LHR与胆结石的关联:基于美国NHANES数据库和中国单中心数据集的横断面研究OA
Association between LHR and gallstone disease:a cross-sectional study based on the US NHANES database and a Chinese single-center dataset
目的 探讨淋巴细胞/高密度脂蛋白胆固醇比值(LHR)与胆结石(GSD)患病率之间是否存在潜在关联.方法 数据来源于2017-2020年美国国家健康与营养调查(NHANES)数据库.根据研究对象是否患有GSD分为GSD组(n=848)与非GSD组(n=7046).以LHR为暴露变量,按四分位数分组(Q1-Q4),评估其与GSD的关联.采用多因素logistic回归模型分析LHR与GSD发生风险之间的关系,同时进行亚组分析、交互作用检验,并采用限制性立方样条(RCS)和阈值效应分析评估非线性关联.结果 共纳入7894名参与者,GSD患病率为10.74%,LHR中位数为1.57(1.13,2.14).多因素logistic回归分析结果显示,LHR升高与GSD发生风险呈明显正相关(完全调整模型OR=1.20,95%CI 1.07～1.35,P=0.002),Q3组较Q1组GSD发生风险增加66%(OR=1.66,95%CI 1.30～2.10,P<0.001),Q4组较Q1组风险增加46%(OR=1.46,95%CI 1.13～1.87,P=0.003).亚组分析显示该关联在各亚组中保持一致,性别和吸烟存在交互作用(P交互<0.05).此外,本研究采用首都医科大学附属北京朝阳医院的255名参与者的数据集进行验证.RCS和阈值效应分析提示LHR与GSD呈非线性相关(P非线性=0.022).结论 LHR与GSD风险升高呈正相关,LHR可作为一种简便且经济的工具用于GSD高危个体的早期发现与管理.
Objective To investigate the association between lymphocyte-to-high-density lipoprotein cholesterol ratio(LHR)and the prevalence of gallstone disease(GSD).Methods Data were drawn from the US National Health and Nutrition Examination Survey(NHANES)database between 2017 and 2020.Participants were divided into GSD group(n=848)and non-GSD group(n=7046)according to the GSD status.LHR was treated as the exposure variable,which was grouped into quartiles(Q1-Q4)to evaluate its association with GSD.A multivariate logistic regression model was used to analyze the relationship between LHR and the risk of GSD.Meanwhile,subgroup analyses and interaction tests were performed,and restricted cubic spline analysis was employed to assess the nonlinear associations.Results A total of 7894 participants were enrolled in this study,with a GSD prevalence of 10.74%.The median LHR was 1.57(interquartile range:1.13,2.14).Multivariate logistic regression analysis revealed a significant positive association between elevated LHR and the risk of GSD[fully adjusted model:odds ratio(OR)=1.20,95%CI 1.07-1.35,P=0.002].Compared with participants in the lowest quartile(Q1),those in the third quartile(Q3)had a 66%increased risk of GSD(OR=1.66,95%CI 1.30-2.10,P<0.001),while those in the fourth quartile(Q4)had a 46%increased risk(OR=1.46,95%CI 1.13-1.87,P=0.003).Subgroup analyses demonstrated that this association remained consistent across all subgroups,and there were significant interactions for gender and smoking status(Pinteraction<0.05).Furthermore,the findings were validated using an independent dataset of 255 participants from Beijing Chaoyang Hospital Affiliated to Capital Medical University.Restricted cubic spline(RCS)and threshold effect analyses suggested a nonlinear association between LHR and GSD(Pnon-linearity=0.022).Conclusions LHR is positively correlated with an increased risk of GSD,suggesting that LHR may serve as a simple and cost-effective tool for the early detection and management of individuals at high risk of GSD.
陈昭光;于剑锋;刘心娟
首都医科大学附属北京朝阳医院消化内科,北京 100020首都医科大学附属北京朝阳医院消化内科,北京 100020首都医科大学附属北京朝阳医院消化内科,北京 100020
医药卫生
胆结石高密度脂蛋白胆固醇淋巴细胞/高密度脂蛋白胆固醇比值全国健康与营养调查横断面研究
gallstone diseasehigh-density lipoprotein cholesterollymphocyte-to-high-density lipoprotein cholesterol ratioNational Health and Nutrition Examination Survey(NHANES)cross-sectional study
《解放军医学杂志》 2026 (7)
1068-1076,9
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