绝经女性OSTA指数对baPWV的影响及对外周动脉硬化的预测价值

doi:10.11958/20240177

天津医药 ›› 2024, Vol. 52 ›› Issue (10): 1079-1083.doi: 10.11958/20240177

绝经女性OSTA指数对baPWV的影响及对外周动脉硬化的预测价值

程方园¹(), 张小琴¹, 李俊祥¹, 李芸², 吴碧华¹, 辜建伟¹, 杨云凤¹, 刘菊华¹^,^△()

1 川北医学院附属医院老年科（邮编637000），2 体检中心

收稿日期:2024-02-02 修回日期:2024-04-07 出版日期:2024-10-15 发布日期:2024-10-14
通讯作者: △ E-mail：juhualiu1984@163.com
作者简介:程方园（2000），女，硕士在读，主要从事老年心血管疾病方面研究。E-mail：squarecycle@163.com
基金资助:
四川省医学会静脉血栓栓塞症防治（恒瑞）专项(2019HR42);自贡市哲学社会科学重点研究基地运动与健康创新研究中心2022年度科研项目(YDJKZ22-03);南充市社会科学研究“十四五”规划(NC21B198)

The effect of OSTA index on baPWV in menopausal women and its predictive value for peripheral atherosclerosis

CHENG Fangyuan¹(), ZHANG Xiaoqin¹, LI Junxiang¹, LI Yun², WU Bihua¹, GU Jianwei¹, YANG Yunfeng¹, LIU Juhua¹^,^△()

1 Department of Geriatrics, 2 Physical Examination Center, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China

Received:2024-02-02 Revised:2024-04-07 Published:2024-10-15 Online:2024-10-14
Contact: △ E-mail：juhualiu1984@163.com

程方园, 张小琴, 李俊祥, 李芸, 吴碧华, 辜建伟, 杨云凤, 刘菊华. 绝经女性OSTA指数对baPWV的影响及对外周动脉硬化的预测价值[J]. 天津医药, 2024, 52(10): 1079-1083.

CHENG Fangyuan, ZHANG Xiaoqin, LI Junxiang, LI Yun, WU Bihua, GU Jianwei, YANG Yunfeng, LIU Juhua. The effect of OSTA index on baPWV in menopausal women and its predictive value for peripheral atherosclerosis[J]. Tianjin Medical Journal, 2024, 52(10): 1079-1083.

摘要/Abstract

摘要：

目的探究绝经女性亚洲骨质疏松自我评估工具（OSTA）指数对其臂-踝脉搏波传导速度（baPWV）和外周动脉硬化的影响及预测价值。方法纳入正常体检的1 138例绝经女性并收集其一般临床资料，计算OSTA指数，测量baPWV，根据baPWV数值将其分为对照组（baPWV<1 400 cm/s，539例）和外周动脉硬化组（baPWV≥1 400 cm/s，599例）。采用线性回归、Logistic回归分析绝经女性OSTA指数对baPWV及外周动脉硬化的影响；受试者工作特征（ROC）曲线评价其对外周动脉硬化的预测价值。结果外周动脉硬化组OSTA指数低于对照组[-0.40（-2.20，1.00） vs. 0.40（-0.60，1.40），P<0.05]；单因素线性回归分析显示OSTA指数为baPWV的影响因素，经校正危险因素后，多因素线性回归分析提示OSTA指数仍影响baPWV数值（P<0.05），线性回归方程为baPWV=-27.911-39.752×OSTA+6.444×收缩压+7.008×舒张压+11.506×同型半胱氨酸+27.942×超敏C反应蛋白。Logistic回归分析提示OSTA指数增高为外周动脉硬化的保护因素（OR=0.664，95%CI：0.535~0.823，P<0.001）。ROC曲线分析提示OSTA指数以-1.25为最佳截断点，预测外周动脉硬化的曲线下面积为0.619，敏感度为36.2%，特异度为86.3%。结论在绝经女性中，OSTA指数为baPWV的影响因素，可通过OSTA指数预测baPWV数值，OSTA指数增高是外周动脉硬化的保护因素。

关键词: 动脉硬化, 绝经期, 外周动脉疾病, OSTA指数, 臂-踝脉搏波传导速度

Abstract:

