脂代谢指标、血清γ-谷氨酰转肽酶与冠心病合并冠状动脉钙化的关联分析

doi:10.11958/20252178

天津医药 ›› 2025, Vol. 53 ›› Issue (11): 1165-1169.doi: 10.11958/20252178

脂代谢指标、血清γ-谷氨酰转肽酶与冠心病合并冠状动脉钙化的关联分析

李雪奇(), 李世光^△(), 许恩文, 张瑞雷, 陈鹏莉, 张庆斌

安徽省第二人民医院心内科（邮编 230041）

收稿日期:2025-05-29 修回日期:2025-08-11 出版日期:2025-11-15 发布日期:2025-11-19
通讯作者: △E-mail：291092345@qq.com
作者简介:李雪奇（1990），男，主治医师，主要从事心血管疾病方面研究。E-mail：Hxueqi0042@163.com

Correlation analysis of lipid metabolism index, serum γ -glutamyltranspeptidase and coronary heart disease complicated with coronary calcification

LI Xueqi(), LI Shiguang^△(), XU Enwen, ZHANG Ruilei, CHEN Pengli, ZHANG Qingbin

Department of Cardiology, Anhui Second People's Hospital, Hefei 230041, China

Received:2025-05-29 Revised:2025-08-11 Published:2025-11-15 Online:2025-11-19
Contact: △E-mail：291092345@qq.com

李雪奇, 李世光, 许恩文, 张瑞雷, 陈鹏莉, 张庆斌. 脂代谢指标、血清γ-谷氨酰转肽酶与冠心病合并冠状动脉钙化的关联分析[J]. 天津医药, 2025, 53(11): 1165-1169.

LI Xueqi, LI Shiguang, XU Enwen, ZHANG Ruilei, CHEN Pengli, ZHANG Qingbin. Correlation analysis of lipid metabolism index, serum γ -glutamyltranspeptidase and coronary heart disease complicated with coronary calcification[J]. Tianjin Medical Journal, 2025, 53(11): 1165-1169.

摘要/Abstract

摘要：

目的分析脂代谢指标、血清γ-谷氨酰转肽酶（γ-GGT）与冠心病（CHD）合并冠状动脉钙化（CAC）的相关性。方法选取300例CHD患者的临床资料并根据是否存在CAC将其分为CAC组193例、非CAC组107例。比较2组患者的基本资料，高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、总胆固醇（TC）、三酰甘油（TG）、载脂蛋白A1（Apo-A1）、载脂蛋白B（Apo-B）以及γ-GGT水平差异，多因素Logistic回归分析CAC的影响因素，并建立列线图预测模型。结果比较CAC组和非CAC组基本资料，CAC组年龄更高，高血压和糖尿病患者占比更高，LDL-C、TC、Apo-B、γ-GGT水平更高，Apo-A1水平更低（P<0.05）。Logistic多因素回归分析结果显示，高龄、合并糖尿病以及LDL-C、TC、Apo-B、γ-GGT升高是CHD合并CAC的危险因素，Apo-A1升高是CHD合并CAC的保护因素（P<0.05）。构建的列线图模型AUC为0.880（95%CI：0.840~0.919），具有较好的区分能力。结论 CHD合并CAC与患者脂代谢及γ-GGT水平有关，基于影响因素构建的列线图模型可用于临床预警CAC风险。

关键词: 冠心病, 血管钙化, 冠状血管, 血脂异常, γ-谷氨酰转移酶, 列线图

Abstract:

