HIV感染者抗病毒治疗后发生血脂异常的相关因素分析及风险预测模型构建

doi:10.19871/j.cnki.xfcrbzz.2025.01.011

新发传染病电子杂志 ›› 2025, Vol. 10 ›› Issue (1): 56-61.doi: 10.19871/j.cnki.xfcrbzz.2025.01.011

HIV感染者抗病毒治疗后发生血脂异常的相关因素分析及风险预测模型构建

吴冬霞¹, 武秀连¹, 常可意¹, 韩佳凝¹, 全晓丽¹, 吕雪¹, 李晨¹, 张莉莉²

1.首都医科大学附属北京佑安医院感染与免疫医学科,北京 100069;
2.首都医科大学附属北京佑安医院护理部,北京 100069

收稿日期:2024-08-21 出版日期:2025-02-28 发布日期:2025-03-31
通讯作者: 张莉莉,Email：Zhanglilivip@163.com
基金资助:
1.北京市医院管理中心青年人才培养“青苗”计划（QML20211714）;2.首都医科大学附属北京佑安医院2021年度院内中青年人才孵育项目（专项建设项目-护理研究）（YAKTHL2021006）

Analysis of related factors of dyslipidemia in HIV-infected patients after antiviral therapy and construction of risk prediction model

Wu Dongxia¹, Wu Xiulian¹, Chang Keyi¹, Han Jianing¹, Quan Xiaoli¹, Lyu Xue¹, Li Chen¹, Zhang Lili²

1. Department of Infection and Immunology, Beijing You'an Hospital, Capital Medical University Beijing, Beijing 100069, China;
2. Department of Nursing, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China

Received:2024-08-21 Online:2025-02-28 Published:2025-03-31

摘要/Abstract

摘要： 目的分析HIV感染者抗病毒治疗（antiviral therapy,ART）后发生血脂异常的相关因素,并构建血脂异常发生的风险预测模型。方法选取首都医科大学附属北京佑安医院2016年5月至2021年5月1000例HIV感染者的资料数据为建模组,同时纳入2022年6–12月于本院治疗的HIV感染者125例为模型验证组,建模组分为血脂异常组（病例组）388例及血脂正常组（对照组）612例。对建模组患者临床指标及实验室检查资料进行单因素分析及二元Logistic回归分析,根据HIV感染发生血脂异常的相关因素并建立风险预测模型并验证。结果 1000例HIV感染者中男性982例,女性18例,平均（36.6±11.2）岁。二元Logistic回归分析显示年龄≥50岁（OR=2.029,95%CI：1.966~2.074,P<0.001）、体重指数（body mass index,BMI）≥24kg/m²（OR=5.008,95%CI：1.216~5.429,P=0.035）、ART方案中非整合酶类药物方案（OR=1.126,95%CI：1.083~1.147,P=0.025）、启动ART时间≥3年（OR=1.722,95%CI：1.203~1.945,P<0.001）、空腹血糖（fasting plasma glucose,FPG）≥6.0mmol/L（OR=1.303,95%CI：1.006~1.586,P=0.038）为ART的HIV感染者发生血脂异常的危险因素。每周运动时间≥1d（OR=0.487,95%CI：0.374~0.636,P<0.001）为HIV感染者发生血脂异常的独立保护因素。风险预测模型中模型验证组各项指标评分与建模组无统计学差异,模型具有较好的拟合度。建模组风险预测模型的曲线下面积为0.918（95%CI：0.898~0.937,P<0.001）,截断点为0.938,敏感度85.60%,特异度93.22%,发生血脂异常的阳性预测率89.90%,阴性预测率91.51%。结论 HIV感染者接受ART后血脂异常发生率为38.80%,年龄、BMI、ART方案、启动ART时间、每周运动时间及FPG为发生血脂异常的相关因素,根据相关因素构建的风险预测模型对HIV感染者发生血脂异常的风险具有较好的预测价值。

关键词: 抗病毒治疗, HIV感染者, 血脂异常, 相关因素, 风险预测模型

Abstract: Objective To analyze the factors related to the occurrence of dyslipidemia in HIV-infected patients after antiviral therapy, and to establish a predictive model for the occurrence of dyslipidemia. Method Data of all HIV-infected patients from May 2016 to May 2021 at Beijing You'an Hospital Affiliated to Capital Medical University were selected. A total of 1000 samples were included as the modeling group, and divided into the dyslipidemia group (case group) 388 cases and the normol lipidemia group (control group) 612 cases, and including 125 HIV infected individuals treated at our hospital from June to December 2022 as the model validation group. Clinical indicators and laboratory examination data were collected, and the related factors of dyslipidemia were analyzed by binary Logistic regression, and a prediction model of risk factors was established. Result Among 1000 HIV-infected patients, 982 were males and 18 were females. The mean age was (36.6± 11.2) years. Binary logistic regression analysis showed age ≥ 50 years (OR=2.029, 95%CI: 1.966-2.074, P<0.001), body mass index (BMI) ≥ 24 kg/m²(OR=5.008, 95%CI: 1.216-5.429, P=0.035), non-integrase drug regimens for antiviral therapy (OR=1.126, 95%CI: 1.083-1.147, P=0.025), duration of antiviral treatment ≥ 3 years (OR=1.722, 95%CI: 1.203-1.945, P<0.001), fasting plasma glucose (FPG) ≥ 6.0 mmol/L (OR=1.303, 95%CI: 1.006-1.586, P=0.038) were risk factors for the occurrence of dyslipidemia in HIV-infected patients treated with antiviral therapy, and weekly exercise time ≥ 1 day (OR=0.487, 95%CI: 0.374-0.636, P<0.001) was an independent protective factor for the occurrence of dyslipidemia. There is no statistically significant difference in the scores of various indicators between the validation group and the modeling group in the risk prediction model, indicating that the model has a good fit. The area under the ROC curve of the risk prediction model for the modeling group was 0.918 (95%CI: 0.898-0.937, P<0.001). The cut-off value was 0.938, with a sensitivity of 85.60%, a specificity of 93.22%, a positive predictive rate of 89.90%, and a negative predictive rate of 91.51% for the occurrence of dyslipidemia. Conclusion The incidence of dyslipidemia in HIV-infected patients receiving antiretroviral therapy is 38.80%. Age, BMI, antiviral drugs, duration of antiviral therapy, weekly exercise time and FPG are the relevant influencing factors for the occurrence of dyslipidemia. The prediction model of risk factors based on independent correlation factors has good predictive value for the occurrence of dyslipidemia in HIV-infected patients.

Key words: Antiviral therapy, Human immunodeficiency virus-infected people, Abnormal blood lipids, Relevant factors, Prediction model

中图分类号:

R512

吴冬霞, 武秀连, 常可意, 韩佳凝, 全晓丽, 吕雪, 李晨, 张莉莉. HIV感染者抗病毒治疗后发生血脂异常的相关因素分析及风险预测模型构建[J]. 新发传染病电子杂志, 2025, 10(1): 56-61.

Wu Dongxia, Wu Xiulian, Chang Keyi, Han Jianing, Quan Xiaoli, Lyu Xue, Li Chen, Zhang Lili. Analysis of related factors of dyslipidemia in HIV-infected patients after antiviral therapy and construction of risk prediction model[J]. Electronic Journal of Emerging Infectious Diseases, 2025, 10(1): 56-61.

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HIV感染者抗病毒治疗后发生血脂异常的相关因素分析及风险预测模型构建

Analysis of related factors of dyslipidemia in HIV-infected patients after antiviral therapy and construction of risk prediction model

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