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 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.