食管癌患者血脂异常与肾功能不全的相关性研究：一项横断面研究

Association between Lipid Abnormalities and Renal Dysfunction in Esophageal Cancer Patients: A Cross-Sectional Study

摘要: 背景：化学药物治疗是治疗食管癌的重要手段。化疗方案的选择常受限于患者的肾功能，因此本研究拟探索患者血脂异常与肾功能不全的相关性。方法：连续纳入2019年1月到2026年1月所有在本院接受新辅助化疗的食管癌患者。收集患者入院时血液检查中的甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和脂蛋白(a)。依据患者的预估肾小球滤过率分为肾功能降低和肾功能正常组。使用单因素和多因素logistic回归分析，探索血脂异常与肾功能不全的相关性，使用箱线图联合小提琴图分别展示两组组间各血脂指标的数据分布。结果：本研究共随访8年，纳入215例患者，平均年龄60.4岁，其中肾功能降低组31人。多因素logistic回归分析显示甘油三酯(OR = 3.904, 95% CI 1.524~6.436, P < 0.001)、总胆固醇(OR = 1.367, 95% CI 0.701~2.668, P = 0.359)、高密度脂蛋白胆固醇(OR = 0.215, 95% CI 0.092~0.502, P < 0.001)、低密度脂蛋白胆固醇(OR = 0.881, 95%CI 0.574~1.353, P = 0.563)和脂蛋白(a) (OR = 1.002, 95% CI 1.000~1.004, P = 0.058)。结论：在食管癌的患者中，高密度脂蛋白胆固醇的降低和甘油三酯的升高与患者的肾功能下降存在显著的相关性。

Abstract: Background: Chemotherapy is a crucial treatment modality for esophageal cancer. The selection of chemotherapy regimens is often constrained by patients’ renal function; therefore, this study aimed to investigate the correlation between dyslipidemia and renal insufficiency. Methods: All esophageal cancer patients receiving neoadjuvant chemotherapy at our hospital from January 2019 to January 2026 were consecutively enrolled. Blood parameters including triglycerides, total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and lipoprotein(a) were measured at admission. Patients were classified into a renal impairment group and a normal renal function group based on estimated glomerular filtration rate (GFR). Univariate and multivariate logistic regression analyses were performed to examine the association between dyslipidemia and renal insufficiency, while box-and-line plots and violin plots were used to visualize the distribution of lipid parameters between the two groups. Results: A total of 215 patients were followed for 8 years, with a mean age of 60.4 years, including 31 in the renal impairment group. Multivariate logistic regression analysis revealed significant associations between decreased triglycerides (OR = 3.904, 95% CI 1.524~0.436, P < 0.001), total cholesterol (OR = 1.367, 5% CI 0.701~0.668, P = 0.359), high-density lipoprotein cholesterol (HDL-C; OR = 0.215, 5% CI 0.092~0.502, P < 0.001), low-density lipoprotein cholesterol (LDL-C; OR = 0.881, 95% CI 0.574~0.353, P = 0.563), and lipoprotein (a) (OR = 1.002, 95% CI 1.000~1.004, P = 0.058) with impaired renal function in esophageal cancer patients. Conclusion: Reduced HDL-C levels and elevated triglycerides are significantly correlated with declining renal function in esophageal cancer patients.