Objective To investigate the effect of Osteoporosis Self-Assessment Tool for Asia (OSTA) index on brachial ankle pulse wave velocity (baPWV) and its predictive value for peripheral atherosclerosis in menopausal women. Methods A total of 1 138 menopausal women who underwent physical examination at our hospital from January 2022 to December 2022 were enrolled in the study. General clinical data were collected, the OSTA index was calculated, and baPWV was measured. Patients were divided into the control group (n=539) and the peripheral atherosclerosis group (n=599) according to the baPWV values (peripheral atherosclerosis occurs with baPWV ≥1 400 cm/s). Linear regression and Logistic regression were used to analyze the effect of OSTA index on baPWV in menopausal women. The predictive value of peripheral atherosclerosis was evaluated using the receiver operating characteristic (ROC) curve. Results The OSTA index was lower in the peripheral atherosclerosis group than that in the control group [-0.40 (-2.20, 1.00) vs. 0.40 (-0.60, 1.40), P<0.05]. Univariate linear regression analysis was used to conclude that the OSTA index was an influencing factor of baPWV, and after correcting for risk factors, multivariate linear regression analysis indicated that OSTA index still affected the value of baPWV (P<0.05). The linear regression equation was baPWV= -27.911-39.752×OSTA+6.444×SBP+7.008×DBP+11.506×HCY+27.942×Hs-CRP. Logistic regression analysis suggested that increased OSTA index was a protective factor for peripheral atherosclerosis (OR=0.664, 95%CI: 0.535-0.823, P<0.001). ROC curve analysis suggested that OSTA index was -1.25 as the optimal cutoff point, which predicted peripheral atherosclerosis with an area under the curve of 0.619, a sensitivity of 36.2% and a specificity of 86.3%. Conclusion In menopausal women, OSTA index is an influential factor for baPWV, and increased OSTA index is a protective factor against peripheral atherosclerosis, which can be used to predict baPWV value.

Key words: arteriosclerosis, menopause, peripheral arterial disease, OSTA index, brachial-ankle pulse wave velocity

中图分类号:

R543.5

图/表 6

参考文献 20

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组别	n		年龄/岁			BMI/（kg/m²）		OSTA指数				SBP/mmHg			DBP/mmHg	吸烟			糖尿病			高血压
对照组	539		54.34±4.14			23.72±2.89		0.40（-0.60，1.40）				116.34±11.29			69.83±8.20	21（3.9）			10（1.9）			21（3.9）
外周动脉硬化组	599		60.06±7.47			24.65±3.04		-0.40（-2.20，1.00）				137.93±17.44			80.72±9.77	269（44.9）			67（11.8）			271（45.2）
t、Z或χ²			16.164^＊＊			5.298^＊＊		7.970^＊＊				25.024^＊＊			20.426^＊＊	251.297^＊＊			41.597^＊＊			254.256^＊＊
组别		FBG/（mmol/L）			HCY/（mmol/L）				TC/（mmol/L）		TG/（mmol/L）		LDL-C/（mmol/L）					HDL-C/（mmol/L）			UA/（μmol/L）
对照组		4.92±0.79			9.56±2.25				4.89±0.52		1.09±0.32		2.72±0.39					1.33±0.17			272.59±49.07
外周动脉硬化组		5.59±1.66			10.26±2.55				4.85±0.56		1.19±0.34		2.76±0.39					1.29±0.18			282.00±46.94
t		8.619^＊＊			4.093^＊＊				0.773		4.621^＊＊		1.286					2.874^＊＊			3.088^＊＊
组别				Cr/（μmol/L）			WBC/（×10⁹/L）			hs-CRP/（mg/L）				LMR			NLR			PLR
对照组				57.93±7.93			5.27±1.02			0.82±1.19				6.68±2.14			1.86±0.73			115.75±38.12
外周动脉硬化组				58.01±8.16			5.70±1.26			1.28±1.65				6.57±2.14			1.97±0.79			112.16±39.46
t				0.151			6.146^＊＊			4.537^＊＊				0.824			2.414^＊			1.496

