背景:慢性消化系统疾病胆结石在世界范围内相当普遍,其发展与氧化应激密切相关,炎症反应和脂质代谢异常。在过去的几年里,作为一种新的脂质代谢生物标志物,非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇的比值(NHHR)引起了人们的极大兴趣.然而,它与胆结石的关系尚未被研究。
方法:3,772人,所有50岁以下的人都被纳入这项研究,他们的全部数据来自2017-2020年的国家健康和营养检查调查(NHANES)数据库。有关胆结石的信息是通过自我报告的问卷获得的。使用平滑曲线拟合多因素逻辑回归来评估NHHR与胆结石形成发生率的关系。随后,应用亚组分析和交互检验。最后,创建一个预测模型,使用逻辑回归和最后绝对收缩和选择运算符(LASSO)进行特征筛选。使用列线图显示所得模型。
结果:在考虑所有因素的多变量逻辑回归中,lnNHHR每升高一个单位,胆结石的可能性增加77%(OR1.77[CI1.11-2.83]).在NHHR分层之后,与Q1水平相比,第4季度NHHR水平与胆结石风险的关联显著(OR1.86[CI1.04-3.32]).这种相关性在女性中更强,35岁以下的人,吸烟者,戒酒者,非西班牙裔白人,那些胆固醇过高的人,COPD患者,和没有糖尿病的人。功能筛选后,胆结石的预测模型和可视化列线图的AUC为0.785(CI0.745-0.819),DCA评估为临床重要。
结论:在≤50岁的人群中,NHHR水平升高与较高的胆结石发病率显著相关.这种相关性在几个特定的群体中更强,例如女性,35岁以下,吸烟者,等等。使用NHHR构建的预测模型在评估胆结石形成方面具有潜在的临床价值。
BACKGROUND: The chronic digestive condition gallstones is quite common around the world, the development of which is closely related to oxidative stress, inflammatory response and abnormalities of lipid metabolism. In the last few years, as a novel biomarker of lipid metabolism, the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) has garnered significant interest. However, its relationship with gallstones has not been studied yet.
METHODS: 3,772 people, all under 50, were included in this study, and their full data came from the National Health and Nutrition Examination Survey (NHANES) database for the years 2017-2020. Information on gallstones was obtained through self-reported questionnaires. Smoothed curve fitting multifactorial logistic regression was utilized to evaluate the connection of NHHR with
gallstone formation incidence. Subsequently, subgroup analysis and interaction tests were applied. Finally, to create a prediction model, logistic regression and feature screening by last absolute shrinkage and selection operator (LASSO) were used. The resulting model was displayed using a nomogram.
RESULTS: In multivariate logistic regression that accounted for all factors, there was a 77% increase in the likelihood of gallstones for every unit rise in lnNHHR (OR 1.77 [CI 1.11-2.83]). Following NHHR stratification, the Q4 NHHR level was substantially more linked to the risk of gallstones than the Q1 level (OR 1.86 [CI 1.04-3.32]). This correlation was stronger in women, people under 35, smokers, abstainers from alcohol, non-Hispanic White people, those with excessively high cholesterol, people with COPD, and people without diabetes. After feature screening, a predictive model and visualized nomogram for gallstones were constructed with an AUC of 0.785 (CI 0.745-0.819), which was assessed by DCA to be clinically important.
CONCLUSIONS: In the group of people ≤ 50 years of age, elevated NHHR levels were substantially linked to a higher incidence of gallstones. This correlation was stronger in several specific groups such as females, under 35 years of age, smokers, and so on. Predictive models constructed using the NHHR have potential clinical value in assessing
gallstone formation.