关键词: 残余胆固醇, 糖尿病, 冠心病, 心力衰竭, 预测价值

Abstract: Objective Residual cholesterol（RC）is an important marker reflecting dyslipidemia associated with atherosclerosis．Its clinical significance in patients with diabetes and coronary heart disease（CHD）remains unclear．To explore the predictive value of RC level for the risk of heart failure（HF）in patients with diabetes and CHD and analyze their association．Methods This retrospective cross-sectional study included 292 patients with diabetes and CHD who were treated at Hebi People's Hospital between January 2021 and January 2024．Patients were divided into the HF group（128 cases）and the non-HF group（164 cases）based on the presence of HF．Baseline characteristics were compared,and univariate and multivariate Logistic regression analyses were performed to assess the association between RC and HF．Additionally,restricted cubic spline（RCS）analysis was used to explore the linear relationship between RC and HF risk,and the predictive value of RC was evaluated using receiver operating characteristic（ROC）curves and the area under the curve（AUC）．Results The HF group had significantly higher proportions of males,hypertension prevalence and RC levels,while estimated glomerular filtration rate were significantly lower compared to the non-HF group（P<0.05）．Univariate analysis showed that RC>0.7 mmol/L significantly increased the risk of HF（OR=1.854,95%CI：1.161-2.960,P=0.010）．In the fully adjusted multivariate Logistic regression model,RC（RC>0.7 mmol/L）was associated with a 1.891-fold increased risk of HF as a categorical variable（OR=1.891,95%CI：1.047-3.415,P=0.035）．As a continuous variable,each increased unit in RC was associated with a 2.464-fold increased risk of HF（OR=2.464,95%CI：1.495-4.064,P<0.001）．The odds ratios for Log₁₀RC and standardized RC were 6.411（95%CI：2.246-18.302,P=0.001）and 1.687（95%CI：1.262-2.255,P<0.001）,respectively．ROC analysis indicated a linear positive association between RC and HF risk（P=0.002）．ROC analysis showed that RC had predictive value for HF,with an AUC of 0.621（95%CI：0.555-0.687,P<0.001）．Conclusions RC levels are significantly associated with the risk of HF in patients with diabetes and CHD,demonstrating a linear positive correlation．RC has potential predictive value and may serve as a useful indicator for assessing HF risk in this population．

Key words: residual cholesterol, diabetes, coronary heart disease, heart failure, predictive value