摘要
目的:探讨中性粒细胞与淋巴细胞比值(NLR)在2型糖尿病(T2DM)合并糖尿病肾病(DKD)患者中的变化及其应用价值。方法:纳入T2DM患者376例,根据尿白蛋白与肌酐比值(UACR)分为单纯DM组(正常蛋白尿)、早期DKD组(微量白蛋白尿)和临床DKD组(大量白蛋白尿)。收集各组患者基本资料和实验室指标,分析NLR等指标在各组间的差异及与早期DKD的相关性。采用Logistic回归分析DKD蛋白尿的独立危险因素。绘制受试者工作特征(ROC)曲线评价NLR对早期DKD的预测价值。结果:NLR随蛋白尿增加而升高,早期DKD组和临床DKD组NLR均高于单纯DM组,且临床DKD组高于早期DKD组(均P<0.05)。Spearman相关分析显示,NLR与24 h尿蛋白及反应肾小管损伤的指标(尿ALB、尿β2-MG)呈显著正相关(r_(s)=0.377、0.256、0.279,均P<0.05),与eGFR呈显著负相关(r_(s)=-0.323,P=0.001)。Logistic回归分析表明NLR是DKD蛋白尿的独立危险因素(P=0.002)。ROC曲线分析结果提示NLR对早期DKD有重要的诊断价值(AUC=0.817,95%CI:0.740~0.894,P<0.001);当NLR临界值为2.9669时,其诊断效能最高,灵敏度为57.90%,特异度为91.10%。结论:NLR升高与DKD密切相关,是DKD的独立危险因素,监测NLR可用于预测评估DKD病情进展。
Objective:To investigate the changes of neutrophil to lymphocyte ratio(NLR)in patients with type 2 diabetes(T2DM)and diabetic kidney disease(DKD)and its application value.Methods:376 patients with T2DM were enrolled and divided into simple DM group(normal albuminuria),early DKD group(microalbuminuria)and clinical DKD group(major albuminuria)according to UACR.The basic data and laboratory indicators of patients in each group were collected,and the differences of NLR and other indicators among the groups and their correlation with early DKD were analyzed.Logistic regression was used to analyze the independent risk factors of DKD proteinuria.Draw ROC curve was used to evaluate the predictive value of NLR for early DKD.Results:NLR increased with the increase of proteinuria.The NLR of the early DKD group and the clinical DKD group were higher than that of the simple DM group,and the clinical DKD group was higher than the early DKD group(all P<0.05).Spearman correlation analysis showed that NLR was significantly positively correlated with 24 hours urine protein and indicators of renal tubular damage(urinary ALB,urineβ2-MG)(r_(s)=0.377,0.256,0.279,all P<0.05),and significantly negatively correlated with eGFR(r_(s)=-0.323,P=0.001).Logistic regression analysis showed that NLR was an independent risk factor for DKD proteinuria(P=0.002).ROC curve analysis results suggested that NLR had important diagnostic value for early DKD(AUC=0.817,95%CI:0.740-0.894,P<0.001);when the NLR cut-off value was 2.9669,its diagnostic efficiency was the highest,with a sensitivity of 57.90%and the specificity of 91.10%.Conclusion:The increase of NLR is closely related to DKD and is the risk factor for DKD.Monitoring NLR can be used to predict and evaluate the progress of DKD.
作者
闫妮
刘玲娇
余湘尤
李婧
YAN Ni;LIU Lingjiao;YU Xiangyou;LI Jing(Department of Rheumatology Immunology,Shaanxi Provincial People’s Hospital,Xi’an 710068,China)
出处
《陕西医学杂志》
CAS
2021年第6期673-677,共5页
Shaanxi Medical Journal
基金
国家自然科学基金资助项目(81700735)。
关键词
2型糖尿病
糖尿病肾病
中性粒细胞与淋巴细胞比值
蛋白尿
相关性
预测
Type 2 diabetes mellitus
Diabetic kidney disease
Neutrophil-to-lymphocyte ratio
Albuminuria
Correlation
Prediction
