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| 血清尿素氮/肌酐比值与骨质疏松症及心血管-肾脏-代谢综合征的关系 |
| Association of serum urea nitrogen/creatinine ratio with osteoporosis and cardiovascular-kidney-metabolic syndrome |
| 投稿时间：2025-10-18 修订日期：2025-12-09 |
| DOI： |
| 中文关键词: 血尿素氮/肌酐比值 骨质疏松症 心血管-肾脏-代谢综合征 NHANES 横断面研究 |
| 英文关键词:blood urea nitrogen/creatinine ratio osteoporosis cardiovascular-kidney-metabolic syndrome NHANES cross-sectional study |
| 基金项目:全国名老中医药专家传承工作室建设项目(国中医药人教函[2022]75号)；第三批江苏省中医药领军人才培养计划(苏中医科教[2023]17号)；江苏省中医药科技发展计划重点项目(ZD202202)；江苏省研究生科研与实践创新计划项目(SJCX24-093) |
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| 中文摘要: |
| 目的 利用美国国家健康与营养检查调查（NHANES）数据，探讨血清尿素氮/肌酐比值（blood urea nitrogen/creatinine[] ratio，BUN/Cr）与骨质疏松症和心血管-肾脏-代谢综合征（cardiovascular-kidney-metabolic syndrome，CKMS）的关系。方法 纳入2 800名1999-2004年NHANES数据，采用多因素Logistic回归模型和限制性立方样条（RCS）回归模型探讨BUN/Cr与疾病发生率的关系，并进行亚组分析以森林图的形式检查结果可靠性。最后，采用受试者工作特征曲线（ROC）进行分析，计算曲线下面积（AUC）量化BUN/Cr对骨质疏松症的预测效能，并确定预测的灵敏度、特异度和最佳截断值。结果 BUN/Cr每升高1个单位，骨质疏松症（OR：1.073，95% CI：1.039 ~ 1.109，P < 0.001）、心血管疾病（OR：1.038，95% CI：1.013 ~ 1.064，P = 0.003）和代谢综合征（OR：1.041，95% CI：1.016 ~ 1.066，P = 0.001）患病风险分别增加7.3%、3.8%和4.1%。限制性立方样条回归分析表明BUN/Cr与骨质疏松症、心血管疾病、代谢综合征、糖尿病和高血压的发病率均呈线性正相关（P < 0.05，nonlinear P > 0.05）。随着BUN/Cr升高，女性骨质疏松症和代谢综合征的风险增加。在男性中，BUN/Cr与心血管疾病和高血压显著正相关。无论男女BUN/Cr与CKMS和糖尿病均显著正相关。ROC分析显示BUN/Cr预测骨质疏松症的AUC = 0.685（95%CI：0.631 ~ 0.739，P < 0.001），最佳截点为18.26，灵敏度和特异度分为0.621和0.692。结论 较高的BUN/Cr与骨质疏松症、CKMS和心血管疾病高发病率呈线性正相关，这些发现表明BUN/Cr可作为评估骨质疏松症和心血管疾病的有效指标。 |
| 英文摘要: |
| Objective This study aimed to examine the relationship of the serum urea nitrogen-to-creatinine ratio (BUN/Cr) with osteoporosis and cardiovascular-kidney-metabolic syndrome (CKMS) based on data from the National Health and Nutrition Examination Survey (NHANES). Methods We analyzed a sample of 2,800 adults from the 1999-2004 NHANES. The associations between BUN/Cr and the incidence of osteoporosis and CKMS components were evaluated using multivariate logistic regression and restricted cubic spline (RCS) analyses. Stratified analyses were performed to verify robustness，and the predictive performance of BUN/Cr for osteoporosis was assessed by receiver operating characteristic (ROC) curve analysis. Results Multivariable-adjusted models demonstrated that per 1-unit increment in BUN/Cr，the odds of osteoporosis，cardiovascular disease，and metabolic syndrome increased by 7.3% (OR：1.073，95% CI：1.039-1.109，P < 0.001)，3.8% (OR：1.038，95% CI：1.013-1.064，P = 0.003)，and 4.1% (OR：1.041，95% CI：1.016-1.066，P = 0.001)，respectively. RCS models confirmed linear positive associations with osteoporosis，cardiovascular disease，metabolic syndrome，diabetes，and hypertension (P < 0.05，nonlinear P > 0.05). Sex-stratified analyses revealed that the positive associations of BUN/Cr with osteoporosis and metabolic syndrome were more pronounced in women，while its links to cardiovascular disease and hypertension were stronger in men. The ROC analysis for osteoporosis prediction yielded an area under the curve of 0.685 (95% CI：0.631-0.739，P < 0.001)，with a cutoff value of 18.26 providing 62.1% sensitivity and 69.2% specificity. Conclusion A higher BUN/Cr level is positively and linearly associated with an increased risk of osteoporosis and CKMS. These findings suggest the potential utility of BUN/Cr as a clinical marker for identifying individuals at risk for osteoporosis and cardiovascular-metabolic diseases. |
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