Triglyceride to High-Density Lipoprotein Cholesterol Ratio is an Important Determinant of Cardiovascular Risk and Poor Prognosis in Coronavirus Disease-19: A Retrospective Case Series Study.
Triglyceride to High-Density Lipoprotein Cholesterol Ratio is an Important Determinant of Cardiovascular Risk and Poor Prognosis in Coronavirus Disease-19: A Retrospective Case Series Study.
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甘油三酯与高密度脂蛋白胆固醇的比率是冠状病毒疾病 19 心血管风险和不良预后的重要决定因素：回顾性病例系列研究。
DOI：
10.2147/dmso.s268992
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Liu L
中科院分区：
文献类型：
--
作者：
Zhang B;Dong C;Li S;Song X;Wei W;Liu L
以心肌肌钙蛋白升高和心脏泵功能下降为特征的急性心肌损伤和心力衰竭是冠状病毒病19（COVID-19）的重要临床特征和预后因素。甘油三酯与高密度脂蛋白胆固醇（TG/HDL-C）的比值是胰岛素抵抗的指标。本研究旨在探讨TG/HDL-C比值与COVID-19心血管风险和预后的关系。本回顾性研究入组了中国武汉一家三级教学医院收治的98例实验室确诊的COVID-19患者。使用回归模型研究了TG/HDL-C比值与COVID-19心肌损伤、心力衰竭、严重程度和死亡率之间的关系。在98例患者中，平均年龄为63.9±1.4岁，男性（58，59%）占多数。46例（47%）患者入住重症监护室（ICU），分别有32例（33%）和46例（47%）患者发生心肌损伤和心力衰竭，36例（37%）患者死亡。TG/HDL-C比值在有心肌损伤、心力衰竭、严重疾病和死亡结局的患者中升高（各P<0.05）。基线TG/HDL-C比值与血浆高敏心肌肌钙蛋白I（r=0.251，P=0.018）、N末端脑钠肽前体（r=0.274，P=0.008）、糖化血红蛋白（r=0.239，P=0.038）和白细胞介素-6（r=0.218，P=0.042）的对数转换水平显著相关。多变量logistic回归分析显示，TG/HDL-C比值升高与心肌损伤[比值比（OR）=2.73; P=0.013]、心力衰竭（OR=2.64; P=0.019）、疾病严重程度（OR=3.01; P=0.032）和致死性结局（OR=2.97; P=0.014）风险独立相关。TG/HDL-C比值升高与COVID-19患者的心肌损伤、心力衰竭、疾病严重程度和死亡率独立相关，可能是早期识别高风险和预后不良患者的有用标志物。
Acute myocardial injury and heart failure characterized by elevated cardiac troponin and decreased heart pump function are significant clinical features and prognostic factors of coronavirus disease-19 (COVID-19). Triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio is an indicator of insulin resistance. This study aimed to explore the association of the TG/HDL-C ratio with cardiovascular risk and prognosis in COVID-19. Ninety-eight laboratory-confirmed patients with COVID-19 admitted in a tertiary teaching hospital in Wuhan, China, were enrolled in this retrospective study. Regression models were used to investigate the association between TG/HDL-C ratio with myocardial injury, heart failure, severity, and mortality in COVID-19. Among the 98 patients, the mean age was 63.9±1.4 years, and male sex (58, 59%) was predominant. Forty-six patients (47%) were admitted to the intensive care unit (ICU), 32 (33%) and 46 (47%) patients suffered from myocardial injury and heart failure, respectively, and 36 (37%) patients died. The TG/HDL-C ratio was increased in patients with myocardial injury, heart failure, severe illness, and fatal outcome (P<0.05 for each). Baseline TG/HDL-C ratio significantly correlated with log transformed levels of plasma high-sensitivity cardiac troponin I (r=0.251, P=0.018), N-terminal brain natriuretic propeptide (r=0.274, P=0.008), glycated hemoglobin (r=0.239, P=0.038), and interleukin-6 (r=0.218, P=0.042). Multivariate logistic regression analysis showed that an increased TG/HDL-C ratio was independently associated with the risk of myocardial injury [odds ratio (OR)=2.73; P=0.013], heart failure (OR=2.64; P=0.019), disease severity (OR=3.01; P=0.032), and fatal outcome (OR=2.97; P=0.014). Increased TG/HDL-C ratio was independently associated with myocardial injury, heart failure, disease severity, and mortality in patients with COVID-19, and it may be a useful marker for early identification of patients with high risk and poor outcome.