脂质蓄积指数联合甘油三酯-葡萄糖-体质量指数预测高血压肥胖患者短期预后的价值OA
Predictive value of lipid accumulation product combined with triglyceride-glucose-body mass index for short-term prognosis in obese patients with hypertension
目的 探讨脂质蓄积指数(LAP)联合甘油三酯-葡萄糖-体质量指数(TyG-BMI)预测高血压肥胖患者短期预后的价值.方法 采用前瞻性队列研究设计,连续纳入2022年6月-2025年6月本院收治的514例高血压合并肥胖患者为研究对象.收集患者基线临床资料,计算LAP和TyG-BMI.随访1年,根据预后情况的不同分为预后不良组与预后良好组.比较2组基线特征;采用Logistic回归分析明确影响因素;基于限制性立方样条(RCS)模型探索剂量-反应关系;绘制受试者工作特征(ROC)曲线及精确率-召回率(PR)曲线评估预测效能.结果 514例高血压肥胖患者随访1年,14例失访,短期预后不良发生率为11.00％(55/500).预后不良组(n=55)患者高血压病程、合并糖尿病、左心室质量指数(LVMI)、甘油三酯(TG)、收缩压(SBP)、血尿酸(SUA)、尿白蛋白与肌酐比值(UACR)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、LAP、TyG-BMI等指标数据均高于预后良好组,差异有统计学意义(P＜0.05).Logistic回归分析显示,合并糖尿病、SBP、高血压病程、LAP、TyG-BMI均是高血压肥胖患者短期预后独立影响因素(P＜0.05).RCS曲线显示,LAP、TyG-BMI与高血压肥胖患者短期预后不良风险呈近似"J"形曲线的非线性关系(P趋势＜0.05,P非线性＜0.05).ROC曲线分析显示,LAP、TyG-BMI联合预测的曲线下面积(AUC)值为0.935,显著高于LAP单独预测的0.740(P＜0.05)和TyG-BMI单独预测的0.725(P＜0.05);PR曲线显示,联合预测模型的PR-AUC为0.869,说明其召回率及精准率较高.结论 LAP和TyG-BMI是高血压肥胖患者短期预后不良的独立影响因素,二者联合应用可显著提高对短期预后不良的预测价值,为临床早期识别高危患者提供简便有效的工具.
Objective To investigate the predictive value of lipid accumulation product(LAP)combined with triglyceride-glucose-body mass index(TyG-BMI)for short-term prognosis in hyperten-sive patients with obesity.Methods A prospective cohort study was conducted,and 514 patients with hypertension and obesity admitted to our hospital from June 2022 to June 2025 were selected as study objects.Baseline clinical data were collected,and LAP and TyG-BMI were calculated.All patients were followed up for 1 year and classified into poor-prognosis and good-prognosis groups according to differed clinical outcomes.Baseline characteristics were compared between the two groups.Logistic re-gression analysis was performed to identify influencing factors.Restricted cubic spline(RCS)models were used to explore dose-response relationships.Receiver operating characteristic(ROC)curves and precision-recall(PR)curves were constructed to evaluate predictive performance.Results Of the 514 patients followed up for 1 year,14 were lost during follow-up,yielding a poor-prognosis rate of 11.00％(55/500).Compared with the good-prognosis group,the poor-prognosis group(n=55)showed significantly higher levels of hypertension duration,comorbid diabetes,left ventricular mass index(LVMI),triglycerides(TG),systolic blood pressure(SBP),serum uric acid(SUA),uri-nary albumin-to-creatinine ratio(UACR),fasting blood glucose(FBG),glycated hemoglobin(HbA1c),LAP,and TyG-BMI(P＜0.05).Logistic regression analysis revealed that comorbid di-abetes,SBP,hypertension duration,LAP,and TyG-BMI were independent predictors of poor short-term prognosis in hypertensive patients with obesity(P＜0.05).RCS analysis demonstrated approx-imate J-shaped nonlinear dose-response relationships between LAP and TyG-BMI and the risk of poor prognosis(Pfor trend＜0.05;Pfor nonlinearity＜0.05).ROC curve analysis showed that the combined LAP and TyG-BMI model achieved an area under the curve(AUC)of 0.935,which was significantly higher than that of LAP alone(AUC:0.740;P＜0.05)and TyG-BMI alone(AUC:0.725;P＜0.05).PR curve analysis indicated a PR-AUC of 0.869 for the combined model,reflecting high re-call and precision.Conclusion LAP and TyG-BMI are independent risk factors for poor short-term prognosis in hypertensive patients with obesity.Their combined use can significantly improve the predictive accuracy for adverse outcomes,providing a simple and effective tool for early identifica-tion of high-risk patients in clinical practice.
祖努然·拜克里;张雅玲;吕忠英;邹婷
新疆医科大学第五附属医院高血压科,新疆乌鲁木齐,830011新疆医科大学第五附属医院高血压科,新疆乌鲁木齐,830011新疆医科大学第五附属医院高血压科,新疆乌鲁木齐,830011新疆医科大学第五附属医院高血压科,新疆乌鲁木齐,830011
医药卫生
高血压肥胖脂质蓄积指数甘油三酯-葡萄糖-体质量指数预后风险预测队列研究受试者工作特征曲线
hypertensionobesitylipid accumulation producttriglyceride-glucose-body mass indexprognosisrisk predictioncohort studyreceiver operating characteristic curve
《实用临床医药杂志》 2026 (14)
49-55,7
新疆维吾尔自治区自然科学基金(2024D01C166)
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