血浆致动脉硬化指数与儿童支气管哮喘的相关性分析

Relationship between atherogenic index of plasma and childhood asthma

摘要:

目的 探讨血浆致动脉硬化指数（atherogenic index of plasma，AIP）与儿童支气管哮喘的关系。 方法 回顾性选取2020年7月—2022年8月于南京医科大学附属常州第二人民医院住院治疗的86例支气管哮喘患儿为哮喘组，选取同期149例健康体检儿童为对照组。收集两组的临床资料，包括血清总胆固醇（total cholesterol，TC）、三酰甘油（triglycerides，TG）、高密度脂蛋白胆固醇（high-density lipoprotein cholesterol，HDL-C）、低密度脂蛋白胆固醇（low-density lipoprotein cholesterol，LDL-C）、血糖检测数据及身高、体重、体重指数（body mass index，BMI）、有无特异性皮炎、吸入性过敏原过敏史、哮喘家族史及喂养史等资料。采用多因素logistic回归分析研究AIP、TG及HDL-C与支气管哮喘的关系。采用受试者操作特征曲线（receiver operating characteristic curve，ROC曲线）评估AIP、TG、HDL-C预测支气管哮喘的价值。 结果 哮喘组AIP、TG水平显著高于对照组，HDL-C显著低于对照组，差异有统计学意义（P<0.05）；两组TC、LDL-C的比较差异无统计学意义（P>0.05）。在调整身高、体重、有无特异性皮炎、吸入性过敏原过敏史、哮喘家族史、人工喂养、混合喂养及血糖前后，多因素logistic回归分析显示AIP、TG、HDL-C均与支气管哮喘相关（P<0.05）。ROC曲线分析发现AIP取-0.333是预测支气管哮喘的最佳临界值，灵敏度为80.2％，特异度为55.0％，阳性预测值为50.71％，阴性预测值为82.85％。比较AIP、TG、HDL-C预测支气管哮喘的AUC发现，AIP的AUC显著高于TG，差异有统计学意义（P=0.009），但AIP与HDL-C的AUC比较差异无统计学意义（P=0.686）。 结论 AIP、TG、HDL-C均与支气管哮喘相关。AIP对支气管哮喘的预测价值高于TG，与HDL-C的价值相当。

Abstract:

Abstract：Objective To explore the relationship between atherogenic index of plasma (AIP) and childhood asthma. Methods This retrospective study included 86 children with asthma admitted to the Changzhou Second People's Hospital Affiliated to Nanjing Medical University from July 2020 to August 2022 as the asthma group and 149 healthy children undergoing physical examination during the same period as the control group. Metabolic parameters including total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and blood glucose, as well as general information of the children such as height, weight, body mass index, presence of specific dermatitis, history of inhalant allergen hypersensitivity, family history of asthma, and feeding history, were collected. Multivariable logistic regression analysis was used to study the relationship between AIP, triglycerides, and high-density lipoprotein cholesterol and asthma. The value of AIP, triglycerides, and high-density lipoprotein cholesterol for predicting asthma was assessed using receiver operating characteristic (ROC) curve analysis. Results The AIP and triglyceride levels in the asthma group were significantly higher than those in the control group, while high-density lipoprotein cholesterol was significantly lower (P<0.05). However, there was no significant difference in total cholesterol and low-density lipoprotein cholesterol between the two groups (P>0.05). Before and after adjusting for height, weight, presence of specific dermatitis, history of inhalant allergen hypersensitivity, family history of asthma, feeding method, and blood glucose, multivariable logistic regression analysis showed that AIP, triglycerides, and high-density lipoprotein cholesterol were associated with asthma (P<0.05). ROC curve analysis showed that the optimal cutoff value for predicting asthma with AIP was -0.333, with a sensitivity of 80.2%, specificity of 55.0%, positive predictive value of 50.71%, and negative predictive value of 82.85%. The area under the curve (AUC) for AIP in predicting asthma was significantly higher than that for triglycerides (P=0.009), but there was no significant difference in AUC between AIP and high-density lipoprotein cholesterol (P=0.686). Conclusions AIP, triglycerides, and high-density lipoprotein cholesterol are all associated with asthma. AIP has a higher value for predicting asthma than triglycerides and comparable value to high-density lipoprotein cholesterol.