国际老年医学杂志2026，Vol.47Issue(5)：583-589,7.DOI:10.3969/j.issn.1674-7593.2026.05.005
不同心功能分级老年慢性心力衰竭伴营养不良患者血清胱抑素C与高密度脂蛋白胆固醇的相关性
Correlation between serum cystatin C and high-density lipoprotein cholesterol in elderly patients with chronic heart failure complicated by malnutrition at different cardiac function grades
摘要
Abstract
Objective To select elderly malnourished patients with chronic heart failure(CHF)stratified by cardiac func-tion grades and explore the correlation between serum cystatin C(Cys C)and blood lipid levels.Methods A total of 207 patients with CHF combined with malnutrition admitted to Tangdu Hospital,Fourth Military Medical University from January 2022 to December 2024 were enrolled as research subjects.Patients were divided into three groups based on the New York Heart Association(NYHA)cardiac function classification:grade Ⅰ-Ⅱ group(67 cases),grade Ⅲ group(76 cases),and grade Ⅳ group(64 cases).Clinical data,serum Cys C and laboratory indicators including blood lipid levels were compared among the three groups.Spearman correlation analysis was applied to assess the correlations between serum Cys C and other indicators.Multivariate linear stepwise regression analy-sis was performed with serum Cys C as the dependent variable,and factors with P<0.05 in the correlation analysis as independent vari-ables.Results There were significant differences in serum levels of Cys C,blood urea nitrogen(BUN),serum creatinine(SCr),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),albumin(ALB),and left ventricular ejection fraction(LVEF)a-mong elderly patients with CHF and malnutrition across different NYHA functional classes(all P<0.05).Specifically,serum levels of Cys C,BUN,and SCr increased with elevated cardiac function class,while HDL-C and LVEF decreased gradually.Notably,serum ALB levels did not show a stepwise downward trend with increasing cardiac function class,and were highest in patients with class.No significant intergroup differences were observed in hemoglobin(Hb),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),total bilirubin(TBIL),or uric acid(UA)levels(all P>0.05).Spearman correlation analysis demonstrated that serum Cys C levels were positively correlated with BUN and SCr(all P<0.05),and negatively correlated with HDL-C,ALB,and LVEF(all P<0.05),but not with TG(P>0.05)in elderly patients with CHF and malnutrition.Multivariate linear stepwise regression analysis revealed that BUN,SCr,HDL-C,and LVEF were major determinants for serum Cys C levels in all included patients,with BUN show-ing the strongest association(β=0.409).In patients stratified by cardiac function class,BUN,SCr,HDL-C,and ALB were major determinants of Cys C levels.BUN was closely associated with Cys C levels in grade Ⅰ-Ⅱ(β=0.447)and grade Ⅲ(β=0.406)groups,whereas SCr exhibited the most significant correlation with Cys C levels in grade Ⅳ patients(β=0.323).Conclusion Serum Cys C levels in elderly patients with CHF complicated by malnutrition increase significantly with the deterioration of cardiac function.Moreover,they are closely associated with cardiorenal injury,nutritional status,and lipid metabolism disorders in these patients.关键词
慢性心力衰竭/营养不良/胱抑素C/血脂/相关性Key words
Chronic heart failure/Malnutrition/Cystatin C/Blood lipids/Correlation引用本文复制引用
高砚丽,任引刚,白莉敏,祝松涛,魏娟茹..不同心功能分级老年慢性心力衰竭伴营养不良患者血清胱抑素C与高密度脂蛋白胆固醇的相关性[J].国际老年医学杂志,2026,47(5):583-589,7.基金项目
陕西省重点研发计划项目(2022SF-160) （2022SF-160）
