单核细胞/高密度脂蛋白胆固醇比值与2型糖尿病肾脏疾病的相关性分析

Association study of monocyte to high-density lipopr otein cholesterol ratio and patients with type 2 diabetic kidney disease

目的分析单核细胞/高密度脂蛋白胆固醇比值(MHR)与2型糖尿病肾脏疾病(DKD)的关系。方法选取锦州医科大学附属第一医院符合入选标准的2型糖尿病患者216例,分为单纯糖尿病组70例(SDM组)、早期糖尿病肾脏疾病组71例(EDKD组)、临床糖尿病肾脏疾病组75例(CDKD组)。采用Pearson法分析与尿白蛋白/尿肌酐比值(uACR)有关的检验指标;采用Logistic回归模型分析DKD的影响因素。采用ROC曲线评价MHR预测DKD的最佳截断值及其特异性和敏感性。结果 CDKD组MHR高于SDM组和EDKD组(P <0.05)。相关性分析显示,uACR与MHR、单核细胞、血小板、甘油三酯、血肌酐、血尿酸、糖化血红蛋白、空腹血糖呈正相关(r=0.552、0.523、0.136、0.214、0.234、0.194、0.137和0.142,均P <0.05),与高密度脂蛋白胆固醇及血红蛋白呈负相关(r=-0.255和-0.321,均P <0.05)。Logistic回归模型分析显示MHR[OR=1.545(95% CI:1.248,1.913)]、体重指数[OR=1.160(95% CI:1.029,1.307)]、血肌酐[OR=1.034(95% CI:1.007,1.061)]、收缩压[OR=1.068(95% CI:1.028,1.110)]是DKD的独立危险因素。对DKD患者,MHR最佳截断值为6.2,MHR的曲线下面积为0.773(95% CI:0.711,0.834),预测的敏感性为71.9%(95% CI:0.646,0.791)、特异性为72.9%(95% CI:0.657,0.801)。结论 MHR是DKD的独立危险因素。

Objective To investigate the relationship of monocyte to high-density lipoprotein cholesterol ratio (MHR) with diabetic kidney disease.Methods A total of 216 type 2 diabetes mellitus patients treated in Jinzhou central hospital were enrolled.The patients were divided into 3 groups:the simple diabetic group (n=70),the incipient diabetic kidney disease group (n=71),and the clinical diabetic kidney disease group (n=75).The Pearson method was used to analyze the test indexes related to the ratio of urine albumin to creatinine.Logistic regression model was used to analyze the influencing factors of diabetic kidney disease.Receiver operating characteristic (ROC) curve was performed to assess the best cut-off value for MHR predicting diabetic kidney disease;Logistic regression analysis was conducted to studied weather MHR could be used as an independent risk factor for diabetic kidney disease.Results The MHR in clinical diabetic kidney disease group was significantly higher than that of both the group of incipient diabetic kidney disease and the group of simple diabetic patients (P < 0.05).Correlation analysis showed that uACR was positively correlated with MHR level (r=0.552),monocyte level (r=0.523),platelet level (r=0.136),triglyceride level (0.214),serum creatinine level (r=0.234),blood uric acid level (0.194),glycosylated hemoglobin level (r=0.137),fasting blood glucose level (r=0.142) (P < 0.05),and negatively correlated with high-density lipoprotein cholesterol (HDL-C) and hemoglobin (r=-0.255) (P < 0.05).Logistic regression analysis showed that MHR[OR=1.545,(95% CI:1.248,1.913)],body mass index[OR=1.160,(95% CI:1.029,1.307)],serum creatinine[OR=1.034,(95% CI:1.007,1.061)],systolic blood pressure[OR=1.068,(95% CI:1.028,1.110)]may be the influencing factors of DKD.For DKD patients,the optimal cut-off point of MHR was 6.2,the area under the curve of MHR was 0.773 (95% CI:0.711,0.834),the predictive sensitivity was 71.9% (95% CI:0.646,0.791),and the specificity was 72.9% (95% CI:0.657,0.801).Conclusion MHR was an independent risk factor for diabetic kindney disease.