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心脏代谢指数(CMI)、脂积累产物(LAP)、腰围甘油三酯指数(WTI)与急性胰腺炎风险的前瞻性研究:来自中国北方成年人的数据。

Cardiometabolic Index (CMI), Lipid Accumulation Products (LAP), Waist Triglyceride Index (WTI) and the risk of acute pancreatitis: a prospective study in adults of North China.

机构信息

Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin Institute of Digestive Diseases, Tianjin Key Laboratory of Digestive Diseases, 154 Anshan Road, Heping District, Tianjin, 300052, China.

Department of Hepatobiliary, Kailuan General Hospital, No.57 Xinhua East Street, Tangshan, 063000, China.

出版信息

Lipids Health Dis. 2023 Nov 9;22(1):190. doi: 10.1186/s12944-023-01948-3.

Abstract

OBJECTIVE

To investigate the correlation between anthropometric indexes [cardiometabolic index (CMI), lipid accumulation products (LAP), waist triglyceride index (WTI), and body mass index (BMI)] and acute pancreatitis (AP) in a Chinese adult population.

METHODOLOGY

The present investigation consisted of a prospective group including 117,326 subjects who were enrolled in the Kailuan investigation. The individuals were categorized into quartiles based on their baseline levels of CMI, LAP, and WIT. BMI was categorized into three distinctive groups: normal weight group (BMI < 24 kg/m), overweight group (BMI 24-28 kg /m), and obesity group (BMI ≥ 28 kg/m). The data were subjected to analysis in order to investigate the correlation between these anthropometric indexes and the incidence of AP. Cox regression models were employed to assess the relative risk of AP while accounting for known risk factors through appropriate adjustments.

OUTCOMES

Over the course of a median follow-up duration of 12.59 ± 0.98 years, we documented 401 incident AP cases. Incidence density and cumulative incidence rates of AP increased with the increase of CMI, LAP, and WTI. After multivariate adjustment, the fourth quartile of CMI, LAP, and WTI exhibited the greatest risk of AP [CMI: hazard ratio (HR) 1.93, 95% confidential interval (CI) (1.45-2.57); LAP: HR 2.00, 95% CI(1.49-2.68); WTI: HR 2.13,95% CI (1.59-2.83)]. In comparison to the normal weight group, the obesity group (BMI ≥ 28 kg/m) had an elevated risk of AP (HR = 1.58, 95% CI: 1.21-2.05). Furthermore, the incremental effect of BMI combined with CMI on the prognostic value of AP was greater than that of BMI alone (the C statistics demonstrated a result of 0.607 versus 0.546; the integrated discrimination improvement revealed a result of 0.321%; net reclassification improvement was 1.975%).

CONCLUSION

We found that CMI, LAP, and WTI were positively and independently connected to the risk of AP. Additionally, CMI demonstrates a superior prognostic capacity than other indexes in anticipating AP.

摘要

目的

在中国成年人中研究人体测量学指标[代谢综合征指数(CMI)、脂堆积产物(LAP)、腰甘油三酯指数(WTI)和体重指数(BMI)]与急性胰腺炎(AP)之间的相关性。

方法

本研究由前瞻性队列研究组成,共纳入 117326 名参加开滦研究的受试者。根据基线 CMI、LAP 和 WTI 水平,将个体分为四分位组。BMI 分为三个不同组:正常体重组(BMI<24kg/m)、超重组(BMI 24-28kg/m)和肥胖组(BMI≥28kg/m)。通过 Cox 回归模型分析这些人体测量学指标与 AP 发生率之间的相关性,同时通过适当调整考虑已知的风险因素。

结果

在中位数为 12.59±0.98 年的随访期间,共记录了 401 例 AP 病例。随着 CMI、LAP 和 WTI 的增加,AP 的发生率密度和累积发生率均增加。多变量调整后,CMI、LAP 和 WTI 的四分位数显示出最大的 AP 风险[CMI:风险比(HR)1.93,95%置信区间(CI)(1.45-2.57);LAP:HR 2.00,95% CI(1.49-2.68);WTI:HR 2.13,95% CI(1.59-2.83)]。与正常体重组相比,肥胖组(BMI≥28kg/m)AP 的风险增加(HR=1.58,95% CI:1.21-2.05)。此外,BMI 与 CMI 联合对 AP 预后价值的增量效应大于 BMI 单独的效应(C 统计量为 0.607 与 0.546;综合鉴别改善为 0.321%;净重新分类改善为 1.975%)。

结论

我们发现 CMI、LAP 和 WTI 与 AP 风险呈正相关且独立相关。此外,CMI 在预测 AP 方面的预后能力优于其他指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4410/10633920/ad6cf3d80863/12944_2023_1948_Fig1_HTML.jpg

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