单核细胞/高密度脂蛋白胆固醇比值与糖尿病足溃疡的相关性分析

Analysis on correlation between monocyte to high density lipoprotein-cholesterol ratio and diabetic foot ulcer

目的分析新型炎症指标单核细胞/高密度脂蛋白胆固醇比值(MHR)与糖尿病足溃疡(DFU)的关系.方法回顾性分析我院120例糖尿病患者的临床资料,其中单纯糖尿病40例,DFU80例作为研究对象,记录年龄、病程、体质量、血压、血常规、糖脂代谢、肝肾功能、CRP等指标,以及足溃疡感染严重程度.分析MHR与DFU之间的关系;logistic回归模型分析DFU的影响因素;ROC曲线评价MHR预测DFU的最佳截断值及其特异性和敏感性.结果DFU组年龄较大,BMI、TG、ALB、淋巴细胞、Hb较低,CRP、单核细胞、MHR均较高;Spearman相关分析显示MHR与年龄、WBC、中性粒细胞、血肌酐、CRP正相关,与Hb、TC、LDL、ALB负相关;二元logistic回归分析显示,MHR是DFU重要的危险因素[OR=10.191(95%CI:2.023,51.349),P=0.005].对DFU的预测价值,受试者工作特征曲线分析显示,MHR最佳截断值为0.6139,MHR的曲线下面积为0.663(95%CI:0.560,0.766),预测的敏感性为53.7%、特异性为86.1%.CRP最佳截断值为3.5800,CRP的曲线下面积为0.791(95%CI:0.706,0.876),预测的敏感性为68.7%,特异性为83.3%.结论MHR与DFU的发生发展密切相关,临床上关注MHR对预测糖尿病患者发生糖尿病足可能具有一定的临床指导意义.

Objective To analyze the relationship between monocyte to high density lipoprotein-cholesterol ratio, a novel inflammatory marker, and diabetic foot ulcer.Methods A retrospective study on clinic data of 120 patients with diabetes who were hospitalized in Zhangzhou Municipal Hospital was conducted, including 40 patients with diabetes alone and 80 patients with diabetic foot ulcer.Age, disease duration, weight, blood pressure, blood routine, glucose and lipids metabolism, hepatic and renal function, C-reactive protein(CRP) and other indexes, and the severity of foot ulcer infection were recorded.The relationship between MHR and diabetic foot ulcer was analyzed.Logistic regression model was used to analyze the influencing factors of diabetic foot ulcer.ROC curve was used to evaluate the optimal cut-off value, specificity and sensitivity of MHR in predicting diabetic foot ulcers.Results Diabetic foot ulcer group was older with lower BMI,TG,ALB,Lymphocyte, Hb and higher CRP,Monocyte, MHR.Spearman correlation analysis showed that MHR was positively correlated with age, WBC,Neutrophils, serum creatinine and CRP,and negatively correlated with Hb, TC, LDL and ALB.Binary logistic regression analysis showed that MHR was independent risk factor for diabetic foot ulcer[OR=10.191(95%CI:2.023,51.349),P=0.005].Receiver operating characteristic curve analysis showed that the optimal cut-off value of MHR for predicting diabetic foot ulcer was 0.613 9,the area under the curve of MHR was 0.663(95%CI: 0.560,0.766),the sensitivity of prediction was 53.7%,and the specificity was 86.1%.The optimal cutoff value of CRP was 3.5800,the area under the curve of CRP was 0.791(95%CI: 0.706,0.876),the sensitivity of prediction was 68.7%,and the specificity was 83.3%.Conclusion MHR is closely related to the occurrence and development of diabetic foot ulcers.Clinical attention to MHR may have certain clinical guiding significance for predicting the occurrence of diabetic foot in diabetic patients.