Objective To analyze the correlation between lipid metabolism indexes, serum gamma-glutamyl transpeptidyase (γ-GGT) and coronary heart disease (CHD) complicated with coronary artery calcification (CAC). Methods A total of 300 CHD patients admitted in this study were divided into the CAC group (n=193) and the non-CAC group (n=107). Clinical data of the two groups were compared, including high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG), Apolipoprotein A1 (Apo-A1), Apo-B (APO-B) and γ-GGT. The influencing factors of CAC were analyzed by multiple Logistic factors. And a nomogram prediction model was established. Results The basic data of the two groups were compared. Patients of the CAC group was older, had higher proportion of patients with hypertension and diabetes, had higher levels of LDL-C, TC, Apo-B and γ-GGT and lower level of Apo-A1 than those of the non-CAC group (P<0.05). The results of Logistic multivariate regression analysis showed that advanced age, combined history of diabetes, elevated LDL-C, TC, Apo-B and γ-GGT were risk factors of CHD complicated with CAC, while elevated Apo-A1 was the protective factor of CHD complicated with CAC (P<0.05). The AUC of the constructed nomogram model was 0.880 (95%CI:0.840-0.919), which showed good distinguishing ability. Conclusion CHD complicated with CAC is related to lipid metabolism and γ-GGT level. The nomogram model constructed based on influencing factors can be used for clinical early warning of CAC risk.

Key words: coronary disease, vascular calcification, coronary vessels, dyslipidemias, gamma-glutamyltransferase, nomograms

中图分类号:

R541.4

图/表 6

参考文献 31

[1]	IN CHINA TWCOTROCHAD, HU S S. Report on cardiovascular health and diseases in China 2021: an updated summary[J]. J Geriatr Cardiol, 2023, 20(6):399-430. doi:10.26599/1671-5411.2023.06.001.
[2]	SHAYA G E, LEUCKER T M, JONES S R, et al. Coronary heart disease risk:low-density lipoprotein and beyond[J]. Trends Cardiovasc Med, 2022, 32(4):181-194. doi:10.1016/j.tcm.2021.04.002.
[3]	刘首宏, 张永全, 王俏. 纤维胶凝蛋白与冠状动脉狭窄程度相关性及其对预后的影响[J]. 天津医药, 2023, 51(7):776-780.
	LIU S H, ZHANG Y Q, WANG Q. Correlation between serum ficolin and coronary artery stenosis and its influence on prognosis in patients with coronary heart disease[J]. Tianjin Med J, 2023, 51(7):776-780. doi:10.11958/20221707.
[4]	ONNIS C, VIRMANI R, KAWAI K, et al. Coronary artery calcification:current concepts and clinical implications[J]. Circulation, 2024, 149(3):251-266. doi:10.1161/CIRCULATIONAHA.123.065657.
[5]	SCHÆFFER M, RASMUSSEN J H, FREDGART M H, et al. Coronary artery calcification score and 19 biomarkers on cardiovascular events;a 10-year follow-up DanRisk substudy[J]. Atheroscler Plus, 2024, 58:9-15. doi:10.1016/j.athplu.2024.09.003.
[6]	CONTOIS J H, LANGLOIS M R, COBBAERT C, et al. Standardization of apolipoprotein B,LDL-cholesterol,and non-HDL-cholesterol[J]. J Am Heart Assoc, 2023, 12(15):e030405. doi:10.1161/JAHA.123.030405.
[7]	SUN W, YAMAGISHI K, ISO H. Current status of low-density lipoprotein cholesterol and cardiovascular diseases in Japan[J]. J Atheroscler Thromb, 2023, 30(5):432-433. doi:10.5551/jat.ED217.
[8]	DUPARC T, RUIDAVETS J B, GENOUX A, et al. Serum level of HDL particles are independently associated with long-term prognosis in patients with coronary artery disease:the GENES study[J]. Sci Rep, 2020, 10(1):8138. doi:10.1038/s41598-020-65100-2.
[9]	郝俊文, 夏斌, 席镇, 等. ApoB、ApoA1、ApoA1/ApoB与急性心肌梗死病人CABG术后主要心血管不良事件的相关性[J]. 中西医结合心脑血管病杂志, 2024, 22(4):691-694.
	HAO J W, XIA B, XI Z, et al. The correlation between ApoB,ApoA1,ApoA1/ApoB and major cardiovascular adverse events after CABG in patients with acute myocardial infarction[J]. Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease, 2024, 22(4):691-694. doi:10.12102/j.issn.1672-1349.2024.04.021.
[10]	XUAN C, LI J, LIU R H, et al. Association between serum gamma-glutamyltransferase and early-onset coronary artery disease:a retrospective case-control study[J]. Ann Med, 2023, 55(2):2289606. doi:10.1080/07853890.2023.2289606.
[11]	颜红兵. 临床冠心病诊断与治疗指南[M]. 北京: 人民卫生出版社, 2010:5-26.
	YAN H B. Guidelines for clinical diagnosis and treatment of coronary heart disease[M]. Beijing: People's Medical Publishing House, 2010:5-26.
[12]	CLARKE R, VON ENDE A, SCHMIDT L E, et al. Apolipoprotein proteomics for residual lipid-related risk in coronary heart disease[J]. Circ Res, 2023, 132(4):452-464. doi:10.1161/CIRCRESAHA.122.321690.
[13]	AL-SUHAIMI E A, AL-RUBAISH A A. Interplay of serum biomarkers bilirubin and γ-glutamyltranspeptidase in predicting cardiovascular complications in type-2 diabetes mellitus[J]. World J Diabetes, 2024, 15(6):1074-1078. doi:10.4239/wjd.v15.i6.1074.
[14]	石丽媛, 孙静, 荆飞闯. 冠心病合并冠状动脉钙化的影响因素及列线图预测模型建立[J]. 安徽医药, 2023, 27(12):2447-2451.
	SHI L Y, SUN J, JING F C. Influencing factors of coronary heart disease complicated with coronary artery calcification and the establishment of a nomogram prediction model[J]. Anhui Medical and Pharmaceutical Journal, 2023, 27(12):2447-2451. doi:10.3969/j.issn.1009-6469.2023.12.025.
[15]	INOUE K, SEEMAN T E, HORWICH T, et al. Heterogeneity in the association between the presence of coronary artery calcium and cardiovascular events:a machine-learning approach in the MESA Study[J]. Circulation, 2023, 147(2):132-141. doi:10.1161/CIRCULATIONAHA.122.062626.
[16]	SÁNCHEZ-CABO F, FUSTER V, SILLA-CASTRO J C, et al. Subclinical atherosclerosis and accelerated epigenetic age mediated by inflammation:a multi-omics study[J]. Eur Heart J, 2023, 44(29):2698-2709. doi:10.1093/eurheartj/ehad361.
[17]	宋小青, 时士伟, 时金凤. 不同年龄急性冠脉综合征患者临床、CCTA特点及近期预后分析[J]. 中国CT和MRI杂志, 2023, 21(10):109-111,141.
	SONG X Q, SHI S W, SHI J F. Clinical characteristics,CCTA characteristics and short-term prognosis of patients with acute coronary syndrome at different ages[J]. Chinese Journal of CT and MRI, 2023, 21(10):109-111,141. doi:10.3969/j.issn.1672-5131.2023.10.033.
[18]	LORENZATTI D, PIÑA P, HUANG D, et al. Interaction between risk factors,coronary calcium, and CCTA plaque characteristics in patients aged 18-45 years[J]. Eur Heart J Cardiovasc Imaging, 2024, 25(8):1071-1082. doi:10.1093/ehjci/jeae094.
[19]	TANG X, QIAN H, LU S, et al. Predictive nomogram model for severe coronary artery calcification in end-stage kidney disease patients[J]. Ren Fail, 2024, 46(2):2365393. doi:10.1080/0886022X.2024.2365393.
[20]	LIS P, RAJZER M, KLIMA Ł. The significance of coronary artery calcification for percutaneous coronary interventions[J]. Healthcare (Basel), 2024, 12(5):520. doi:10.3390/healthcare12050520.
[21]	GADDE K M, YIN X, GOLDBERG R B, et al. Coronary artery calcium and cognitive decline in the diabetes prevention program outcomes study[J]. J Am Heart Assoc, 2023, 12(21):e029671. doi:10.1161/JAHA.123.029671.
[22]	安娜, 张明健, 牛利, 等. 2型糖尿病患者冠状动脉钙化与骨代谢指标的相关性研究[J]. 中国骨质疏松杂志, 2023, 29(8):1141-1146.
	AN N, ZHANG M J, NIU L, et al. Correlation between coronary artery calcification and bone metabolic markers in patients with type 2 diabetes[J]. Chinese Journal of Osteoporosis, 2023, 29(8):1141-1146. doi:10.3969/j.issn.1006-7108.2023.08.008.
[23]	DU J, WU W, ZHU B, et al. Recent advances in regulating lipid metabolism to prevent coronary heart disease[J]. Chem Phys Lipids, 2023, 255:105325. doi:10.1016/j.chemphyslip.2023.105325.
[24]	MORTENSEN M B, DZAYE O, BØTKER H E, et al. Low-density lipoprotein cholesterol is predominantly associated with atherosclerotic cardiovascular disease events in patients with evidence of coronary atherosclerosis:the Western Denmark Heart Registry[J]. Circulation, 2023, 147(14):1053-1063. doi:10.1161/CIRCULATIONAHA.122.061010.
[25]	赵丹丹, 赵华云, 何明丰, 等. 血瘀型冠心病患者冠脉病变情况与Apo-B和Apo-A1比值的相关性[J]. 广州中医药大学学报, 2023, 40(9):2136-2140.
	ZHAO D D, ZHAO H Y, HE M F, et al. Correlation between coronary artery lesions and the ratio of apo-B and apo-A1 in patients with coronary heart disease of blood stasis type[J]. Journal of Guangzhou University of Traditional Chinese Medicine, 2023, 40(9):2136-2140. doi:10.13359/j.cnki.gzxbtcm.2023.09.002.
[26]	GLEASON B, CHISARI E, PARVIZI J. Osteoarthritis can also start in the gut:the gut-joint axis[J]. Indian J Orthop, 2022, 56(7):1150-1155. doi:10.1007/s43465-021-00473-8.
[27]	ARNOLD N, BLAUM C, GOßLING A, et al. Impact of lipoprotein(a) level on low-density lipoprotein cholesterol- or apolipoprotein b-related risk of coronary heart disease[J]. J Am Coll Cardiol, 2024, 84(2):165-177. doi:10.1016/j.jacc.2024.04.050.
[28]	YANG G, MASON A M, WOOD A M, et al. Dose-response associations of lipid traits with coronary artery disease and mortality[J]. JAMA Netw Open, 2024, 7(1):e2352572. doi:10.1001/jamanetworkopen.2023.52572.
[29]	涂诗琴, 高凌云. Non-HDL-C水平和ApoB/ApoA1比值与初发心肌梗死的相关性研究[J]. 中国循证心血管医学杂志, 2024, 16(4):436-440.
	TU S Q, GAO L Y. Correlation among non-high-density lipoprotein-cholesterol,apolipoprotein B/apolipoprotein A1 ratio and incipient acute myocardial infarction[J]. Chinese Journal of Evidence-Based Cardiovascular Medicine, 2024, 16(4):436-440. doi:10.3969/j.issn.1674-4055.2024.04.11.
[30]	杨瑞霞, 顾明. 血清PTX-3、γ-GGT与冠心病及冠脉狭窄程度的相关性分析[J]. 北华大学学报(自然科学版), 2023, 24(5):613-616.
	YANG R X, GU M. Correlation analysis of serum PTX-3 and γ-GGT with coronary heart disease and severity of coronary artery stenosis[J]. Journal of Beihua University(Natural Science), 2023, 24(5):613-616. doi:10.11713/j.issn.1009-4822.2023.05.009.
[31]	ISMAIL Q M, PRASAD M K, MARANDI S, et al. Serum gamma-glutamyl transferase level as a risk factor in acute stroke[J]. J Family Med Prim Care, 2023, 12(12):3172-3179. doi:10.4103/jfmpc.jfmpc_750_23.

