SIRI在评估2型糖尿病患者微量清蛋白尿发生风险中的价值  

Estimate of the incidence of microalbuminuria in patients with type 2 diabetes mellitus by SIRI

作　　者：王松姣 王思颖 张宇晨 杨大勇 周斌武[1] 龚国富[1] WANG Songjiao;WANG Siying;ZHANG Yuchen;YANG Dayong;ZHOU Binwu;GONG Guofu(Department of Clinical Laboratory,Ezhou Central Hospital,Ezhou,Hubei 436000,China)

机构地区：[1]鄂州市中心医院检验科,湖北鄂州436000

出　　处：《国际检验医学杂志》2023年第3期336-340,共5页International Journal of Laboratory Medicine

摘　　要：目的探讨全身性炎症反应指数(SIRI)在评估2型糖尿病(T2DM)患者微量清蛋白尿发生风险中的价值。方法收集2021年5月至2022年5月在湖北省鄂州市中心医院就诊的115例单纯T2DM患者(NA组)和297例T2DM合并微量清蛋白尿患者(MA组)的临床及实验室资料。比较两组间SIRI水平,并采用Logistic回归分析筛选与微量清蛋白尿发生相关的变量。根据临床危险因素单独或联合SIRI建立的预测模型,绘制受试者工作特征曲线(ROC)。采用DeLong方法、净重新分类指数(NRI)和整体鉴别指数(IDI)评价SIRI在预测微量清蛋白尿风险方面的改善效果。结果两组患者SIRI比较差异有统计学意义(P<0.001)。在调整混杂因素后,T2DM患者中SIRI每增加一个标准差,微量清蛋白尿的风险就增加3.695倍。ROC分析显示,SIRI纳入已建立的微量清蛋白尿危险因素模型时,ROC曲线下的面积显著提高(P=0.005),NRI和IDI均显示有显著改善(P<0.001)。结论SIRI与微量清蛋白尿之间存在明显的相关性,SIRI可能是优化T2DM患者微量清蛋白尿风险分层评估的可靠工具。Objective To investigate the value of systemic inflammatory response index(SIRI)in assessing microalbuminuria in type 2 diabetes mellitus(T2DM)patients.Methods Clinical and laboratory examination data of 115 T2DM patients with normoalbuminuria(NA group)and 297 T2DM patients with microalbuminuria(MA group)who visited Ezhou Central Hospital of Hubei Province from May 2021 to May 2022 were collected.SIRI levels were compared between the two groups,and Logistic regression analysis was used to screen variables associated with the occurrence of microalbuminuria.The receiver operating characteristic(ROC)curves were analyzed based on the prediction models established by clinical risk factors simply or combined with SIRI.The DeLong method,net reclassification index(NRI),and integrated discrimination improvement(IDI)were used to evaluate the improvement of SIRI in predicting the risk of microalbuminuria.Results SIRI level was significantly different between MA and NA groups(P<0.001).After adjusting for confounders,each SD increase of SIRI in T2DM patients caused a 3.695-fold additional risk for microalbuminuria.ROC analysis showed that the area under the ROC curve was significantly higher when SIRI was included in the established risk factor model for microalbuminuria(P=0.005).The NRI(P<0.001)and IDI(P<0.001)showed significant improvement.Conclusion A clear association was found between the SIRI and microalbuminuria in T2DM patients.SIRI may be a quick and reliable tool to optimize risk stratification and prevention of microalbuminuria in patients with T2DM.

关 键 词：微量清蛋白尿 2型糖尿病 炎症 全身性炎症反应指数 

分 类 号：R446.1[医药卫生—诊断学]