慢性低度炎性反应与糖尿病肾脏疾病的相关性分析：一项大样本病例-对照研究

Relationship between chronic low-grade inflammation and diabetic kidney disease： a large case-con- trol study

目的探讨慢性低度炎性反应与糖尿病肾脏疾病（DKD）的关系。方法将1254例2型糖尿病患者分为DKD组（487例）与单纯T2DM组（767例），DKD诊断依据：符合估算的肾小球滤过率（eGFR）〈60ml／（min·1．73m^2）或尿微量白蛋白／肌酐比值（UACR）≥30mg／g。通过自动分析仪测定血清慢性低度炎性反应指标：超敏C反应蛋白（hs．CRP）、白细胞总数、中性粒细胞百分比（NCR），并记录性别、病程、收缩压、舒张压等指标。利用多元Logistic回归分析慢性低度炎性反应指标与DKD的关系。结果与单纯T2DM组相比，DKD组的hs-CRP、白细胞总数、NCR均显著升高（t=～3．60、-3．43、3．10，P均〈0．01）。多元Logistic回归分析显示，hs—CRP（OR：1．116，95％CI：1．042～1．195，P=0．002）、白细胞总数（OR=1．092，95％CI：1．002～1．189，P=0．044）和NCR（OR：1．018，95％CI：1．004～1．033，P=0．015）与DKD风险增加显著相关。结论DKD的慢性低度炎性反应指标显著升高，hs—CRP、白细胞总数、NCR是DKD的独立危险因素。

Objective To explore the relationship between chronic low-grade inflammation and dia- betic kidney disease （DKD）. Methods A total of 1 254 patients with type 2 diabetes mellitus （T2DM） were enrolled and divided into two groups：DKD group （487 cases） and T2DM group （767 cases）. DKD was diagnosed if the estimated glomerular filtration rate （eGFR） were less than 60 ml/（ min · 1.73 m2） or if the urine albumin creatinine ratio （UACR） were no less than 30 mg/g. Serum chronic low-grade inflam- mation indexes including high sensitive C-reactive protein （hs-CRP）, total white blood cell count and neu- trophil percentage （NCR） were measured with an automatic analyzer. Sex, duration, systolic blood pres- sure, diastolic blood pressure and other indicators were recorded as well. Muhiple Logistic regression analy- sis was conducted to analyze the relationship between chronic low-grade inflammation indexes and DKD. Results The hs-CRP, total white blood cell count and NCR were significantly higher in DKD group than those in T2DM group （ t= - 3.60, - 3.43, 3.10, all P 〈 0.01 ）. Multiple Logistic regression analysis showed that hs-CRP （OR =1. 116, 95% CI： 1.042-1. 195, P=0.002）, total white blood cell count （0R=1.092, 95% CI： 1.002-1.189, P=0.044） and NCR （0R=1.018, 95% CI： 1.004-1.033, P = 0. 015） were related to the increased risk of DKD. Conclusions Chronic low-grade inflammation inde- xes are increased in DKD. Moreover, hs-CRP, total white blood cell count and NCR are independent risk factors of DKD.