组别	n	男性	年龄/岁	BMI/（kg/m²）	CHD病程/年	高血压	糖尿病	吸烟
非CAC组	107	57（53.27）	58.56±9.29	22.45±2.13	1.26±0.26	41（38.32）	34（31.78）	44（41.12）
CAC组	193	102（52.85）	66.74±11.23	22.67±2.26	1.28±0.23	103（53.37）	121（62.69）	82（42.49）
χ²或t		0.005	6.417^＊＊	0.822	0.366	6.247^＊	26.351^＊＊	0.053
组别	饮酒	HDL-C/（mmol/L）	LDL-C/（mmol/L）	TC/ （mmol/L）	TG/ （mmol/L）	Apo-A1/（g/L）	Apo-B/ （g/L）	γ-GGT/（U/L）
非CAC组	38（35.51）	1.23±0.34	2.49±0.61	4.44±1.35	1.83±0.37	1.35±0.21	0.86±0.21	59.77±6.27
CAC组	65（33.68）	1.25±0.37	2.94±0.74	5.23±1.28	1.88±0.41	1.16±0.19	1.24±0.46	68.55±7.63
χ²或t	0.103	0.636	5.346^＊＊	5.064^＊＊	1.036	8.067^＊＊	8.186^＊＊	10.145^＊＊

