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Objective@#To investigate the relationship between neutrophil to lymphocyte ratio (NLR) and estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes mellitus.@*Methods@#The clinical data of 117 patients with type 2 diabetes mellitus from January 2016 to June 2017 in Anhui No.2 Provincial People′s Hospital were analyzed retrospectively. According to the eGFR level, the patients were divided into 3 groups: eGFR ≥ 90 ml/(min·1.73 m2) in 68 cases (DM0 group), eGFR 60 to 89 ml/(min·1.73 m2) in 33 cases (DM1 group), and eGFR<60 ml/(min·1.73 m2) in 16 cases (DM2 group). In addition, 30 healthy people in the same period were selected as control group (NC group), eGFR ≥ 90 ml/(min·1.73 m2). The systolic blood pressure, diastolic blood pressure, blood routine, glycosylated hemoglobin (HbA1c), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), urea nitrogen, creatinine and uric acid were recorded; and the NLR was calculated. The influencing factors of eGFR in patients with type 2 diabetic mellitus were analyzed, and the relationship between NLR and eGFR was evaluated.@*Results@#Compared with that in NC group and DM0 group, the eGFR in DM1 group and DM2 group was significantly lower: (75.12 ± 8.14) and (46.31 ± 13.25) ml/(min·1.73 m2) vs. (114.17 ± 12.21) and (113.21 ± 12.04) ml/(min·1.73 m2), the NLR was significantly higher: 2.50 ± 1.16 and 2.75 ± 1.39 vs. 1.53 ± 0.22 and 1.83 ± 0.65, and there were statistical differences (P<0.05). Compared with that in DM1 group, the eGFR in DM2 group was significantly lower, the NLR was significantly higher, and there were statistical differences (P<0.05). There were no statistical differences in NLR and eGFR between DM0 group and NC group (P>0.05). Correlation analysis result showed that NLR, age, course of disease, systolic blood pressure, TC, HDL-C, urea nitrogen, creatinine and uric acid were negatively correlated with eGFR (r=-0.415, -0.555, -0.491, -0.432, -0.259, -0.237, -0.584, -0.840 and -0.261; P < 0.05); gender, diastolic pressure, HbA1c, TG and LDL-C were not correlated with eGFR (P > 0.05). Multiple linear regression analysis result showed that NLR, age, TC, creatinine and systolic blood pressure were independent risk factors of eGFR in patients with type 2 diabetes mellitus (P<0.01 or < 0.05).@*Conclusions@#There is a close relationship between the increase of NLR and the decrease of eGFR in patients with type 2 diabetes mellitus. Monitoring NLR is helpful to understand the changes of eGFR in patients with type 2 diabetes mellitus.
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Objective To investigate the relationship between neutrophil to lymphocyte ratio (NLR) and estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes mellitus.Methods The clinical data of 117 patients with type 2 diabetes mellitus from January 2016 to June 2017 in Anhui No.2 Provincial People's Hospital were analyzed retrospectively.According to the eGFR level,the patients were divided into 3 groups:eGFR ≥ 90 ml/(min· 1.73 m2) in 68 cases (DM0 group),eGFR 60 to 89 ml/(min· 1.73 m2) in 33 cases (DM1 group),and eGFR ＜ 60 ml/(min· 1.73 m2) in 16 cases (DM2 group).In addition,30 healthy people in the same period were selected as control group (NC group),eGFR ≥ 90 ml/(min · 1.73 m2).The systolic blood pressure,diastolic blood pressure,blood routine,glycosylated hemoglobin (HbA1c),total cholesterol （TC),high-density lipoprotein cholesterol (HDL-C),urea nitrogen,creatinine and uric acid were recorded;and the NLR was calculated.The influencing factors of eGFR in patients with type 2 diabetic mellitus were analyzed,and the relationship between NLR and eGFR was evaluated.Results Compared with that in NC group and DM0 group,the eGFR in DM1 group and DM2 group was significantly lower:(75.12 ± 8.14) and (46.31 ± 13.25) ml/(min· 1.73 m2) vs.(114.17 ± 12.21) and (113.21 ± 12.04) ml/(min· 1.73 m2),the NLR was significantly higher:2.50 ± 1.16 and 2.75 ± 1.39 vs.1.53 ± 0.22 and 1.83 ± 0.65,and there were statistical differences (P ＜ 0.05).Compared with that in DM1 group,the eGFR in DM2 group was significantly lower,the NLR was significantly higher,and there were statistical differences (P ＜ 0.05).There were no statistical differences in NLR and eGFR between DM0 group and NC group (P ＞ 0.05).Correlation analysis result showed that NLR,age,course of disease,systolic blood pressure,TC,HDL-C,urea nitrogen,creatinine and uric acid were negatively correlated with eGFR (r =-0.415,-0.555,-0.491,-0.432,-0.259,-0.237,-0.584,-0.840 and-0.261;P ＜ 0.05);gender,diastolic pressure,HbA1c,TG and LDL-C were not correlated with eGFR (P ＞ 0.05).Multiple linear regression analysis result showed that NLR,age,TC,creatinine and systolic blood pressure were independent risk factors of eGFR in patients with type 2 diabetes mellitus (P ＜ 0.01 or ＜0.05).Conclusions There is a close relationship between the increase of NLR and the decrease of eGFR in patients with type 2 diabetes mellitus.Monitoring NLR is helpful to understand the changes of eGFR in patients with type 2 diabetes mellitus.
