中性粒细胞/淋巴细胞比值与2型糖尿病患者肾小管损伤的相关性研究  

Association between neutrophil to lymphocyte ratio and renal tubular injury in type 2 diabetes mellitus patients

作　　者：姜莹莹 王靖宇[1] 孔岩[1] 王颖[1] 程静丽[1] 王珊珊 单春艳[1] JIANG Yingying;WANG Jingyu;KONG Yan;WANG Ying;CHENG Jingli;WANG Shanshan;SHAN Chunyan(NHC Key Laboratory of Hormones and Development,Tianjin Key Laboratory of Metabolic Diseases,Chu Hsien-I Memorial Hospital&Tianjin Institute of Endocrinology,Tianjin Medical University,Tianjin 300134,China)

机构地区：[1]天津医科大学朱宪彝纪念医院天津市内分泌研究所国家卫健委激素与发育重点实验室天津市代谢性疾病重点实验室,300134

出　　处：《天津医药》2022年第1期83-87,共5页Tianjin Medical Journal

摘　　要：目的探讨中性粒细胞/淋巴细胞比值(NLR)与2型糖尿病(T2DM)患者肾小管损伤的关系。方法选取T2DM患者258例,测定中性粒细胞、淋巴细胞绝对值,计算NLR;采用免疫透射比浊法测定24 h尿微量白蛋白(24 h UMA);测定肾小管标志物β2-微球蛋白(β2-MG)、β-半乳糖苷酶(GAL)、视黄醇结合蛋白(RBP)、N-乙酰-β-D-葡萄糖苷酶(NAG),以上4种标志物均正常者视为肾小管功能正常,任意1种或以上标志物超过上限视为肾小管功能受损。根据肾小管功能是否受损将患者分为正常组142例,受损组116例,比较2组间NLR水平差异。根据存在任意1种、2种、3种肾小管标志物异常将肾小管功能受损组进行分组,比较各亚组间NLR水平差异。另外,分析NLR与β2-MG、GAL、RBP、NAG的相关性。采用二分类Logistic回归分析T2DM患者肾小管损伤的影响因素。结果受损组NLR水平高于正常组(P<0.05)。随着肾小管标志物异常种类增多、肾小管损伤程度加重,NLR水平逐渐升高(P<0.05)。NLR与β2-MG、GAL、RBP、24 h UMA具有正相关性(r分别为0.191、0.152、0.131及0.158,P<0.05)。Logistic回归分析结果显示,较高水平NLR、24 h UMA是T2DM患者肾小管损伤的危险因素,而较高水平的HDL-C为其保护因素。结论NLR与T2DM患者肾小管损伤关系密切,可以反映肾小管损伤程度。Objective To investigate the association between neutrophil to lymphocyte ratio(NLR) and renal tubular injury in type 2 diabetes mellitus patients(T2 DM).Methods A total of 258 patients with T2 DM were selected in this study.Data of the general data,the absolute values of neutrophils and lymphocytes were collected.The NLR was calculated.The 24 h urinary microalbumin(24 h UMA) and renal tubular markers β_(2)-microglobulin(β_(2)-MG),β-galactosidase(GAL),and retinol-binding protein(RBP),N-acetyl-β-D-glucosidase(NAG) were detected by immunity transmission turbidity.The renal tubular function was considered as the normal if the above four markers were normal.If any one or more markers exceed the upper limit,it was regarded as renal tubular injury.The patients were divided into the normal group(n=142) and the injury group(n=116) according to whether the renal tubular function was impaired.The difference of NLR levels was compared between the two groups.According to the presence of any one,two and three types of renal tubular marker abnormalities,the patients in the injury group were divided into subgroups,and the differences of NLR levels were compared between the subgroups.In addition,the correlation between NLR and β_(2)-MG,GAL,RBP and NAG was analyzed.Binary Logistic regression was used to analyze the influencing factors of renal tubular injury in patients with T2 DM.Results The level of NLR was significantly higher in the injury group than that of the normal group(P<0.05).The level of NLR increased gradually with the increase of abnormal types of renal tubular markers and the aggravation of the renal tubular damage(P<0.05).NLR was positively correlated with β_(2)-MG,GAL,RBP and 24 h UMA(r=0.191,0.152,0.131 and 0.158,P<0.05).Logistic regression analysis showed that the higher levels of NLR and 24 h UMA were risk factors for renal tubular injury in patients with T2 DM,and the higher level of HDL-C was its protective factor.Conclusion NLR is closely related to renal tubular injury in patients with T2 DM,and whic

关 键 词：糖尿病 2型 糖尿病肾病 Β2微球蛋白 β半乳糖苷酶类 视黄醇结合蛋白质类 乙酰氨基葡糖苷酶 中性粒细胞/淋巴细胞比值 肾小管损伤 

分 类 号：R587.24[医药卫生—内分泌]