MHR-TyG联合多元模型对社区老年人群慢性肾脏病的预测价值研究OA

Objective To discuss the correlation among monocyte to high-density lipoprotein cholesterol ratio(MHR),triglyceride-glucose(TyG)index,and chronic kidney disease(CKD)in the community-dwelling elderly population,and to evaluate the predictive value of a multivariate joint prediction model based on MHR,TyG index combined with uric acid,body mass index(BMI),and age for CKD in the elderly.Methods Clinical data and peripheral blood test results were collected from a total of 1 653 elderly individuals in the Lujiazui community of Pudong New Area,Shanghai,in 2022.Based on the estimated glomerular filtration rate(eGFR),the study population was divided into a non-CKD group[eGFR≥60 mL/(min·1.73 m2)]and a CKD group[eGFR<60 mL/(min·1.73 m2)].The predictive value of the combined MHR-TyG model for CKD in the elderly was analyzed.Results Logistic regression analysis showed that age,BMI,uric acid,MHR,and TyG index were all independent risk factors for CKD(all P<0.05).Restricted cubic spline(RCS)curves and mediation analysis demonstrated that MHR was significantly non-linearly and positively associated with the risk of CKD(P for overall<0.001,P for nonlinear=0.016).When MHR>0.3,the risk of CKD increased significantly.The proportion of the mediation effect of MHR was 23.88%in the relationship between BMI and CKD,and 4.77%in the relationship between age and CKD.Receiver operating characteristic(ROC)curve analysis showed that the combined MHR-TyG prediction model achieved an area under the curve(AUC)of 0.826(95%CI:0.793-0.859,P<0.001),with a sensitivity of 79.1%and a specificity of 73.4%,demonstrating predictive performance superior to any single indicator.Subgroup analysis suggested that MHR remained a significant predictor in non-high-risk populations,such as those with normal BMI,uric acid,and triglyceride levels.Conclusions Age,BMI,uric acid,MHR,and TyG index are all independent risk factors for CKD.The risk prediction model constructed by combining MHR-TyG with age,BMI,and uric acid has good predictive performance and is superior to any single indicator.