外周血NLR和LMR与2型糖尿病患者颈动脉粥样硬化的关系  

ASSOCIATION OF PERIPHERAL BLOOD NEUTROPHIL-TO-LYMPHOCYTE RATIO AND LYMPHOCYTE-TO-MONOCYTE RATIO WITH CAROTID ATHEROSCLEROSIS IN PATIENTS IN TYPE 2 DIABETES MELLITUS

作　　者：邓志莹 郭宗君[1] 廖萍萍 唐思思 王超[1] DENG Zhiying;GUO Zongjun;LIAO Pingping;TANG Sisi;WANG Chao(Department of Geriatrics,The Affiliated Hospital of Qingdao University,Qingdao 266100,China)

机构地区：[1]青岛大学附属医院老年医学科,山东青岛266100

出　　处：《精准医学杂志》2023年第5期455-459,共5页Journal of Precision Medicine

基　　金：中央引导地方科技发展专项计划项目(21-1-2-2-zyyd-nsh);青岛市社会科学规划项目(QDSKL2201376);山东省老年医学学会科技项目(LKJGG2021Z013)。

摘　　要：目的探讨血浆中中性粒细胞/淋巴细胞比值(NLR)、淋巴细胞/单核细胞比值(LMR)与2型糖尿病(type 2 diabete mellitus,T2DM)颈动脉粥样硬化(CAS)的关系。方法选择2021年8月—2022年10月就诊于我院内分泌科及保健科的211例T2DM患者作为试验组,根据是否合并CAS将试验组患者分为CAS组(136例)和非CAS组(75例);另选取同期我院健康体检中心的47例健康体检者作为对照组。收集并比较3组患者的一般资料及血常规、血生化等实验室检查结果,采用Pearson相关分析法分析血浆NLR、LMR与T2DM CAS患者各临床指标的相关性,采用多因素logistic回归分析T2DM患者CAS的影响因素。结果3组受试者的年龄、体质量指数、病程、收缩压、血浆中的中性粒细胞计数、淋巴细胞计数、单核细胞计数、NLR、LMR及空腹血糖(FBG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平比较差异有显著性(χ^(2)=33.651、14.038,F=4.714~68.693,H=6.192~112.809,P<0.05)。Pearson相关分析显示,试验组患者血浆NLR与FBG、HbA1c水平呈正相关性(r=0.232、0.273,P<0.05);试验组患者血浆LMR与HDL-C水平呈正相关性(r=0.155,P<0.05),与病程、收缩压及血浆TC、FBG、HbA1c水平呈负相关性(r=-0.353~-0.131,P<0.05)。多因素logistic回归分析显示,年龄、病程、LMR、NLR和HbA1c均为T2DM CAS的影响因素(P<0.05);受试者工作特征曲线示血浆NLR、LMR水平评估T2DM患者合并CAS风险的曲线下面积均>0.70,评估价值较高。结论T2DM人群中血浆NLR和LMR水平与CAS的发生显著相关,利用血浆NLR、LMR水平在一定程度上可以预测T2DM合并CAS的发生。Objective To investigate the association of plasma neutrophil-to-lymphocyte ratio(NLR)and lymphocyte-to-monocyte ratio(LMR)with carotid atherosclerosis(CAS)in type 2 diabetes mellitus(T2DM).Methods A total of 211 T2DM patients who attended Department of Endocrinology and Department of Health Care in our hospital from August 2021 to October 2022 were enrolled as experimental group,and according to the presence or absence of CAS,the experimental group was further divided into CAS group with 136 patients and non-CAS group with 75 patients.A total of 47 individuals who underwent physical examination in Physical Examination Center of our hospital during the same period of time were enrolled as control group.The three groups were compared in terms of general information and laboratory examination results including routine blood test and blood biochemistry.The Pearson correlation analysis was used to investigate the correlation of NLR and LMR with the clinical indices of T2DM patients with CAS,and the multivariate logistic regression analysis was used to investigate the influence factors for CAS in T2DM patients.Results There were significant differences between the three groups in age,body mass index,course of disease,systolic pressure,plasma neutrophil count,lymphocyte count,monocyte count,NLR,LMR,fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(χ^(2)=33.651,14.038,F=4.714-68.693,H=6.192-112.809,P<0.05).The Pearson correlation analysis showed that in the experimental group,plasma NLR was positively correlated with FBG and HbA1c(r=0.232,0.273,P<0.05);plasma LMR was positively correlated with HDL-C(r=0.155,P<0.05)and was negatively correlated with course of di-sease,systolic pressure,TC,FBG,and HbA1c(r=-0.353--0.131,P<0.05).The multivariate logistic regression analysis showed that age,course of disease,LMR,NLR,and HbA1c were influence factors for CAS in T2DM patients(P<0.05),and the receiver operating char

关 键 词：糖尿病 2型 中性白细胞 淋巴细胞计数 颈动脉疾病 

分 类 号：R587.1[医药卫生—内分泌] R543.4[医药卫生—内科学]