中老年2型糖尿病患者中性粒细胞/淋巴细胞比值与颈动脉粥样硬化相关性的研究

The relationship between neutrophil/lymphocyte ratio and carotid atherosclerosis in middle-aged and elderly patients with type 2 diabetes mellitus

目的探讨中老年T2DM患者中性粒细胞/淋巴细胞比值(NLR)与颈动脉粥样硬化(CAS)的相关性。方法选取2018年12月至2020年12月于上海交通大学附属第六人民医院南院内分泌代谢科住院治疗的中老年T2DM患者478例。根据颈动脉内膜中层厚度(CIMT)分为CIMT<1.0 mm组(n=125)、1.0≤CIMT<1.5 mm组(n=117)及CIMT≥1.5 mm组(n=236)。比较各组一般资料及生化指标。Spearman相关分析NLR与其他指标的相关性。Logistic回归分析CAS的影响因素。受试者工作特征(ROC)曲线评价NLR诊断CAS的效能。结果与CIMT<1.0 mm组比较,1.0≤CIMT<1.5 mm、CIMT≥1.5 mm组NLR升高(P<0.05)。Spearman相关分析显示,NLR与年龄、脉压、TG、LDL-C、FC-P及C-RP呈正相关(P<0.05或P<0.01),与HbA1c呈负相关(P<0.01)。Logistic回归分析显示,NLR是中老年T2DM患者CAS的影响因素。ROC曲线分析显示,NLR预测CAS的曲线下面积为0.661,切点为1.63时的灵敏度为88.4%,特异度为48.8%,诊断效能最高。结论NLR升高与中老年T2DM患者CAS发生风险密切相关。

Objective To investigate the relationship between neutrophil/lymphocyte ratio and carotid atherosclerosis(CAS)lesions in middle-aged and elderly patients with type 2 diabetes mellitus(T2DM).Methods478 middle-aged and elderly T2DM patients hospitalized in the Department of Endocrinology,Sixth People's Hospital,Shanghai Jiao Tong University from December 2018 to December 2020 were selected.The carotid intima-medial thickness(CIMT)was grouped according to color Doppler ultrasound measurements(CIMT1.0 mm group,n=125;1.0≤CIMT1.5 mm group,n=117;CIMT≥1.5 mm,n=236).General data and blood biochemistry were collected.Spearman correlation analysis was used to evaluate the correlation between NLR and clinical indicators.Logistic regression was used to analyze the influencing factors of CAS.Receiver operating characteristic(ROC)curve was used to evaluate the efficacy of NLR in diagnosing CAS lesions.ResultsCompared with CIMT1.0 mm group,NLR levels were elevated in 1.0≤CIMT1.5 mm group and CIMT≥1.5mm group(P<0.05).Spearman correlation analysis showed that NLR was positively correlated with age,PP,TG,LDL-C,FC-P and C-RP(P<0.05 or P<0.01),and negatively correlated with HbA_1c(P<0.01).Logistic regression analysis showed that NLR was an independent influencing factor for CAS lesions in middle-aged and elderly T2DM patients.ROC curve showed that the area under the curve for predicting CAS by NLR was 0.661.The diagnostic efficacy was highest when the cut point of NLR was 1.63,with a sensitivity of 88.4%and a specificity of 48.8%.ConclusionElevated NLR is strongly associated with the risk of CAS lesions in middle-aged and elderly T2DM patients.