糖尿病微血管病变与外周血中性粒细胞计数

Diabetic microangiopathy and peripheral blood neutrophil count

背景:糖尿病病程和高血压是糖尿病微血管并发症发生的独立危险因素,而空腹C肽水平是其保护因素。糖化血红蛋白、C-反应蛋白、白细胞计数与糖尿病微血管并发症的相关研究报道较多,但关于中性粒细胞的报道较少。目的:分析外周血中性粒细胞计数与糖尿病微血管并发症的关系。方法:112例2型糖尿病患者根据是否合并微血管并发症将其分为2组:2型糖尿病合并微血管并发症组和2型糖尿病。收集2组患者性别、年龄、民族、既往史、实验室检查指标等各项临床资料,通过单因素及多因素分析进行统计学比较。结果与结论:1单因素分析结果显示:合并微血管病变组患者年龄、糖尿病病程、球蛋白、肌酐、中性粒细胞百分比、中性粒细胞绝对值、合并高血压的比率明显高于2型糖尿病组(P<0.05),然而合并微血管病变组淋巴细胞百分比、肾小球滤过率、三酰甘油水平明显低于2型糖尿病组(P<0.05)。2多因素Logistic回归分析结果示:患者的年龄、糖尿病病程、中性粒细胞绝对值是2型糖尿病患者发生微血管并发症的独立危险因素(OR=1.155、2.145、2.275,均P<0.01)。控制年龄因素后,对所有对象偏相关分析结果显示:中性粒细胞计数与肌酐、低密度脂蛋白胆固醇、球蛋白、血红蛋白呈正相关,与血胆汁酸、肾小球滤过率呈负相关。结果提示,慢性亚临床炎症反应与2型糖尿病患者微血管并发症的发生密切相关,中性粒细胞计数可作为预测2型糖尿病患者微血管并发症的一个指标。

BACKGROUND：Course of diabetes and hypertension are independent risk factors for diabetic microvascular complications, and fasting C-peptide level is a protective factor. There are many studies concerning glycated hemoglobin, C-reactive protein, white blood cel count and diabetic microvascular complications, but studies about neutrophils are rarely reported. OBJECTIVE：To investigate the relationship of peripheral blood neutrophil count with diabetic microvascular complications. METHODS：Totaly 112 patients with type 2 diabetes melitus were selected and divided into two groups according to the presence or absence of microvascular complications： diabetes group and diabetes＋ microvascular complication group. The gender, age, ethnic group, disease history and laboratory examination parameters were colected and analyzed with univariate analysis and multivariate analysis. RESULTS AND CONCLUSION：（1） Univariate analysis： Patients in the diabetes＋microvascular complication group had significantly higher age, course of diabetes, globulin, creatinine, the percentage of neutrophile granulocytes, nertrophil count, rate of hypertension than those in the diabetes group （P 〈 0.05）, while the lymphocyte percentage, glomerular filtration rate, and triglyceride level were significantly lower than those in the diabetes group （P 〈 0.05）. （2） Logistic regression analysis showed that age, course of diabetes and nertrophil count were the independent risk factors of microvascular complications in patients with type 2 diabetes melitus （odds ratio=1.155, 2.145, 2.275, alP 〈 0.01）. Based on the adjustment of the age factor, the partial correlation analysis showed that the nertrophil count was positively correlated to the levels of creatinine, low-density lipoprotein cholesterol, globulin and hemoglobin, but negatively correlated to the levels of serum bile acid and glomerular filtration rate. Chronic subclinical inflammations are closely correlated to the occurrence of microvascular complication in patients with type 2 diabetes melitus, and peripheral blood neutrophil count can be used as a predictor of microvascular complication in patients with type 2 diabetes melitus.