组别	n		年龄/岁			BMI/（kg/m²）		OSTA指数				SBP/mmHg			DBP/mmHg	吸烟			糖尿病			高血压
对照组	539		54.34±4.14			23.72±2.89		0.40（-0.60，1.40）				116.34±11.29			69.83±8.20	21（3.9）			10（1.9）			21（3.9）
外周动脉硬化组	599		60.06±7.47			24.65±3.04		-0.40（-2.20，1.00）				137.93±17.44			80.72±9.77	269（44.9）			67（11.8）			271（45.2）
t、Z或χ²			16.164^＊＊			5.298^＊＊		7.970^＊＊				25.024^＊＊			20.426^＊＊	251.297^＊＊			41.597^＊＊			254.256^＊＊
组别		FBG/（mmol/L）			HCY/（mmol/L）				TC/（mmol/L）		TG/（mmol/L）		LDL-C/（mmol/L）					HDL-C/（mmol/L）			UA/（μmol/L）
对照组		4.92±0.79			9.56±2.25				4.89±0.52		1.09±0.32		2.72±0.39					1.33±0.17			272.59±49.07
外周动脉硬化组		5.59±1.66			10.26±2.55				4.85±0.56		1.19±0.34		2.76±0.39					1.29±0.18			282.00±46.94
t		8.619^＊＊			4.093^＊＊				0.773		4.621^＊＊		1.286					2.874^＊＊			3.088^＊＊
组别				Cr/（μmol/L）			WBC/（×10⁹/L）			hs-CRP/（mg/L）				LMR			NLR			PLR
对照组				57.93±7.93			5.27±1.02			0.82±1.19				6.68±2.14			1.86±0.73			115.75±38.12
外周动脉硬化组				58.01±8.16			5.70±1.26			1.28±1.65				6.57±2.14			1.97±0.79			112.16±39.46
t				0.151			6.146^＊＊			4.537^＊＊				0.824			2.414^＊			1.496

变量	β	SE	标准化β	t	P
年龄	28.718	1.210	0.576	23.744	<0.001
BMI	16.226	3.290	0.145	4.932	<0.001
OSTA指数	-56.837	4.383	-0.359	12.969	<0.001
SBP	12.959	0.386	0.706	33.588	<0.001
DBP	18.595	0.769	0.583	24.196	<0.001
吸烟	436.370	18.919	0.565	23.065	<0.001
糖尿病	340.217	37.152	0.266	9.157	<0.001
高血压	441.480	18.752	0.573	23.543	<0.001
FBG	76.672	6.629	0.332	11.565	<0.001
HCY	26.448	4.402	0.210	6.008	<0.001
TC	-7.266	23.986	-0.012	0.303	0.762
TG	128.389	33.248	0.131	3.862	<0.001
LDL-C	28.650	32.913	0.033	0.870	0.384
HDL-C	-211.594	76.451	-0.104	2.768	<0.001
UA	0.760	0.203	0.118	3.745	<0.001
Cr	2.350	1.197	0.060	1.963	0.050
WBC	62.958	8.303	0.229	7.583	<0.001
hs-CRP	53.366	7.791	0.237	6.850	<0.001
LMR	-11.275	4.521	-0.075	2.494	0.013
NLR	64.000	12.613	0.152	5.074	<0.001
PLR	-0.224	0.258	-0.027	0.870	0.384

变量	β	SE	标准化β	t	P
年龄	28.718	1.210	0.576	23.744	<0.001
BMI	16.226	3.290	0.145	4.932	<0.001
OSTA指数	-56.837	4.383	-0.359	12.969	<0.001
SBP	12.959	0.386	0.706	33.588	<0.001
DBP	18.595	0.769	0.583	24.196	<0.001
吸烟	436.370	18.919	0.565	23.065	<0.001
糖尿病	340.217	37.152	0.266	9.157	<0.001
高血压	441.480	18.752	0.573	23.543	<0.001
FBG	76.672	6.629	0.332	11.565	<0.001
HCY	26.448	4.402	0.210	6.008	<0.001
TC	-7.266	23.986	-0.012	0.303	0.762
TG	128.389	33.248	0.131	3.862	<0.001
LDL-C	28.650	32.913	0.033	0.870	0.384
HDL-C	-211.594	76.451	-0.104	2.768	<0.001
UA	0.760	0.203	0.118	3.745	<0.001
Cr	2.350	1.197	0.060	1.963	0.050
WBC	62.958	8.303	0.229	7.583	<0.001
hs-CRP	53.366	7.791	0.237	6.850	<0.001
LMR	-11.275	4.521	-0.075	2.494	0.013
NLR	64.000	12.613	0.152	5.074	<0.001
PLR	-0.224	0.258	-0.027	0.870	0.384