组别	n	男性	年龄/岁	BMI/（kg/m²）	CHD病程/年	高血压	糖尿病	吸烟
非CAC组	107	57（53.27）	58.56±9.29	22.45±2.13	1.26±0.26	41（38.32）	34（31.78）	44（41.12）
CAC组	193	102（52.85）	66.74±11.23	22.67±2.26	1.28±0.23	103（53.37）	121（62.69）	82（42.49）
χ²或t		0.005	6.417^＊＊	0.822	0.366	6.247^＊	26.351^＊＊	0.053
组别	饮酒	HDL-C/（mmol/L）	LDL-C/（mmol/L）	TC/ （mmol/L）	TG/ （mmol/L）	Apo-A1/（g/L）	Apo-B/ （g/L）	γ-GGT/（U/L）
非CAC组	38（35.51）	1.23±0.34	2.49±0.61	4.44±1.35	1.83±0.37	1.35±0.21	0.86±0.21	59.77±6.27
CAC组	65（33.68）	1.25±0.37	2.94±0.74	5.23±1.28	1.88±0.41	1.16±0.19	1.24±0.46	68.55±7.63
χ²或t	0.103	0.636	5.346^＊＊	5.064^＊＊	1.036	8.067^＊＊	8.186^＊＊	10.145^＊＊

变量	β	SE	Wald χ²	P	OR （95%CI）
年龄	0.100	0.022	20.795	<0.001	1.105（1.059~1.154）
高血压	0.791	0.426	3.447	0.063	2.205（0.957~5.080）
糖尿病	1.870	0.476	15.439	<0.001	6.491（2.553~16.500）
LDL-C	0.668	0.314	4.527	0.033	1.951（1.054~3.610）
TC	0.454	0.158	8.249	0.004	1.574（1.155~2.145）
Apo-A1	-5.448	1.183	21.200	<0.001	0.004（0.000~0.044）
Apo-B	3.180	0.660	23.228	<0.001	24.045（6.598~87.631）
γ-GGT	0.199	0.035	33.055	<0.001	1.220（1.140~1.306）
常数项	-20.047	3.616	30.741	<0.001	<0.001

变量	β	SE	Wald χ²	P	OR （95%CI）
年龄	0.100	0.022	20.795	<0.001	1.105（1.059~1.154）
高血压	0.791	0.426	3.447	0.063	2.205（0.957~5.080）
糖尿病	1.870	0.476	15.439	<0.001	6.491（2.553~16.500）
LDL-C	0.668	0.314	4.527	0.033	1.951（1.054~3.610）
TC	0.454	0.158	8.249	0.004	1.574（1.155~2.145）
Apo-A1	-5.448	1.183	21.200	<0.001	0.004（0.000~0.044）
Apo-B	3.180	0.660	23.228	<0.001	24.045（6.598~87.631）
γ-GGT	0.199	0.035	33.055	<0.001	1.220（1.140~1.306）
常数项	-20.047	3.616	30.741	<0.001	<0.001

