCAS group(94 patients).Compared with the patients of NCAS group,the proportion of patients with history of smoking,hypertension and diabetic in CAS group significantly increased(P<0.05);The comparison between the mild group,moderate group and severe group of CAS showed that there was no statistically significant difference for the baseline information of smoking,drinking,gender,age,hypertension and diabetic for the degree of CAS of ICVD patients(P>0.05).2.Comparison of biochemical indexes:Compared with patients without CAS,the total cholesterol、TG、LDL-C、TG/HDL-C、UA and Hcy of patients from NCAS group increased significantly with a statistically significant difference(P<0.05);HDLC and apoA level decreased significantly with a statistically significant difference(P<0.05);apoB level had no statistically significant difference(P>0.05).Statistical analysis was done for TG、apoA、TG/HDL-C and HDL-C of patients from CAS moderate group and CAS mild group,which showed a statistically significant difference(P<0.05);Statistical analysis was done for TG、TG/HDL-C、HDL-C、UA and apoA of patients from CAS severe group and CAS mild group,which showed a statistically significant difference(P<0.05);Statistical analysis was done for TG and TG/HDL-C of patients from CAS severe group and CAS moderate group,which showed a statistically significant difference(P<0.05);Statistical analysis was done for LDL-C、apoB、Hcy and TC of patients from the three groups,which showed no statistically significant difference(P>0.05).Correlation analysis showed that the degree of CAS was positively correlated to TG、UA and TG/HDL-C(P<0.05)and was negatively correlated to HDL-C and apoA(P<0.05)which meant that as TG、UA and TG/HDL-C increased,the degree of CAS increased,while as HDL-C and apoA decreased,the degree of CAS decreased.3.Logistic regression analysis:the collinearity diagnostics for continuous biochemical indexes screened out through single factor analysis showed collineation of TG/HDL-C and TG、HDL-C.TG、HDL-C and differentiated biochemical indexes screened out through single factor analysis were included into logistic regression model for analysis and the regression analysis results were shown in TG and HDL-C logistic regression model:TG(OR=5.978,P<0.05)and TC(OR=3.209,P<0.05)which were positively correlated to the occurrence risk of CAS.After adjusting the patients’gender、age、hypertension、diabetic、history of smoking、history of drinking and other concomitant variables,the analysis results in TG and HDL-C logistic regression model showed TG(OR=8.564,P<0.05)which was still positively correlated to the occurrence risk of CAS;Serum TG increased by 1mmol per liter and the risk of CAS increased by 8.564 times which were more significant than the level before adjustment;the adjusted TC was uncorrelated to the occurrence risk of CAS.Except for TG and HDL-C index,TG/HDL-C and the differentiated indexes screened out through single factor analysis were included into logistic regression model for statistical analysis and the analysis results in TG/HDL-C logistic regression model showed TG/HDL-C(OR=4.900,P<0.05 and TC(OR=3.433,P<0.05)which were positively correlated to the occurrence risk of CAS;after adjusting the patients’ gender、age、hypertension、diabetic、history of smoking、history of drinking and other concomitant variables,the analysis results in TG/HDL-C logistic regression model showed TG/HDL-C(OR=4.922,P<0.05)and TC(OR=3.588,P<0.05)which were still positively correlated to the occurrence risk of CAS;Serum TG/HDL-C and TC increased by one standard unit per liter,and the risk of CAS increased by 4.922 and 3.588 times which were more significant than the level before adjustment.So,TG/HDL-C was statistically significant for prediction of the occurrence risk of CAS.4.Diagnostic efficiency analysis:the areas under the ROC curve of CAS evaluated with TG and TG/HDL-C ratio were respectively 0.8235 and 0.8272 with a statistically significant difference(P<0.05).TG/HDL-C showed the highest scoring accuracy.Conclusion:1.TG and TG/HDL-C are the objective indexes to evaluate CAS in patients whose LDL-C is controlled within the safe range,and the TG/HDL-C ratio is more significant to evaluate the residual risk of CAS.2.The degree of carotid atherosclerotic stenosis was positively correlated with TG、UA and TG/HDL-C in patients controlled by low density lipoprotein;It was negatively correlated with HDLC and ApoA.That is to say,with the increase of TG,UA and TG/HDL-C indicators,the degree of CAS will increase.With the decrease of HDL-C and apoA,the degree of CAS is lighter.