中性粒细胞淋巴细胞比值与老年糖尿病患者早期肾功能水平的相关性研究

Correlation between neutrophil to lymphocyte ratio and early renal function level in elderly diabetic patients

目的研究在老年2型糖尿病(T2DM)患者中中性粒细胞与淋巴细胞比值(NLR)与早期肾功能水平的相关性。方法回顾性收集中国科学技术大学附属第一医院内分泌科及老年医学科2018年6月至2019年1月收治的老年T2DM患者346例,对比分析不同估算肾小球滤过率(eGFR)水平下患者一般资料,包括性别、年龄、体质量指数、NLR、尿白蛋白排泄率(UAE)等指标,以eGFR作为目标变量进行回归分析探讨不同混杂因素对eGFR的影响,使用皮尔逊相关系数检验eGFR与各变量之间的关系。结果随着eGFR的降低,年龄、存在心血管疾病、服用降压药、血尿酸(SUA)及NLR等水平升高,舒张压、HDL-C及HbA1c水平降低,且差异有统计学意义(P<0.05);NLR与eGFR呈负相关;当使用eGFR作为目标变量进行多重线性回归分析时,在校正各种混杂因素后结果提示NLR(β=-0.101,P=0.009)以及年龄(β=-0.525,P<0.001)、体质量指数(β=-0.083,P=0.036)、血尿酸水平(β=-0.360,P<0.001)、使用降尿酸药物(β=-0.128,P=0.001)和eGFR独立显著相关。结论NLR对老年T2DM患者早期肾功能水平是一个有效评价指标,且简单易行,方便临床使用。

Objective To explore the correlation between neutrophil to lymphocyte ratio(NLR)and early renal function levelin elderly patients with type 2 diabetes.Methods A total of 346 elderly diabetic patients hospitalized in Department of Endocrinology and Department of Gerontology in The First Affiliated Hospital of USTC from June 2018 to January 2019 were enrolled in this study.Generalclinical data such as age,gender,body mass index,NLR,urinary albumin excretion(UAE)in patients with different estimated glomerular filtration rate(eGFR)levels were compared and analyzed.Logistic regression analysis was used to evaluate the effect of each confounding factor on eGFR using eGFR as an objective variable.Pearson’s correlation coefficients were used to test the associations between various variables and eGFR.Results Age,risk of cardiovascular diseases,use of antihypertensive medication,serum uric acid(SUA)and NLR were higher in correlation with decreased eGFR,but DBP,HDL-C,and HbA1c were lower.with the statistically significant difference(P<0.05).NLR was negatively related to eGFR.Multiple linear regression analysis using eGFR as objective variable indicated that NLR(β=-0.101,P=0.009)as well as age(β=-0.525,P<0.001),body mass index(β=-0.083,P=0.036),serum uric acid(β=-0.360,P<0.001),and use of medication against SUA(β=-0.128,P=0.001)were significantly and independently associated with eGFR.Conclusions NLR is an effective evaluation index for early renal function in elderly patients with type 2 diabetes,which is easy and convenience for clinical use.