糖尿病周围神经病变患者血清中性粒细胞/淋巴细胞比值、β2微球蛋白水平与颈动脉内膜中层厚度的关系

Correlation of serum NLR and β2-MG with carotid intima media thickness in patients with diabetic peripheral neuropathy

目的 探讨糖尿病周围神经病变(DPN)患者血清中性粒细胞/淋巴细胞比值(NLR)、β2微球蛋白(β2-MG)与颈动脉内膜中层厚度(CIMT)的关系。方法 选取2019年9月至2021年3月于我院内分泌科收治的DPN患者246例,根据CIMT分为CIMT<1.0 mm组(n=122)和CIMT≥1.0 mm组(n=124)。比较各组血清NLR、β2-MG,受试者工作特征(ROC)曲线评估NLR、β2-MG预测DPN患者CIMT风险。结果 CIMT≥1.0 mm组血清NLR、β2-MG高于CIMT<1.0 mm组[(2.38±0.55)vs(1.91±0.32),(2.98±0.86)vs(2.33±0.62)mg/L,P<0.01]。Pearson相关分析显示,血清NLR、β2-MG与CIMT呈正相关(P<0.01)。Logistic回归分析显示,FPG、HbA1c、TG、NLR、β2-MG是DPN患者CIMT的危险因素,HDL-C是CIMT的保护因素。NLR的ROC曲线下面积(AUC)=0.862,截断值为1.751,敏感度为86.80%,特异度为82.50%,β2-MG的AUC=0.847,截断值为2.065 mg/L,敏感度为83.66%,特异度为84.00%;二者联合诊断的AUC=0.922,敏感度为90.00%,特异度为92.65%。结论 DPN患者血清NLR、β2-MG升高,可能共同参与动脉粥样硬化的发生发展,二者联合检测可用于诊断DPN患者CIMT。

Objective To investigate the relationship between serum neutrophil/lymphocyte ratio(NLR)and β2 microglobulin(β2-MG)and carotid intimamedia thickness(CIMT)in patients with diabetic peripheral neuropathy(DPN). Receiver operating characteristic(ROC)curve evaluation NLR,β2-MG predicts CIMT risk in DPN patients.Methods 246 patients with DPN were selected from September2019 to March 2021. According to the levels of CIMT,DPN patients were divided into CIMT < 1. 0 mm group(n=122)and CIMT≥1. 0 mm group(n=124). Serum NLR and β2-MG level and its predictive value for CIMT in patients with DPN were analyzed. Receiver operating characteristic(ROC)curve evaluation NLR, β2-MG predicts CIMT risk in DPN patients.Results Serum NLR,β2-MG in CIMT≥1. 0 mm group was higher than CIMT < 1. 0 mm group[(2. 38±0. 55)vs(1. 91±0. 32),(2. 98±0. 86)vs(2. 33±0. 62)mg/L,P<0. 01]. Pearson correlation analysis showed that serum NLR and β2-MG levels were positively correlated with CIMT(P<0. 01). Logistic regression analysis showed that FPG,HbA1c,TG,NLR,β2-MG were the risk factors of CIMT in patients with DPN and HDL-C was the protective factor of CIMT. The area under the ROC curve(AUC)of NLR is 0. 862,the cutoff point is 1. 751,the sensitivity is86. 80%,and the specificity is 82. 50%,AUC of β2-MG is 0. 847,the cutoff point is 2. 065 mg/L,the sensitivity is 83. 66%,and the specificity is 84. 00%;AUC of the combined diagnosis was 0. 922,the sensitivity was90. 00%,and the specificity was 92. 65%,both of which were better than the single detection.Conclusion The increase of serum NLR and β2-MG may participate in the occurrence and development of atherosclerosis.The combined detection of NLR,β2-MG can be used for the clinical diagnosis of CIMT in DPN patients.