变量	β	SE	标准化β	t	P
OSTA指数	-39.752	5.596	-0.260	7.103	<0.001
SBP	6.444	1.311	0.395	4.913	<0.001
DBP	7.008	1.824	0.244	3.843	<0.001
糖尿病	98.287	120.376	0.083	0.816	0.415
高血压	77.680	39.966	0.110	1.944	0.053
FBG	6.450	22.591	0.029	0.285	0.776
HCY	11.506	4.293	0.097	2.680	0.008
TG	6.981	33.649	0.008	0.207	0.836
HDL-C	-22.702	66.422	-0.013	0.342	0.733
UA	0.107	0.233	0.017	0.457	0.648
WBC	-7.696	10.826	-0.028	0.711	0.478
hs-CRP	27.942	8.115	0.129	3.443	0.001
LMR	-1.447	6.252	-0.010	0.231	0.817
NLR	2.401	18.983	0.006	0.126	0.899
常数项	-27.911	199.917	-	0.140	0.889

绝经女性OSTA指数对baPWV的影响及对外周动脉硬化的预测价值

The effect of OSTA index on baPWV in menopausal women and its predictive value for peripheral atherosclerosis

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变量	β	SE	Wald χ²	P	OR	OR95%CI
年龄	0.173	0.014	161.942	<0.001	1.189	1.157~1.221
BMI	0.107	0.021	26.689	<0.001	1.113	1.069~1.159
OSTA 指数	-0.228	0.031	55.050	<0.001	0.796	0.749~0.845
SBP	0.111	0.007	272.637	<0.001	1.118	1.103~1.133
DBP	0.138	0.009	230.560	<0.001	1.147	1.127~1.168
吸烟	3.001	0.237	159.980	<0.001	20.107	12.629~32.012
糖尿病	1.945	0.345	31.837	<0.001	6.994	3.559~13.746
高血压	3.015	0.237	161.447	<0.001	20.380	12.801~32.446
FBG	0.517	0.075	47.596	<0.001	1.676	1.447~1.941
HCY	0.122	0.030	16.105	<0.001	1.130	1.064~1.199
TC	-0.109	0.141	0.598	0.439	0.897	0.680~1.182
TG	0.952	0.210	20.598	<0.001	2.591	1.718~3.909
LDL-C	0.248	0.193	1.652	0.199	1.281	0.878~1.870
HDL-C	-1.259	0.442	8.115	<0.001	0.284	0.119~0.675
UA	0.004	0.001	9.394	0.002	1.004	1.001~1.007
Cr	0.001	0.008	0.023	0.880	1.001	0.986~1.016
WBC	0.331	0.056	34.510	<0.001	1.392	1.247~1.554
hs-CRP	0.242	0.057	18.047	<0.001	1.274	1.139~1.424
LMR	-0.023	0.028	0.679	0.410	0.977	0.925~1.033
NLR	0.194	0.081	5.750	0.016	1.215	1.036~1.424
PLR	-0.002	0.002	2.231	0.135	0.998	0.995~1.001

变量	β	SE	Wald χ²	P	OR	OR95%CI
OSTA 指数	-0.410	0.110	13.930	<0.001	0.664	0.535~0.823
SBP	0.080	0.025	10.297	0.001	1.083	1.032~1.137
DBP	0.073	0.034	4.480	0.034	1.075	1.005~1.150
高血压	0.763	0.832	0.841	0.359	2.144	0.420~10.949
糖尿病	-0.109	2.445	0.002	0.964	0.896	0.007~108.164
FBG	0.348	0.419	0.692	0.406	1.416	0.624~3.217
HCY	0.130	0.077	2.863	0.091	1.139	0.980~1.325
TG	0.804	0.608	1.749	0.186	2.235	0.679~7.364
HDL-C	-1.821	1.275	2.041	0.153	0.162	0.013~1.968
UA	-0.009	0.004	4.606	0.032	0.991	0.983~0.999
WBC	-0.220	0.188	1.367	0.242	0.802	0.555~1.161
Hs-CRP	0.228	0.149	2.363	0.124	1.257	0.939~1.682
NLR	-0.098	0.283	0.119	0.731	0.907	0.520~1.581
常数项	-13.255	3.929	11.382	0.001	0.000

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