老年人代谢综合征与血细胞计数比值及白细胞计数的相关性研究

Correlation of metabolic syndrome with neutrophils-lymphocytes ratio, platelet-lymphocyte ratio and white blood cell count in the elderly

目的比较中性粒细胞-淋巴细胞比值（NLR）、血小板-淋巴细胞比值（PLR）及白细胞与老年人代谢综合征存在及严重程度的相关性。方法选取2010年在我院体检中心进行健康体检老年人（年龄≥65岁）2322例。采集一般资料，测量腰围、身高、体质量、血压，测定血常规、血糖、胰岛素、血脂、肝肾功能，计算体质指数（BMI）、NLR、PLR、稳态胰岛素评估模型胰岛素抵抗指数（HOMA—IR）和稳态胰岛素评估模型β细胞功能（HOMA-β），按《中国成人血脂异常防治指南（2007年）》中对代谢综合征定义分成代谢综合征组与非代谢综合征组，对两组相关指标进行比较。结果代谢综合征组与非代谢综合征组比较，NLR1．7（1．3，2．2）比1．7（1．3，2．2），差异无统计学意义（P=0．273）；PLRE84．0（67．0，105．7）比89．0（67．2，112．0）3显著降低（P=0．006），且随着异常代谢组分的增加呈现明显降低趋势（P〈0.05）；白细胞[6．3（5．4，7．3）比5．8（5．0，6．7）]明显升高（P=0．000），且随着异常代谢组分的增加呈现明显升高趋势（P〈0．05）。按三分位数将代谢综合征患者分成3组，HOMA—IR在NLR组间差异无统计学意义（P〉0．05），在PLR组间呈明显降低趋势（P〈0．05），在白细胞组间呈现明显升高趋势（P〈0．05）。Logistic回归分析显示，白细胞是代谢综合征独立危险因素[OR=1．24（1．15～1．33）]，亦是代谢综合征严重程度的独立危险因素[MS2：OR=1．12（1．01～1．24），MS3：OR=1．40（1．04～1．89）]。结论白细胞预测老年代谢综合征的存在及严重程度优于NLR和PLR。

Objective To analyze and compare the correlation of neutrophils-lymphocytes ratio （NLR）, platelet-lymphocyte ratio（PLR）and white blood cell count with metabolic syndrome（MS）in the elderly. Methods A total of 2, 322 people aged 65 years and over who took physical examination in health medical center of our hospital in 2010 were selected. The general information, waist circumference, height, weight, blood pressure were collected. Routine blood cell test, blood glucose, insulin, blood lipids, liver and kidney function were detected. Then, body mass index（BMI）, NLR, PLR, homeostasis model assessment of insulin resistance （ HOMA- IR）, HOMA-β cells （HOMA-β） were calculated. According to the MS definition of Chinese adult dyslipidemia prevention guide（2007）, all participants were divided into two groups：MS group and non MS group. The relevant indices were compared between two groups. Results NLR had no significant difference between MS and non-MS groups（1.7（1.3, 2.2）vs. 1.7（1.3, 2.2）, P=0.273]. PLR was lower in MS group than in non-MS group（84.0（67.0, 105.7） vs. 89.0（67.2, 112.0）, P=0.006], and PLR showed a significantly decreasing trend in MS group along with the increase of abnormal metabolic component numbers（P〈 0. 05）. The white blood cell count was higher in MS group than in non-MS group[6. 3（5. 4, 7.3） vs. 5.8 （5.0, 6.7）, P = 0. 000], and the white blood cell count showed a significantly increasing trend in MS group along with the increase of abnormal metabolic component numbers（P〈0.05）. HOMA- IR had no significant difference between tertiles-divided three groups of NLR in MS （P 〉 0.05 ）. HOMA IR showed a significantly decreasing trend in the three subgroups which was divided by tertiles of PLR（P〈0.05）. While HOMA-IR showed a significantly increasing trend in the three subgroups which was divided by tertiles of white blood cells（P〈0.05）. Logistic regression analysis showed that the white blood cells was the independent risk factors for the occurrence and the severity of MS[OR= 1.24（1. 15- 1.33） ;MS2 ：OR = 1.12（1.01- 1.24）and MS3 ：OR= 1.40（1.04- 1.89）]. Conclusions The white blood cells is superior to the NLR and PLR as a predictive factor for the presence and severity of MS in the elderly.