单核细胞/高密度脂蛋白胆固醇比值与2型糖尿病肾脏疾病进展及预后的相关性研究  

Correlation of monocyte/high density lipoprotein cholesterol ratio with progression and prognosis of type 2 diabetic nephropathy

作　　者：姜楠 杨晓萍[1] 林智峰[1] 贾林[1] 杨锐[1] 张国锐[1] 袁茜宁 张春江[1] Jiang Nan;Yang Xiao-ping;Lin Zhi-feng;Jia Lin;Yang Rui;Zhang Guo-rui;Yuan Qian-ning;Zhang Chunjiang(Department of Nephrology,The First Affiliated Hospital of Shihezi University,Shihezi 832008,China)

机构地区：[1]石河子大学第一附属医院肾病科, 石河子 832008

出　　处：《临床肾脏病杂志》2024年第10期808-816,共9页Journal Of Clinical Nephrology

基　　金：石河子大学第一附属医院科技计划项目临床研究基金(LC202104)。

摘　　要：目的探讨单核细胞/高密度脂蛋白胆固醇比值(monocyte/high density lipoprotein cholesterol,MHR)与2型糖尿病肾脏疾病(diabetic kidney disease,DKD)进展及预后的关系。方法选取2017年1月1日至2022年12月31日在石河子大学第一附属医院肾病科确诊的269例2型DKD患者作为DKD组,同期在体检科选取269名健康体检者作为健康组,比较两组受试者MHR水平的差异。将269例DKD组患者按MHR中位数分为低水平MHR组和高水平MHR组,比较其一般资料和临床资料的差异,分析MHR水平与临床资料指标的相关性;比较两组患者终点事件的发生率,并比较不同预后DKD患者的基线肾功能及MHR水平;生存分析比较低水平MHR组和高水平MHR组患者肾脏累计生存率的差异;Cox回归分析探索DKD患者肾脏不良预后的独立危险因素;绘制受试者工作特征曲线(receiver operator characteristic curve,ROC),探索MHR对DKD不良预后的诊断效能。结果(1)与健康组相比,DKD组患者的MHR水平[0.4918(0.3788,0.6818)×10^(9)/mmol比0.2984(0.1867,0.4112)×10^(9)/mmol]更高(P<0.05);(2)高水平MHR组患者白细胞(white blood cell,WBC)[7.70(6.40,8.70)×10^(9)/L比6.50(5.40,8.00)×10^(9)/L]、中性粒细胞(neutrophil,Ne)[4.60(3.60,5.53)×10^(9)/L比3.99(3.18,5.19)×10^(9)/L]、单核细胞(monocyte,Mono)[0.69(0.60,0.70)×10^(9)/L比0.50(0.40,0.60)×10^(9)/L]、尿白蛋白肌酐比值(urinary albumin to creatinine ratio,UACR)[1214.59(373.48,3410.02)mg/g比1050.96(180.26,3341.06)mg/g]、24 h尿蛋白定量(24 hour urine protein,24 hUP)[3.21(1.42,5.51)g比2.66(0.58,4.56)g]、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)[2.72(2.06,3.40)mmol/L比2.23(1.63,2.80)mmol/L]、血肌酐(serum creatinine,Scr)[152.10(95.20,221.60)μmol/L比126.00(92.48,186.55)μmol/L]比低水平MHR组更高;高水平MHR组淋巴细胞(lymphocyte,Lym)[1.60(1.27,2.20)×10^(9)/L比1.82(1.30,2.40)×10^(9)/L]、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)[0.94(0.83,1.Objective To explore the relationship between monocyte/high-density lipoprotein cholesterol ratio(MHR)and the progression and prognosis of type 2 diabetic kidney disease(DKD).Methods From January 1,2017 to December 31,2022,269 type 2 DKD patients were selected as DKD group while 269 healthy medical check-ups during the same period as healthy group.And the differences in MHR levels of two groups were compared.According to median MHR,DKD group were assigned into low-level MHR and high-level MHR sub-groups.General profiles,clinical data,the incidence rate of endpoint events and cumulative renal survival were compared two groups.Cox regression analysis was performed for exploring the independent risk factors for poor renal prognosis in DKD patients and drawing receiver operator characteristic curve(ROC)for exploring the diagnostic efficacy of MHR for poor prognosis of DKD.Results MHR level was higher in DKD group than that in healthy group[0.4918(0.3788,0.6818)×10^(9)/mmol vs 0.2984(0.1867,0.4112)×10^(9)/mmol](P<0.05);high-level MHR group had higher levels of white blood cells(WBC)[7.70(6.40,8.70)×10^(9)/L vs 6.50(5.40,8.00)×10^(9)/L],neutrophils(Ne)[4.60(3.60,5.53)×10^(9)/L vs 3.99(3.18,5.19)×10^(9)/L]and monocyte(Mono)[0.69(0.60,0.70)×10^(9)/L vs 0.50(0.40,0.60)×10^(9)/L],urinary albumin to creatinine ratio(UACR)[1214.59(373.48,3410.02)mg/g vs 1050.96(180.26,3341.06)mg/g],24 h urine protein(24 hUP)[3.21(1.42,5.51)g vs 2.66(0.58,4.56)g],low-density lipoprotein cholesterol(LDL-C)[2.72(2.06,3.40)mmol/L vs 2.23(1.63,2.80)mmol/L],serum creatinine(Scr)[152.10(95.20,221.60)μmol/L vs 126.00(92.48,186.55)μmol/L]than those in low-level MHR group;lymphocyte(Lym)[1.60(1.27,2.20)×10^(9)/L vs 1.82(1.30,2.40)×10^(9)/L],high-density lipoprotein cholesterol(HDL-C)[0.94(0.83,1.07)mmol/L vs 1.39(1.15,1.65)mmol/L]and estimated glomerular filtration rate(eGFR)[39.69(25.19,65.10)mL·min^(-1)·(1.73 m^(2))^(-1) vs 47.12(28.86,73.60)mL·min^(-1)·(1.73 m^(2))^(-1)]were lower than those in low-level MHR group;high-level MHR gro

关 键 词：单核细胞/高密度脂蛋白胆固醇比值 糖尿病肾脏疾病 生存分析 预后 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]