体质量标化的肌酐与胱抑素C比值对中老年人群心血管事件的预测作用:基于CHARLS队列的全国前瞻性研究OA
Prognostic value of the weight-adjusted creatinine-to-cystatin C ratio for cardiovascular events in middle-aged and older adults:A nationwide prospective study based on the CHARLS cohort
目的 探讨我国中老年人群体质量标化的肌酐与胱抑素C比值(weight adjusted creatinine-to-cystatin C ratio,WCCR)与心血管疾病(cardiovascular disease,CVD)风险关联及预测价值.方法 采用中国健康与养老追踪调查数据,选取参加2011年基线调查并追踪至2020年随访结束的5 994例中老年人为研究对象,收集其社会人口学特征、体格检查数据、生活方式信息、健康状况、医疗保险及生化指标等.采用血肌酐及胱抑素C指标计算体质量标化的WCCR,并按性别进行三份位数分组.采用Cox比例风险回归模型分析WCCR与CVD发病风险关联.结果 中位随访8.92(7.00,9.00)年,共有1517例发生CVD,其中心脏病1 158例,脑卒中521例.总体CVD、心脏病及脑卒中的发病密度分别为33.3/1 000人年(95％CI:31.7～35.0/1 000 人年)、25.4/1 000 人年(95％CI:24.0～26.9/1 000 人年)和 11.4/1 000 人年(95％CI:10.5～12.5/1 000人年).经多因素校正后,与WCCR最低分位数组相比,最高分位数组总体CVD和心脏病风险分别降低19.8％(95％CI:9.2％～29.1％)和22.1％(95％CI:10.3％～32.3％);在男性和女性的最高分位数组中总体 CVD 和心脏病风险分别降低 19.5％(95％CI:2.6％～33.5％)、20.9％(95％CI:0.6％～37.1％)和 20.3％(95％CI:6.3％～32.3％)、25.0％(95％CI:9.7％～37.8％).结论 在我国中老年人群中,WCCR 与 CVD 风险呈负相关,较低的WCCR水平是心血管疾病的独立危险因素,该指标有助于完善心血管风险分层及防控策略.
Objective To investigate the association between the weight-adjusted creatinine-to-cystatin C ratio(WCCR)and the risk of incident cardiovascular disease(CVD)among middle-aged and older adults in China.Methods Data were obtained from the China Health and Retirement Longitudinal Study(CHARLS).A total of 5 994 participants who completed the 2011 baseline survey and were followed up until 2020 were included.Data on sociodemographic characteristics,physical examinations,lifestyle factors,health status,health insurance,and biochemical indicators were collected.The WCCR was calculated using serum creatinine and cystatin C levels,adjusted for body weight,and participants were categorized into sex-specific tertiles.Cox proportional hazards regression models were used to evaluate the association between the WCCR and the risk of CVD.Results Over a median follow-up of 8.92(7.00,9.00)years,1 517 cases of CVD were recorded,including 1 158 cases of heart disease and 521 cases of stroke.The incidence densities of overall CVD,heart disease,and stroke were 33.3/1 000 person-years(95％CI:31.7-35.0),25.4/1 000 person-years(95％CI:24.0-26.9),and 11.4/1 000 person-years(95％CI:10.5-12.5),respectively.After multivariable adjustment,compared with the lowest WCCR tertile,the highest tertile was associated with a 19.8％(95％CI:9.2％-29.1％)reduction in overall CVD risk and a 22.1％(95％CI:10.3％-32.3％)reduction in heart disease.In the highest WCCR tertile,overall CVD risk was re-duced by 19.5％(95％CI:2.6％-33.5％)in men and 20.3％(95％CI:6.3％-32.3％)in women,while heart dis-ease risk was reduced by 20.9％(95％CI:0.6％-37.1％)in men and 25.0％(95％CI:9.7％-37.8％)in women.Conclusions Among middle-aged and older adults in China,the WCCR is inversely associated with the risk of CVD.A lower WCCR is an independent risk factor for cardiovascular events,highlighting its potential utility in improving cardiovascular risk stratification and informing prevention strategies.
张云盛;王娟;薛丽晶;贾莉莉;张文娟
天津医科大学总医院空港医院心血管内科(天津 300308)天津医科大学总医院空港医院心血管内科(天津 300308)天津医科大学总医院心血管内科(天津 300052)天津医科大学总医院心血管内科(天津 300052)天津医科大学总医院心血管内科(天津 300052)
医药卫生
心血管疾病肌酐胱抑素C中老年
cardiovascular diseasecreatininecystatin Cmiddle-aged and older adults
《实用医学杂志》 2026 (15)
2706-2713,8
天津市卫生健康科研项目(编号:TJWJ2023QN108)天津市医学重点学科建设资助项目(编号:TJYXZDXK-3-003B)
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