红细胞分布宽度与中性粒细胞/淋巴细胞比值对老年2型糖尿病病人不良预后的预测价值

doi:10.3969/j.issn.1003-9198.2022.07.011

摘要/Abstract

摘要： 目的探讨红细胞分布宽度(RDW)和中性粒细胞/淋巴细胞比值(NLR)对老年T2DM病人不良预后的预测价值。方法本研究为回顾性研究,纳入2015年1月至2018年1月我院收治的316例老年T2DM病人,电话随访记录其是否发生全因死亡,根据随访结果,分为死亡组以及生存组。比较2组病人的一般资料;采用Pearson相关系数描述RDW、NLR与其他实验室指标的相关性;ROC曲线分析RDW及NLR预测老年T2DM病人全因死亡风险的价值;根据ROC曲线的截断值,分析RDW及NLR预测老年T2DM病人并发症的价值。结果本研究随访时间为(46.22±11.48)个月,失访13例,最终纳入303例,其中发生全因死亡71例。2组年龄、性别、BMI、DM病程差异无统计学意义,FPG、HbA1c、白蛋白(ALB)、肌酐(Cr)、RDW及NLR水平差异有统计学意义(P均<0.05)。Pearson相关分析结果显示,RDW、NLR均与FPG、HbA1c、Cr呈正相关,与ALB呈负相关(P<0.05)。ROC曲线分析结果显示,RDW预测老年T2DM病人全因死亡风险的截断值为13.2%,灵敏度为78.87%,特异度为68.10%,AUC为0.795;NLR预测老年T2DM病人全因死亡风险的截断值为6.13%,灵敏度为88.73%,特异度为64.66%,AUC为0.838;两者联合预测的灵敏度为81.69%,特异度为85.78%,AUC为0.903。与RDW≤13.2%及NLR≤6.13%的病人相比,RDW>13.2%及NLR>6.13%的老年T2DM病人发生糖尿病肾病、糖尿病视网膜病变、糖尿病足、糖尿病神经病变的比例更高(P<0.01)。结论 RDW及NLR可作为老年T2DM病人全因死亡的独立预测因子,且两者联合预测价值更高;RDW及NLR水平升高的老年T2DM病人更易并发糖尿病并发症。

关键词: 红细胞分布宽度, 中性粒细胞/淋巴细胞比值, 糖尿病, 老年人

Abstract: Objective To explore the predictive value of red blood cell distribution width (RDW) and neutrophil/lymphocyte ratio (NLR) on the poor prognosis of elderly patients with type 2 diabetes mellitus (T2DM). Methods A total of 316 elderly patients with T2DM in our hospital from January 2015 to January 2018 were enrolled. All patients were followed up by telephone to record whether all-cause deaths occurred. According to the follow-up results, the patients were divided into death group and survival group, and the general data of the two groups were compared. Pearson correlation coefficient was used to describe the correlation of RDW and NLR with other laboratory indicators. Receiver operating characteristic (ROC) curve was drawn to analyze the value of RDW and NLR in predicting the all-cause mortality risk of the elderly T2DM patients. According to the cut-off value of the ROC curve, the preditive value of RDW and NLR for the complications of elderly patients with T2DM was analyzed. Results The follow-up time of this study was 46.22±11.48 months, and 303 patients were enrolled in this study. There were 71 cases occurring all-cause deaths. There were no significant differences in age, gender, body mass index, and duration of diabetes between the two groups (P>0.05). There were statistically significant differences in the levels of fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), albumin (ALB), creatinine (Cr), RDW and NLR between the two groups (P<0.05). Pearson correlation analysis showed that RDW and NLR were positively correlated with FPG, HbA1c and Cr, but negatively correlated with ALB (P<0.05). ROC curve analysis showed the area under the curve of RDW, NLR alone and combination of the two indicators for predicting the risk of all-cause mortality in the elderly T2DM patients was 0.795 (sensitivity: 78.87%; specificity: 68.10%; cut-off value: 13.2%), 0.838 (sensitivity: 88.73%; specificity: 64.66%; cut-off value: 6.13%) and 0.903 (sensitivity: 81.69%; specificity: 85.78%). Compared with the patients with RDW≤13.2% and NLR≤6.13%, the patients with RDW>13.2% and NLR>6.13% were prone to presenting with diabetic nephropathy, diabetic retinopathy, diabetic foot and diabetic neuropathy (P<0.01). Conclusions RDW and NLR can be used as independent predictors of all-cause mortality in the elderly patients with T2DM, and the combination of the two indicators has higher predictive value. Elderly T2DM patients with elevated levels of RDW and NLR are more prone to presenting with the complications of diabetes.

Key words: red blood cell distribution width, neutrophils/lymphocytes ratio, diabetes, aged

中图分类号:

R587.1

李春惠, 程京, 彭爽, 严小宏. 红细胞分布宽度与中性粒细胞/淋巴细胞比值对老年2型糖尿病病人不良预后的预测价值[J]. 实用老年医学, 2022, 36(7): 693-696.

LI Chun-hui, CHENG Jing, PENG Shuang, YAN Xiao-hong. Value of red blood cell distribution width and neutrophil/lymphocyte ratio in predicting the poor prognosis of elderly patients with type 2 diabetes mellitus[J]. Practical Geriatrics, 2022, 36(7): 693-696.

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