中性粒细胞/淋巴细胞比值与糖尿病患者eGFR的相关性:基于NHANES数据库的横断面分析

Correlation Between Neutrophil-to-lymphocyte Ratio and eGFR in Diabetic Patients: A Cross-sectional Analysis Based on NHANES Data

  • 摘要: 目的 慢性肾脏病(chronic kidney disease,CKD)是糖尿病患者的常见并发症,炎症与其发生发展密切相关。血清中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)是一项反应全身炎症的指标,但其在糖尿病患者中的作用尚不明确。本研究旨在探讨NLR与糖尿病患者肾功能的相关性。方法 本研究基于2009年至2014年美国国家健康与营养调查(National Health and Nutrition Examination Survey,NHANES)数据库中确诊糖尿病患者的数据进行横断面分析。统计研究人群的基线特征,数据以中位数±标准差的形式表示。根据是否合并CKD,使用Student’s t检验方法进行组间比较。根据NLR的四分位数进行分组,使用One-way ANOVA方法进行组间比较。采用多元线性回归模型分析NLR与估算肾小球滤过率(estimated glomerular filtration rate,eGFR)之间的关系。统计学检验以P<0.05为显著性标准。结果 本研究最终纳入857例糖尿病患者,其中男性438例(51.11%),平均年龄(61.54±13.27)岁,平均NLR 2.49±1.93。合并CKD患者共190例(22.17%),其平均NLR显著高于未合并CKD患者(CKD组:2.94±1.69;非CKD组:2.36±1.98;P<0.001)。按NLR四分位数分组(Q1组:0.01~1.42;Q2组:1.42~1.89;Q3组:1.89~2.54;Q4组:2.54~28.66),随着NLR增大,eGFR逐渐下降(Q1组:87.05±24.93;Q2组:83.68±24.98;Q3组:83.10±26.26;Q4组:72.55±28.15;P<0.001)。NLR与eGFR呈弱负相关,相关系数为-0.15(P<0.0001)。多元线性回归分析显示NLR可能是糖尿病患者肾功能受损的危险因素(OR=0.403,95% CI=0.210~0.772,P<0.01)。结论 NLR与糖尿病患者肾功能独立负相关,且具有无创、灵敏度高、检测迅速等优点,具备潜在的临床应用价值。本研究为回顾性横断面研究,未来可通过前瞻性研究深入探讨NLR对糖尿病人群中CKD发生与进展的影响。

     

    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.

     

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