脂代谢指标、血清γ-谷氨酰转肽酶与冠心病合并冠状动脉钙化的关联分析

Correlation analysis of lipid metabolism index, serum γ -glutamyltranspeptidase and coronary heart disease complicated with coronary calcification

引用本文

RichHTML

PDF (PC)

可视化

摘要/Abstract

使用本文

图/表 6

参考文献 31

相关文章 15

编辑推荐

Metrics

本文评价

[1]	徐培璐, 乔建民, 李静, 刘建荣, 陈树军, 季春鹏. 心外膜脂肪厚度联合血清ADAM10、STIM1对冠心病的诊断价值[J]. 天津医药, 2025, 53(9): 963-966.
[2]	刘志远, 杨声飞, 钱释然, 邓忆莲, 黎东伟, 李君久. 胸乳入路腔镜甲状腺术后早期低钙血症的危险因素分析及预测模型构建[J]. 天津医药, 2025, 53(8): 826-830.
[3]	刘鹏勇, 刘梦友, 周昱, 管海, 田振, 胡浩, 岳晓松, 关倩楠. 甲状腺全切术后并发永久性甲状旁腺功能减退的危险因素及列线图建立[J]. 天津医药, 2025, 53(8): 850-855.
[4]	金吴娟, 倪刚, 黄欣宇, 王羊洋. 老年消化道出血患者不良预后的列线图预测模型的构建与验证[J]. 天津医药, 2025, 53(7): 694-699.
[5]	陈英, 郭长英, 张静, 李娟, 陈丰毅. 基于术前肺动脉压评估心脏移植术后右心衰竭的发生风险[J]. 天津医药, 2025, 53(7): 751-755.
[6]	李婉婷, 刘弘扬, 桑婧, 阮育凤, 徐丽, 李冬梅. 老年下肢骨折患者术后发生急性心脑血管意外的影响因素分析[J]. 天津医药, 2025, 53(6): 648-653.
[7]	王欣欣, 许慧, 吴晓. 妊娠期肝内胆汁淤积症合并GDM孕妇不良妊娠结局的影响因素及预测模型构建[J]. 天津医药, 2025, 53(5): 503-508.
[8]	董丹, 陈立娟, 俞荷花. 急性胰腺炎并发低血压的危险因素分析及预测模型建立[J]. 天津医药, 2025, 53(5): 509-513.
[9]	赵晶晶, 刘亚敏, 索睿, 茹仙古丽·吾买尔, 刘双君, 李颖, 赵晓赟. 咳嗽患者百日咳感染特征分析及症状组合预测模型的构建与验证[J]. 天津医药, 2025, 53(4): 434-439.
[10]	卜静, 王芃堉, 杨兴肖. 食管癌患者术后多重耐药菌感染预测模型的构建与效果评价[J]. 天津医药, 2025, 53(3): 242-246.
[11]	贾方, 李平, 李静, 尹路. 全膝关节置换术后神经认知功能障碍的影响因素及列线图模型的构建[J]. 天津医药, 2025, 53(3): 287-292.
[12]	刘妍, 孙红, 孙敬文. 老年糖尿病性白内障患者术源性散光的发生风险及预测模型建立[J]. 天津医药, 2025, 53(11): 1208-1213.
[13]	汪海霞, 何飞, 朱丛梅, 王静. ICU患者早期肠内营养治疗发生误吸的列线图风险预测模型建立与验证[J]. 天津医药, 2025, 53(10): 1037-1042.
[14]	蒋晓涵, 曹杰, 刘丹丹, 薛丹, 郭志国. aMAP评分联合RAR及PIV构建慢性肝病患者肝细胞癌发生风险的预测模型[J]. 天津医药, 2025, 53(1): 42-46.
[15]	王远珍, 魏红艳, 常丽仙, 张映媛, 刘春云, 刘立. 原发性肝癌干预前并发肺部感染风险预测模型的建立与验证[J]. 天津医药, 2024, 52(9): 940-945.