系统免疫炎症指数与2型糖尿病下肢血管病变的相关性研究

Correlation between systemic immune-inflammation index and lower extremity vascular disease in patients with type 2 diabetes mellitus

目的探讨系统免疫炎症指数(systemic immune-inflammation index,SII)与2型糖尿病(type 2 diabetes mellitus,T2DM)患者下肢血管病变的关系。方法采用横断面研究设计,收集2013年1月至2024年1月在我科诊治的390例T2DM患者资料,根据T2DM下肢血管病变诊断标准分为T2DM有下肢血管病变组(n=158)和无下肢血管病变对照组(n=232),分析2组之间的一般资料、实验室检查结果等差异。采用Spearman相关分析研究与T2DM下肢血管病变的相关因素。采用Row Mean Scores和Cochran-Armitage Trend检验研究SII与T2DM下肢血管病变的关系。采用多因素“向前:LR”Logistic回归分析研究T2DM下肢血管病变的危险因素。采用受试者工作特征曲线评估SII对T2DM下肢血管病变的诊断效能。结果与无下肢血管病变的T2DM患者相比,T2DM下肢血管病变患者的年龄较大,总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)和SII水平较高,颈动脉血管病变的比例增加,未服用他汀类药物占比增加。下肢血管病变与SII/100(r=0.429,P<0.001)、年龄(r=0.517,P<0.001)、TC(r=0.161,P=0.001)、LDL-C(r=0.117,P=0.021)、颈动脉病变(r=0.101,P=0.047)、未服用他汀类药物(r=0.266,P<0.001)呈正相关。Logistic回归分析显示,SII、年龄、LDL-C、未服用他汀类药物是T2DM下肢血管病变的危险因素(P<0.01)。SII联合年龄、LDL-C和未服用他汀类药物预测T2DM下肢血管病变的曲线下面积为0.896。结论SII不仅是T2DM下肢血管病变的危险因素,也是反映T2DM下肢血管病变的简便标志物,提示炎症反应对T2DM的下肢血管病变发生发展具有重要作用。

ObjectiveTo investigate the relationship between systemic immune-inflammation index(SII)and lower extremity vascular disease in patients with type 2 diabetes mellitus(T2DM).MethodsA cross-sectional study was conducted on 390 T2DM patients admitted in our department from January 2013 to January 2024.According to the diagnostic criteria for lower extremity vascular disease in T2DM patients,they were divided into a lower extremity vascular disease group(n=158)and a control group(n=232).General data and results of laboratory tests were compared between the 2 groups.Spearman correlation analysis was used to identify the related factors for lower extremity vascular diseases in T2DM patients.The correlation between SII and lower extremity vascular diseases in T2DM patients was analyzed using the Row Mean Scores and Cochran-Armitage Trend analysis.Multivariate logistic regression analysis was applied to identify the risk factors for lower limb vascular lesions in T2DM patients.Receiver operating characteristic(ROC)curve was plotted to evaluate the diagnostic efficacy of SII for lower extremity vascular disease in the patients.ResultsCompared with T2DM patients without lower extremity vascular disease,those with lower extremity vascular disease were older,had higher levels of total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),SII,larger proportion of carotid vascular lesions,and increased proportion of no-taking statins.The lower extremity vascular disease in T2DM patients was positively correlated with SII/100(r=0.429,P<0.001),age(r=0.517,P<0.001),TC(r=0.161,P=0.001),LDL-C(r=0.117,P=0.021),carotid artery lesions(r=0.101,P=0.047),no-taking statins(r=0.266,P<0.001).Logistic regression analysis showed that SII,age,LDL-C,and no-taking statins were the risk factors for lower extremity vascular lesions in T2DM patients(P<0.01).The area under the curve(AUC)value of SII combined with age,LDL-C,and no-taking statins in predicting lower extremity vascular disease in T2DM patients was 0.896.ConclusionSII is not only a risk factor,but also a simple marker for lower extremity vascular disease in T2DM patients,suggesting that inflammatory response plays an important role in the occurrence and development of lower extremity vascular disease in T2DM.