NLR、uACR、Homa-islet与早期2型糖尿病视网膜病变的相关性分析  

Correlation Analysis Between NLR、uACR、Homa-islet and Early Type 2Diabetic Retinopathy

作　　者：汤胜楠 翁孝刚[2] TANG Shengnan;WENG Xiaogang(the Third Clinical College of Xinxiang Medical University,Xinxiang 453000,China;Department of Endocrinology,the Third Affiliated Hospital of Xinxiang Medical College,Xinxiang 453000,China)

机构地区：[1]新乡医学院第三临床学院,河南新乡453000 [2]新乡医学院第三附属医院内分泌科,河南新乡453000

出　　处：《河南医学研究》2021年第18期3297-3301,共5页Henan Medical Research

摘　　要：目的探讨中性粒细胞与淋巴细胞比值(NLR)、尿微量白蛋白与肌酐比值(uACR)、改良胰岛功能指数(Homa-islet)与早期2型糖尿病(T2DM)视网膜病变的相关性,评估NLR、uACR、Homa-islet对早期T2DM视网膜病变的诊断价值。方法收集2019年6月至2020年8月新乡医学院第三附属医院内分泌科收治的216例T2DM患者的一般资料及实验室指标,根据眼底检查结果分为T2DM组(T2DM未合并视网膜病变,94例)和糖尿病视网膜病变(DR)组(T2DM合并早期视网膜病变,122例)。比较两组的一般资料及实验室指标,包括NLR、uACR、Homa-islet等指标在两组间的差异,分析NLR、uACR、Homa-islet与DR的相关性,采用二元logistic回归分析DR的危险因素,应用受试者工作特征(ROC)曲线评价NLR、uACR、Homa-islet对DR的诊断价值。结果两组间收缩压(SBP)、NLR、uACR、Homa-islet等指标比较,差异有统计学意义(P<0.05)。两组间肌酐、尿酸、胱抑素C、总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白比较,差异无统计学意义(P>0.05)。相关性分析结果显示,SBP、NLR、uACR与DR的发生呈正相关,Homa-islet与DR的发生呈负相关。二元logistic分析显示SBP、uACR、NLR为DR的危险因素,Homa-islet为DR的保护性因素(P<0.05)。ROC曲线分析显示,NLR、uACR、Homa-islet及3项指标联检诊断DR的曲线下面积(AUC)分别为0.725、0.654、0.754、0.820,3项指标联检诊断效能优于NLR、uACR、Homa-islet单项检测,差异有统计学意义(P<0.05)。结论 NLR、uACR、Homa-islet与DR的发生和发展有显著相关性,NLR、uACR均为早期DR的危险因素,Homa-islet为DR的保护因素,且3项指标联合检测对早期DR的诊断价值优于各指标单项检测。Objective To investigate the relationship between neutrophil to lymphocyte ratio(NLR),urinary microalbumin to creatinine ratio(uACR),modified islet function index(Homa-islet)and early type 2 diabetic(T2DM)retinopathy,and to evaluate the diagnostic value of these three factors for early T2DM retinopathy.Methods The general data and laboratory indexes of 216 T2DM patients who were admitted to the endocrine department of the Third Affiliated Hospital of Xinxiang Medical College from June 2019 to August 2020 were collected.According to the results of fundus examination,they were divided into T2DM group(94 patients with T2DM without retinopathy)and diabetic retinopathy(DR)group(122 patients with type 2 diabetes mellitus with early retinopathy).The general data and laboratory indexes of the two groups were compared.The differences of NLR,uACR,Homa-islet between the two groups were compared.The relationship between NLR,uACR,Homa-islet and DR were analyzed.The risk factors of DR were analyzed by binary logistic regression.The diagnostic value of NLR,uACR,Homa-islet for DR were evaluated by receiver operating characteristic(ROC)curve.Results Systolic blood pressure(SBP),NLR,uACR and Homa-islet were different between the two groups,and the differences were statistically significant(P<0.05).There were no significant differences in creatinine,uric acid,Cystatin C,total cholesterol,triglyceride,low density lipoprotein and high density lipoprotein between the two groups(P>0.05).Correlation analysis showed that SBP,NLR,uACR were positively correlated with the occurrence of DR,while Homa-islet was negatively correlated with the occurrence of DR.Binary logistic analysis showe that SBP,uACR and NLR were risk factors of DR,and Homa-islet was protective factor of DR(P<0.05).ROC curve analysis showe that the area under the curve(AUC)of NLR,uACR,Homa-islet and the combined detection of the three indicators in the diagnosis of DR were 0.725,0.654,0.754 and 0.820,respectively.The diagnostic efficiency of the combined detection of the th

关 键 词：2型糖尿病 糖尿病视网膜病变 中性粒细胞与淋巴细胞比值 尿微量白蛋白与肌酐比值 改良胰岛功能指数 

分 类 号：R587.1[医药卫生—内分泌]