Abstract:
Objective Chronic kidney disease (CKD) is a common complication in patients with diabetes and is closely related to inflammatory processes. The neutrophil-to-lymphocyte ratio (NLR) is an indicator of systemic inflammation, but its role in diabetic patients remains unclear. This study aims to investigate the association between NLR and kidney function in diabetic patients.
Methods This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2014, focusing on individuals diagnosed with diabetes. Baseline characteristics of the study population were summarized, with data expressed as median±standard deviations. Patients were grouped according to whether they had CKD or not, and Student's t test was used for comparison between groups. Patients were grouped according to their NLR quartiles, and inter-group comparisons were performed using One-way ANOVA. A multivariate linear regression model was applied to assess the association between NLR and estimated glomerular filtration rate (eGFR). Statistical significance was defined as P<0.05.
Results A total of 857 diabetic patients were included in the study, of whom 438 were male (51.11%), with a mean age of (61.54±13.27) years and a mean NLR of 2.49±1.93. Among them, 190 patients (22.17%) had CKD, and these patients had significantly higher NLR values than those without CKD (CKD: 2.94±1.69; non-CKD: 2.36±1.98; P<0.001). When grouped by NLR quartiles (Q1: 0.01~1.42; Q2: 1.42~1.89; Q3: 1.89~2.54; Q4: 2.54~28.66), a gradual decline in eGFR was observed with increasing NLR (Q1: 87.05±24.93; Q2: 83.68±24.98; Q3: 83.10±26.26; Q4: 72.55±28.15; P<0.001). NLR was weakly negatively correlated with eGFR, with a correlation coefficient of -0.15 (P<0.0001). Multivariate linear regression analysis indicated that NLR may be a risk factor for kidney function impairment in diabetic patients (OR=0.403, 95% CI: 0.210~0.772; P<0.01).
Conclusions NLR exhibits an independent and negative correlation with renal function in diabetic patients. It offers advantages such as non-invasiveness, high sensitivity, and rapid detection, suggesting potential clinical utility. Prospective studies are warranted to further investigate the impact of NLR on CKD development and progression in diabetic populations.