通讯作者: 刘师伟, 809949254@qq.com

DOI：10.12201/bmr.202408.00066

The predictive value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in the type 2 diabeticnephropathy

• 摘要：目的 探讨中性粒细胞/淋巴细胞（neutrophil-to-lymphocyte ratio, NLR）、血小板/淋巴细胞（platelet-to-lymphocyte ratio, PLR）同2型糖尿病肾病（type 2 diabetic nephropathy, T2DN）的相关性，分别探讨NLR、PLR独立及联合预测T2DN的价值。方法 回顾分析2021年12月至2023年9月山西白求恩医院内分泌科收治的2型糖尿病患者300例，以尿白蛋白/肌酐（albumin-creatinin ration, ACR）分正常蛋白尿（A1）组100例，微量蛋白尿（A2）组100例，大量蛋白尿（A3）组100例。采集空腹血测定血指标，并测定ACR。结果 A3组和A2组NLR(2.63±1.16比1.73±0.55、2.14±1.09比1.73±0.55, 均P<0.05)、PLR (131.32±45.79 比101.46±26.50、115.62±41.33比101.46±26.50, 均P<0.05)均高于A1组，A3组NLR、PLR均高于A2组(2.63±1.16比2.14±1.09、131.32±45.79 比115.62±41.33，均P<0.05)；Logistic回归分析示，NLR【OR=1.70 (95%CI 1.29-2.25), P<0.01】、PLR【OR=1.01(95%CI 1.00-1.01), P=0.03】是T2DN的独立危险因素；受试者工作特征曲线(receiver operating characteristic curve, ROC)显示，NLR较PLR有更高的预测价值（曲线下面积（area under the curve, AUC）：0.72 vs 0.66），截断值分别为1.98、126.14时，对应的敏感性、特异性分别为72.00%、64.00%和53.00%、74.00%。NLR和PLR联合预测T2DN的AUC是0.71，敏感度是68.00%、特异度是68.50%。结论 NLR和PLR均是T2DN的危险因素，均可用来预测T2DN，其中NLR的预测价值更大，NLR与PLR联合预测价值较NLR未见提升。

  关键词： 中性粒细胞/淋巴细胞; 血小板/淋巴细胞; 糖尿病肾病; 2型糖尿病

   

  Abstract: Objective To discuss the correlation of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio(PLR) with type 2 diabetic nephropathy (T2DN), and to analyze the value of NLR and PLR independently and combinedly in predicting T2DN. Methods A total of 300 patients with type 2 diabetes from the Endocrinology Department of Shanxi Bethune Hospital from December 2021 to September 2023 were analyzed retrospectively. According to the urinary albumin-creatinin ration(UACR), they were splitinto the normoalbuminuria group(A1 group, n=100), microalbuminuria group (A2 group, n=100) and the macroalbuminuria group (A3 group, n=100). The clinical and biochemical data were collected. Results NLR (2.63±1.16vs1.73±0.55，2.14±1.09vs1.73±0.55, allP<0.05) and PLR (131.32±45.79 vs101.46±26.50、115.62±41.33vs101.46±26.50, all P<0.05) were higher in A3 and A2 groups than those of A1 group. NLR and PLR were higher in A3 group than those of A2 group (2.63±1.16vs2.14±1.09、131.32±45.79vs115.62±41.33, allP<0.05).Logistic regression analysis displayed that NLR OR=1.70 (95%CI 1.29-2.25), P<0.01 and PLR OR=1.01(95%CI 1.00-1.01), P=0.03 were risk factors for T2DN. According to the analysis of ROC curves, the value of NLR for predicting T2DN was higher than PLR. The cut-off values of NLR and PLR for predicting T2DN were 1.98 and 126.14, and the AUC were 0.72 and 0.66, respectively. The corresponding sensitivity and specificity were 72.00%, 64.00% and 53.00%, 74.00%, respectively. When NLR was combined with PLR, the AUC was 0.71. The sensitivity of combined prediction was 68.00%, and the specificity was 68.50%. Conclusion NLR and PLR are both risk factors for T2DN, and both can be used to predict T2DN. NLR has the greatest predict value for T2DN. The combined predictive value of NLR and PLR were not improved compared with NLR.

  Key words: neutrophil-to-lymphocyte ratio; platelet-to-lymphocyte ratio; Diabetic nephropathy; Type 2 diabetes

  提交时间：2024-08-27

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• 序号	提交日期	编号	操作
  1	2024-07-25	bmr.202408.00066V1	下载

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