中性粒细胞/淋巴细胞比值与糖尿病患者eGFR的相关性:基于NHANES数据库的横断面分析  

Correlation Between Neutrophil to Lymphocyte Ratio and eGFR in Diabetic Patients:A Cross⁃sectional Analysis Based on NHANES Data

作　　者：贾淳钰 王淦淦 王佳慧 陈罡[2] 郑可[2] 李雪梅[2] JIA Chunyu;WANG Gangan;WANG Jiahui;CHEN Gang;ZHENG Ke;LI Xuemei(Graduate School,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Nephrology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院研究生院,北京100730 [2]中国医学科学院北京协和医院肾内科,北京100730

出　　处：《协和医学杂志》2025年第2期379-385,共7页Medical Journal of Peking Union Medical College Hospital

基　　金：中央高水平医院临床科研专项(2022-PUMCH-B-021)。

摘　　要：目的基于大样本数据,探究中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)与糖尿病患者肾功能指标估算的肾小球滤过率(estimated glomerular filtration rate,eGFR)的相关性。方法基于2009-2014年美国国家健康与营养调查(National Health and Nutrition Examination Survey,NHANES)数据库中确诊糖尿病患者的资料进行横断面分析。比较合并/未合并慢性肾脏病(chronic kidney disease,CKD)患者的NLR差异,并采用Pearson相关性分析和多元线性回归模型分析NLR与eGFR的相关性。结果共纳入857例糖尿病患者,其中合并CKD 190例(22.2%),未合并CKD 667例(77.8%),且与后者比较,前者的NLR显著升高(2.94±1.69比2.36±1.98,P<0.001),eGFR显著降低[(43.54±12.79)mL/(min·1.73 m^(2))比(92.50±18.20)mL/(min·1.73 m^(2)),P<0.001]。按NLR四分位数分组分析后发现,随NLR增大,糖尿病患者eGFR逐渐下降[Q1组:(87.05±24.93)mL/(min·1.73 m^(2));Q2组:(83.68±24.98)mL/(min·1.73 m^(2));Q3组:(83.10±26.26)mL/(min·1.73 m^(2));Q4组:(72.55±28.15)mL/(min·1.73 m^(2));P<0.001]。Pearson相关性分析显示,NLR与eGFR呈弱负相关(r=-0.15,P<0.001)。多元线性回归模型校正混杂因素后表明,NLR与糖尿病患者eGFR存在独立的负相关性(OR=0.403,95%CI:0.210~0.772,P=0.006)。结论NLR与糖尿病患者的eGFR呈负相关,具有反映糖尿病患者肾功能下降及CKD风险的潜在价值。Objective To investigate the association between neutrophil to lymphocyte ratio(NLR)and estimated glomerular filtration rate(eGFR)in patients with diabetes using large⁃scale data.Methods A cross⁃sectional analysis was conducted using data from diabetic patients in the National Health and Nutrition Ex⁃amination Survey database from 2009 to 2014.Differences in NLR between patients with and without chronic kidney disease(CKD)were compared.Pearson correlation analysis and multiple linear regression models were applied to assess the relationship between NLR and eGFR.Results A total of 857 diabetic patients were in⁃cluded,with 190(22.2%)having CKD and 667(77.8%)without CKD.NLR was significantly higher in pa⁃tients with CKD compared to those without CKD(2.94±1.69 vs.2.36±1.98,P<0.001),while eGFR was significantly lower[(43.54±12.79)mL/(min·1.73 m^(2))vs.(92.50±18.20)mL/(min·1.73 m^(2)),P<0.001].Quartile analysis revealed a progressive decline in eGFR with increasing NLR[Q1:(87.05±24.93)mL/(min·1.73 m^(2));Q2:(83.68±24.98)mL/(min·1.73 m^(2));Q3:(83.10±26.26)mL/(min·1.73 m^(2));Q4:(72.55±28.15)mL/(min·1.73 m^(2));P<0.001].Pearson correlation analysis showed a weak negative relationship between NLR and eGFR(r=-0.15,P<0.001).After adjusting for con⁃founders,multiple linear regression demonstrated an independent negative association between NLR and eGFR(OR=0.403,95%CI:0.210-0.772,P=0.006).Conclusions NLR is independently negatively associated with eGFR in diabetic patients,demonstrating potential clinical value as an indicator of kidney function decline and CKD risk in this population.

关 键 词：糖尿病 慢性肾脏病 中性粒细胞/淋巴细胞比值 NHANES数据库 

分 类 号：R692[医药卫生—泌尿科学] S941.427[医药卫生—外科学]