解放军医学杂志2026，Vol.51Issue(5)：684-693,10.DOI:10.11855/j.issn.0577-7402.2230.2026.0213
残余胆固醇炎症指数对心血管疾病的预测价值:基于开滦队列的前瞻性研究
Predictive value of remnant cholesterol inflammatory index for cardiovascular diseases:a prospective study based on the Kailuan cohort
摘要
Abstract
Objective Based on the large prospective Kailuan cohort study to explore the association between remnant cholesterol(RC)inflammatory index(RCII)and the risk of cardiovascular disease(CVD),as well as its predictive value for CVD.Methods This study was a prospective cohort study.Participants from the Kailuan study population who participated in the 2006 physical examination were included as study subjects(n=101 510).Participants were grouped according to quartiles of RCII:Q1 group(RCII<0.925,n=21 287),Q2 group(0.925≤RCII<2.923,n=21 280),Q3 group(2.923≤RCII<9.293,n=21 293),Q4 group(RCII≥9.293,n=21 286).They were followed up every 2 years.The endpoint of the follow-up was the occurrence of CVD(including stroke and ischemic heart disease),death,or the end of observation(December 31,2022).A Cox proportional hazards regression model was used to analyze the association between RCII and the risk of incident CVD.The predictive values of RC,high-sensitivity C-reactive protein(hs-CRP),and RCII for CVD were compared using C-index,net reclassification improvement(NRI),and integrated discrimination improvement(IDI).RC,hs-CRP,and RCII were standardized using Z-scores and their association with CVD risk was analyzed.Results After an average follow-up of(14.21±3.77)years,among 85 146 study subjects,a total of 10 105 study subjects developed incident CVD.After adjusting for confounding factors and grouping by RCII quartiles,compared with Q1 group,the HR(95%CI)of incident CVD in Q2-Q4 groups were 1.120(1.053-1.191),1.206(1.136-1.282),and 1.347(1.268-1.430),respectively,with P for trend<0.01.For each one standard deviation increase in RCII,the risk of incident CVD increased by 7.2%,and the HR(95%CI)was 1.072(1.055-1.090).ROC curve analysis showed that RCII had the highest area under the curve(AUC)value(0.568),higher than hs-CRP(0.560)or RC(0.544),with P<0.01.The C-index,NRI,and IDI values of RCII were higher than those of RC and hs-CRP.Conclusion The predictive value of RCII for CVD is superior to that of RC or hs-CRP,and as RCII increases,the risk of incident CVD also increases.关键词
残余胆固醇炎症指数/心血管疾病/残余胆固醇/高敏C反应蛋白Key words
remnant cholesterol inflammation index/cardiovascular diseases/remnant cholesterol/high sensitivity C-reactive protein分类
医药卫生引用本文复制引用
曹柳柳,杨永娜,王越,张晓玲,吴寿岭,孙丽霞,李曼,武朝辉,张宇欣,张丽,辛蕊,李鹏,王冲,赵茂林..残余胆固醇炎症指数对心血管疾病的预测价值:基于开滦队列的前瞻性研究[J].解放军医学杂志,2026,51(5):684-693,10.基金项目
河北省重点研发计划项目(19277791D)This work was supported by the Hebei Province Key Research and Development Program Project(19277791D) （19277791D）
