2型糖尿病患者合并左心室肥厚与炎症指标水平的相关性研究

Correlations between type 2 diabetes patients with left ventricular hypertrophy and levels of inflammatory markers

目的探讨2型糖尿病(T2DM)患者合并左心室肥厚(LVH)与中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、平均血小板体积(MPV)的相关性。方法选取T2DM患者216例为研究对象,根据左心室质量指数(LVMI)将其分为LVH组103例和非LVH组113例。比较2组一般临床资料、血常规指标和生化指标水平。结果LVH组甘油三酯(TG)、NLR、PLR、MPV及24 h尿蛋白、尿微量白蛋白/肌酐(UACR)水平均高于非LVH组,高密度脂蛋白胆固醇(HDL-C)、左心室射血分数(LVEF)水平均低于非LVH组,差异有统计学意义(P<0.05)。T2DM合并LVH与TG、NLR、PLR、MPV及24 h尿蛋白、UACR指标水平呈正相关(r_(s)=0.192、0.490、0.442、0.313、0.205、0.167,P<0.05),与HDL-C、LVEF指标水平呈负相关(r_(s)=-0.214、-0.232,P<0.05)。NLR、PLR、MPV是T2DM患者合并LVH的独立影响因素(P<0.05)。NLR、PLR及MPV分别预测T2DM合并LVH的曲线下面积(AUC)为0.783(95%CI:0.723~0.844)、0.756(95%CI:0.692~0.819)、0.681(95%CI:0.610~0.751),最佳截断值分别为1.97、97.37、11.15 fL,灵敏度分别为87.4%、84.5%、62.1%,特异度分别为61.9%、57.5%、61.8%。结论T2DM合并LVH患者中NLR、PLR、MPV水平明显升高,NLR、PLR、MPV可作为T2DM合并LVH的预测指标,NLR的预测价值优于PLR和MPV。

Objective To investigate the correlations between type 2 diabetes(T2DM)patients with left ventricular hypertrophy(LVH)and neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),mean platelet volume(MPV).Methods A total of 216 patients with T2DM were enrolled in the study.According to left ventricular mass index(LVMI),these patients were divided into LVH group(n=103)and non-LVH group(n=113).The general clinical data,blood routine indicators,and biochemical indicators of the two groups were compared.Results The levels of triglycerides(TG),NLR,PLR,MPV and 24h urine protein,albumin-to-creatinine ratio(UACR)in the LVH group were higher than those in the non-LVH group,high-density lipoprotein cholesterol(HDL-C)and left ventricular ejection fraction(LVEF)levels were lower than that of the non-LVH group(P<0.05).T2DM combined with LVH was positively correlated with TG,NLR,PLR,MPV and 24 h urine protein and UACR index levels(r_(s)=0.192,0.490,0.442,0.313,0.205,0.167,P<0.05),and was negatively correlated with HDL-C and LVEF index levels(r_(s)=-0.214,-0.232,P<0.05).NLR,PLR and MPV are independent influencing factors of T2DM patients with LVH(P<0.05).The areas under the curve(AUC)of NLR,PLR and MPV forecasted T2DM with LVH were 0.783(95%CI,0.723 to 0.844),0.756(95%CI,0.692 to 0.819)and 0.681(95%CI,0.610 to 0.751)respectively,the best cut-off values were 1.97,97.37 and 11.15 fL respectively,the sensitivities were 87.4%,84.5% and 62.1%,and the specificities were 61.9%,57.5% and 61.8%.Conclusion The levels of NLR,PLR and MPV in T2DM patients with LVH are significantly increased.NLR,PLR,and MPV can be used as predictors of T2DM combined with LVH,and the predictive value of NLR is better than PLR and MPV.