2型糖尿病患者中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值、单核细胞与淋巴细胞比值、C反应蛋白与泌汗功能的相关性研究

Association between neutrophil-lymphocyte ratio or platelet-lymphocyte ratio or macrophage-lymphocyte ratio or C-reactive protein and sudomotor function in type 2 diabetes mellitus

目的探讨T2DM患者中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、单核细胞与淋巴细胞比值(MLR)、C-RP与泌汗功能的相关性。方法选取2020年1~12月于河北省人民医院内分泌科住院的T2DM患者404例。根据双手皮肤电导率(HESC)和双足皮肤电导率(FESC)分为泌汗功能正常组(Con,n=250)、中度异常组(M,n=115)和重度异常组(S,n=39)。分析NLR、PLR、C-RP与泌汗功能的相关性。结果Con、M、S组年龄、血肌酐(Scr)、C-RP、NLR、PLR、MLR依次升高(P<0.05),eGFR、HESC、FESC依次降低(P<0.05)。Spearman相关分析显示,HESC、FESC与eGFR呈正相关(P<0.01),与年龄、DM病程、BUN、Scr、血尿酸、NLR、PLR、MLR、C-RP呈负相关(P<0.05)。Logistic回归分析显示,NLR、PLR、C-RP是T2DM患者泌汗功能的影响因素。受试者工作特征(ROC)曲线显示,NLR、PLR、C-RP判定HESC和FESC>60μs的ROC曲线下面积分别为0.732、0.658、0.816,NLR、PLR、C-RP对DM合并泌汗功能异常有重要诊断价值。当NLR、PLR、C-RP水平切点分别为2.085、128.125、3.585时,其诊断效率最高,灵敏度分别为74.7%、61.0%、61.7%,特异度分别为61.6%、61.2%、85.2%。结论T2DM患者NLR、PLR、C-RP水平升高与泌汗功能障碍密切相关,是重要影响因素。

Objective To investigate the association between neutrophil-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),macrophage-lymphocyte ratio(MLR)or C-reactive protein and sudomotor function in patients with type 2 diabetes mellitus(T2DM).Methods A total of 404 patients with T2DM who were hospitalized in The Hebei General Hospital from January 2020 to December 2020 were assigned to three groups according to electrochemical skin conductance:normal sudomotor function(Con group,n=250),mild abnormal sudomotor function(M group,n=115)and severely abnormal sudomotor function group(S group,n=39).The relationship between inflammatory index and ESC were analyzed.Results Ages,Scr,C-RP,NLR,PLR,and MLR were gradually increased(P<0.05),while eGFR,HESC and FESC were gradually decreased in Con,M and S group(P<0.05).Spearman correlation analysis showed that HESC and FESC were positively correlated with eGFR(P<0.01)and negatively correlated with NLR,PLR,MLR,C-RP,duration of diabetes,BUN,Scr,SUA(P<0.05).Logistic regression analysis showed that NLR,PLR,and C-RP were independent risk factors for sudomotor dysfunction.In addition,ROC curve analyses showed that the AUC of NLR,PLR and C-RP in predicting ESC>60μs were 0.732,0.658,0.816,respectively.The diagnostic efficiency was the highest when NLR was 2.085 or PLR was128.125 or C-RP was 3.585.And the sensitivities were 74.7%,61.0%,61.7%,respectively;the specificities were 61.6%,61.2%,85.2%,respectively.Conclusion The level of NLR,PLR and C-RP were important influencing factors for sudomotor function,and closely related to it in patients with T2DM.