2型糖尿病患者血清中性粒细胞/淋巴细胞比值、25羟维生素D与颈动脉粥样硬化的相关性

Correlation of serum neutrophil to lymphocyte ratio and 25(OH)D with carotid atherosclerosis in patients with type 2 diabetes mellitus

目的 探讨2型糖尿病(T2DM)患者血清中性粒细胞/淋巴细胞比值(NLR)、25羟维生素D[25(OH)D]与颈动脉粥样硬化(carotid atherosclerosis,CAS)的关系.方法 选取2018年9月至2019年4月于遵义医科大学附属医院内分泌科住院的T2DM患者167例,根据颈动脉彩超结果 将其分为两组,其中单纯糖尿病组(T2DM组)74例,T2DM合并CAS组(CAS组)93例,另选我院同期健康体检者为正常对照组(NC组)70例.收集三组患者临床指标并进行分析.结果 CAS组患者的血清NLR高于T2DM组及NC组:(2.16±0.46)vs(1.96±0.36)vs(1.77±0.49);CAS组及T2DM组患者的血清25(OH)D均低于NC组[(16.68±3.77)ng/mL vs(22.58±4.37)ng/mL vs(25.31±4.35)ng/mL],且CAS组患者的血清25(OH)D低于T2DM组,以上各项指标比较差异均有统计学意义(P<0.05);Logistic回归分析结果 显示,TG、HOMA-IR、NLR是CAS的独立危险因素(P<0.05),25(OH)D、HDL-C是CAS的独立保护因素(P<0.05);Pearson相关分析结果 显示,T2DM患者血清中NLR与25(OH)D呈负相关(r=-2.64,P<0.05),与HOMA-IR、BMI呈正相关(r=0.373、0.159,P<0.05);25(OH)D与LDL-C、HOMA-IR、NLR呈负相关(r=-0.168、-0.196、-2.64,P<0.05),与HDL-C呈正相关(r=0.263 4,P<0.05).结论 血清NLR、25(OH)D水平与T2DM合并颈动脉粥样硬化相关,可能参与了T2DM合并大血管病变的发生发展.

Objective To investigate the correlation of serum neutrophil-to-lymphocyte ratio(NLR)and 25(OH)D with carotid atherosclerosis(CAS)in patients with type 2 diabetes mellitus(T2DM).Methods From September 2018 to April 2019,a total of 167 T2DM patients admitted to the Department of Endocrinology,the Affiliated Hospital of Zunyi Medical University were recruited in this study and divided into 2 groups according results of carotid artery ultrasound,that is,74 patients in the simple T2DM group(T2DM group)and 93 patients in the T2DM combined with CAS group(CAS group).Seventy healthy subjects were enrolled as normal control group during the same time(NC group).The clinical indexes of 3 groups were collected and compared.Results Serum NLR in the CAS group was significantly higher than that in the T2DM group and NC group:(2.16±0.46)vs(1.96±0.36)vs(1.77±0.49);serum 25-hydroxyvitamin D(25(OH)D)level in the CAS group and T2DM group was significantly lower than that in NC group:(16.68±3.77)ng/mL vs(22.58±4.37)ng/mL vs(25.31±4.35)ng/mL;serum 25(OH)D level in the CAS group was significantly lower than that in the T2DM group(all P<0.05).Logistic repression analysis showed that triglycerides(TG),homeostasis model assessment of insulin resistance(HOMA-IR),NLR were independent risks factors for CAS,and 25(OH)D,high-density lipoprotein cholesterol(HDL-C)were independent protect factors for CAS(P<0.05).Pearson correlation analysis showed that serum NLR level was negatively correlated with the level of 25(OH)D(r=-2.64,P<0.05)in T2DM patients,and positively correlated with HOMA-IR,BMI(r=0.373,0.159,P<0.05).The serum 25(OH)D level was negatively corrected with the level of low-density cholesterol(LDL-C),HOMA-IR,NLR(r=-0.168,-0.196,-2.64,P<0.05),and positively correlated with HDL-C(r=0.2634,P<0.05).Conclusion Serum NLR,25(OH)D levels are associated with CAS in T2DM and may be involved in the development of T2DM combined with macrovascular lesions.