外周血NLR与2型糖尿病患者肾损伤指标的关联性分析

Correlation Analysis of Peripheral Blood NLR and renal injury indexes in patients with type 2 diabetes mellitus

目的分析外周血中性粒细胞/淋巴细胞比值(NLR)与2型糖尿病(T2DM)患者肾损伤指标之间的关联性,评估NLR在糖尿病肾病(DN)临床诊断中的价值。方法选取2018年2月至2019年12月于该院住院治疗的T2DM患者(284例)作为研究对象,按照NLR的三分位数将研究对象分为3组。收集研究对象一般资料及实验室检查指标,采用血β_(2)微球蛋白(β_(2)MG)、血肌酐(Scr)、24 h尿白蛋白(UP24)、尿β_(2)微球蛋白(UMG)作为肾损伤评价指标,分析NLR与DN之间的关系。结果随着NLR升高,T2DM患者收缩压、空腹血糖、Scr、β_(2)MG、UMG水平升高,而BMI降低,差异均有统计学意义(P<0.05)。Pearson相关分析发现,NLR与β_(2)MG、UMG呈正相关(r=0.183、0.179,P<0.05),且相关性具有线性趋势(趋势性P<0.05)。多因素回归分析结果显示,NLR与β_(2)MG、UMG均呈正相关(OR=1.022、1.070,P<0.05)。受试者工作特征曲线分析显示,NLR预测中早期DN的灵敏度和特异度分别为60.30%和68.30%,曲线下面积为0.674。结论NLR和早期肾损伤标志物β_(2)MG、UMG水平有良好的相关性,具有发现T2DM患者中早期肾损伤的能力。

Objective To analyze the correlation between the peripheral blood neutrophil-to-lymphocyte ratio(NLR)and renal injury indicators in patients with type 2 diabetes mellitus(T2DM),and to evaluate the value of NLR in the clinical diagnosis of diabetic nephropathy(DN).Methods A total of 284 patients with T2DM who were hospitalized in the hospital from February 2018 to October 2019 were selected as the research subjects.and they were divided into 3 groups according to the tertiles of the NLR.The general data and laboratory test indicators of the research subjects were collected,and serumβ_(2)-microglobulin(β_(2)MG),serum creatinine(Scr),24-hour urine protein(UP24),and urineβ_(2)-microglobulin(UMG)were used as the evaluation indicators of renal injury in order to analyze the relationship between NLR and DN.Results With the increase of NLR,the levels of systolic blood pressure,fasting plasma glucose,Scr,β_(2)MG and UMG in T2DM patients increased,while BMI decreased,the difference was statistically significant(P<0.05).Pearson correlation analysis showed that NLR was positively correlated withβ_(2)MG and UMG(r=0.183,0.179,P<0.05),and the correlation had a linear trend(trend P<0.05).The results of multivariate regression analysis showed that NLR was positively correlated withβ_(2)MG and UMG(OR=1.022,1.070,P<0.05).The receiver operating characteristic curve analysis showed that the sensitivity and specificity of NLR in predicting mid-to-early DN were 60.30%and 68.30%,respectively,and the area under the curve was 0.674.Conclusion NLR has a good correlation with the early renal injury markersβ_(2)MG and UMG,which has the ability to detect early renal injury in patients with T2DM.