中性粒与淋巴细胞比值与2型糖尿病肾病的相关性

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Abstract Objective To investigate the relationship between neutrophil-to-lymphocyte ratio (NLR) and type 2 diabetic kidney disease (DKD). Methods A total of 148 patients with type 2 diabetes mellitus admitted to Beijing Luhe Hospital from July 2012 to June 2018, and they were divided into 5 groups according to urine albumer excretion rate in 8 h (8°UAER). Thirty patients with 8°UAER＜20 μg/min and normal serum creatinine were DM1 group; 30 patients with 20 μg/min≤8°UAER＜200 μg/min and normal serum creatinine were DM2 group; 28 patients with 8°UAER≥200 μg/min and normal serum creatinine were DM3 group; 29 patients with 8°UAER≥200 μg/min and serum creatinine＞120 μmol/L, not yet been dialysis were DM4 group; 31 patients diagnosed as DKD and been dialysis were DM5 group. Twenty-nine health control individuals were selected as control group (N group). Blood was collected by fasting vein. Blood routine examination, glucose, lipid, liver and kidney function were examined in each group. Eight-hour urine in DM1, DM2, DM3 and DM4 group were collected and 8°UAER were detected. Results NLR gradually increased in DKD progress and NLR in DM4 and DM5 group were higher than that in N, DM1, DM2, DM3 group (P ＜ 0.05 or P ＜ 0.01), NLR in DM3 group was higher than that in N and DM1 group (P ＜ 0.05). The results of Pearson correlation analysis showed that NLR was positively correlated with age (r ＝ 0.317, P ＜ 0.001), course of disease (r ＝ 0.306, P ＜ 0.001), 8°UAER (r ＝ 0.293, P = 0.006), urea nitrogen (r ＝ 0.404, P ＜ 0.001), total parathyroid hormone (iPTH) (r = 0.465, P ＜ 0.001) and was negatively correlated with glomerular filtration rate (r ＝ -0.438, P ＜ 0.001), albumin (r ＝ -0.194, P = 0.019), high-density lipoprotein cholesterol (r ＝ -0.182, P = 0.028). Multiple linear regression equation: YLogNLR = 0.29+0.54Log8°UAER+0.004 age (R2 ＝ 0.152, P ＝ 0.001). ROC curve showed NLR=2.29 as the cut point, and the sensitivity and specificity of DKD diagnosis were 52.6% and 73.3% (area under the ROC curve is 0.661, 95%CI: 0.544-0.779, P ＝ 0.014). Conclusion NLR gradually increases during the progression of diabetic nephropathy, and is significantly high in patients with type 2 diabetes mellitus with proteinuria. It is positively correlated with 8°UAER, but the increase of NLR is later than 8°UAER, suggesting that increasing NLR may predict the occurrence of diabetic kidney disease.

Key words： Diabetic kidney disease Neutrophils to lymphocytes ratio Type 2 diabetes mellitus mellitus Urinary albumin excretion rate in 8 h

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	ZHANG Baoyu1 SUN Rongxin1 SHI Wei1 ZHAO Dong1▲ XIA Weibo2▲

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ZHANG Baoyu1 SUN Rongxin1 SHI Wei1 ZHAO Dong1▲ XIA Weibo2▲. Relationship between neutrophils to lymphocytes ratio and type 2 diabetic kidney disease[J]. 中国医药导报, 2019, 16(4): 83-87.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2019/V16/I4/83

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