NLR、MLR和MPVLR对2型糖尿病合并非酒精性脂肪性肝病的诊断价值  

Diagnostic value of NLR,MLR and MPVLR in type 2 diabetes with nonalcoholic fatty liver disease

作　　者：周颖[1] 窦家庆[1] ZHOU Ying;DOU Jiaqing(Department of Endocrinology,Affitiated Chaohu Hospital,Anhui Medical University,Chaohu 238000,CHINA)

机构地区：[1]安徽医科大学附属巢湖医院内分泌科,安徽巢湖238000

出　　处：《江苏医药》2023年第8期790-795,共6页Jiangsu Medical Journal

摘　　要：目的探讨新型炎症指标中性粒细胞/淋巴细胞比值(NLR)、单核细胞/淋巴细胞比值(MLR)和平均血小板体积/淋巴细胞比值(MPVLR)对2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)的诊断价值。方法330例T2DM患者根据腹部超声结果分成单纯T2DM组(A组,119例)和T2DM合并NAFLD组(B组,211例),比较两组临床资料。采用Pearson相关分析NLR、MLR及MPVLR与各临床指标的相关性。采用多因素logistic回归分析T2DM合并NAFLD的独立危险因素。绘制ROC曲线评估NLR、MLR及MPVLR对T2DM合并NAFLD的诊断价值。结果B组患者NLR、MLR和MPVLR均高于A组(P<0.05)。Pearson相关分析显示,NLR、MLR和MPVLR均与BMI、腰围、尿酸和胱抑素C呈正相关(P<0.05)。多因素logistic回归分析表明,NLR、MLR、BMI、腰围、TC和HOMA-IR升高是T2DM合并NAFLD的独立危险因素(P<0.05)。ROC曲线分析显示,NLR、MLR和MPVLR诊断T2DM合并NAFLD的AUC分别为0.861[95%CI(0.819~0.903),P<0.01]、0.949[95%CI(0.920~0.979),P<0.01]和0.782[95%CI(0.727~0.837),P<0.01]。结论NLR、MLR、MPVLR与T2DM患者合并NAFLD密切相关,可作为T2DM合并NAFLD早期筛查的简易指标。Objective To explore the diagnostic value of the novel inflammatory indexes including neutrophil/lymphocyte ratio(NLR),monocyte/lymphocyte ratio(MLR)and mean platelet volume/lymphocyte ratio(MPVLR)for type 2 diabetes mellitus(T2DM)with nonalcoholic fatty liver disease(NAFLD).Methods Based on abdominal ultrasound results,330 T2DM patients were divided into two groups of A(simple T2DM,119 cases)and B(T2DM combined with NAFLD,211 cases).The clinical data of the two groups were compared.Pearson correlation analysis was used to investigate the correlation between NLR,MLR and MPVLR with various clinical indicators.Multivariate logistic regression analysis was used to identify the independent risk factors for T2DM combined with NAFLD.ROC curve analysis was used to evaluate the diagnostic value of NLR,MLR and MPVLR for T2DM with NAFLD.Results The NLR,MLR and MPVLR of the patients in group B were higher than those in group A(P<0.05).Pearson correlation analysis showed that NLR,MLR and MPVLR were all positively correlated with BMI,waist circumference,uric acid,and cystatin C(P<0.05).Multivariate logistic regression analysis showed that increased NLR,MLR,BMI,waist circumference,TC and HOMA-IR were the independent risk factors for T2DM combined with NAFLD(P<0.05).ROC curve analysis showed that the AUC of NLR,MLR and MPVLR in diagnosing T2DM with NAFLD were 0.861[95%CI(0.819-0.903),P<0.01],0.949[95%CI(0.920-0.979),P<0.01]and 0.782[95%CI(0.727-0.837),P<0.01],respectively.Conclusion NLR,MLR and MPVLR are closely related to the occurrence of NAFLD in T2DM patients,and can be used as the simple indicators for early screening of T2DM combined with NAFLD.

关 键 词：中性粒细胞/淋巴细胞比值 单核细胞/淋巴细胞比值 平均血小板体积/淋巴细胞比值 2型糖尿病 非酒精性脂肪性肝病 

分 类 号：R587[医药卫生—内分泌]