Study on the relationship between neutrophil to lymphocyte ratio and estimation of glomerular filtration rate in patients with type 2 diabetes mellitus / 中国医师进修杂志

ABSTRACT

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 groupseGFR ≥ 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 higher2.50 ± 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.