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Objective To investigate the diagnostic and prognostic value of presepsin for sepsis.Methods Diagnostic accuracy test.The plasma presepsin levels of 57 sepsis patients,64 systemic inflammatory response syndrome (SIRS) patients and 120 healthy individuals admitted to the 263 Clinical Branch,General Hospital of Beijing Military Region between January 2012 and December 2013were detected by PATHFAST system.Receiver operating characteristic (ROC) curve analysis was used to assess and compare the diagnostic value of presepsin and procalitonin (PCT).Logistic regression model was used to estimate the association between presepsin and sepsis.In addition,the correlations between presepsin and the clinical characteristics were analyzed in sepsis patients.Results Sepsis patients [1 266 (754-2 181) pg/ml] had higher presepsin level than SIRS[517 (349-939)pg/ml] and healthy individual controls [(182 ± 56)pg/ml] (Z value was 5.94 and 10.71,respectively,P value was ＜ 0.01 for all).The areas under curve (AUCs) of presepsin and PCT were 0.81 (95％ CI:0.74-0.89) and 0.78 (95％ CI:0.71-0.86),respectively,with no statistical significance (x2 =0.60,P =0.47).After adjusted for PCT,presepsin ＞ 1 060 pg/ml was independently associated with sepsis,with odds ratio (OR) of 7.80 (95 ％ CI:3.07-20.32).Severe sepsis patients [2 723 (2 002-4 234) pg/ml] had higher presepsin than sepsis patients[1 145 (656-1 436) pg/ml] (Z =4.00,P ＜0.01).The patients with inhosptal mortality [2 365 (1 256-3 567)pg/ml] had higher presepsin than survival ones[1 146 (660-1 452) pg/ml] (Z =2.99,P =0.003).Presepsin was positively correlated with PCT (r =0.75,P ＜ 0.01).The reference for presepsin was 72 to 292 pg/ml.Conclusions Presepsin was an useful biomarker for sepsisdiagnosis.The diagnostic value of presepsin and PCT was not completely overlap,and combinational using of these two biomarkers may improve the diagnostic accuracy of sepsis.In addition,presepsin had potential value for prognosis estimation.
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AIM: To investigate the dynamic variety of frequency and function of FoxP3~+ regulatory T cells in patients with acute hepatitis B (AHB). METHODS: Peripheral blood mononuclear cells (PBMCs) from 15 AHB patients at acute phase (week 1 of illness), convalescent phase (primary occurrence of both ALT level normalization and HBsAg negative conversion), resolved phase (at least 8 weeks after both ALT normalization and HBsAg seroconversion, and 15 health subjects were analyzed for FoxP3 (Forkhead/winged helix transcription factor) mRNA expression in MACS magnetic beads-purified CD4~+ T cells by real-time RT-PCR assay. The effects of Treg cells on the proliferation of CD4~+CD25~- T cells were examined by a ~3[H]-thymidine incorporation assay. RESULTS: AHB patients presented a significantly higher FoxP3 mRNA expression at convalescent phase than acute phase (t=-6.04, P<0.01) and resolved phase (t=4.45, P<0.01), and healthy controls (t=3.44, P<0.01). We also observed that the suppression efficiency of Treg cells on proliferation of CD4~+CD25~- T cells was lower at acute phase than convalescent phase (t=-5.30, P<0.01) and resolved phase (t=-3.20, P<0.05), but there was no significant difference between healthy controls and any phase of AHB. CONCLUSION: AHB patients presented lower circulating Treg frequency and suppression function at acute phase, and both of them are increased at convalescent phase, and then return to normal level along with disease resolved. This follow-up study furthers our understanding of Treg' s role in immunopathogenesis of hepatitis B.