The Correlation Between Neutrophil To Lymphocyte Ratio,Red Blood Cell Distribution Width And Coronary Heart Disease With Diabetes Mellitus

Objective: To explore the relationship between neutrophil to lymphocyte ratio,red blood cell distribution width and coronary heart disease(CHD)complicated with diabetes mellitus,and to explore the best cut-off value of these two indexes in predicting CHD complicated with diabetes mellitus.Objects and Methods: A total of 210 patients(145 males and 65 females,aged 34 to93 years,with an average age of(62.40±11.13)years)who were admitted to the Department of Cardiology and underwent coronary angiography(CAG)during their hospitalization from January 2019 to August 2020 were included in the study.Patients’ medical history and related data were collected according to inclusion and exclusion criteria: age,gender,height,weight,smoking history,history of diabetes,history of hypertension and other basic information.Blood samples were collected before CAG:blood cell analysis(WBC,RBC,hemoglobin,RBC distribution width,neutrophils,lymphocytes,platelet distribution width,etc.).Fastening specimens were collected: blood glucose,glycated hemoglobin,renal function(creatinine,urea nitrogen,uric acid),lipid analysis(triglyceride,total cholesterol,low density lipoprotein cholesterol),etc.SPSS20.0 was used for statistical analysis of the collected data.One-way ANOVA and rank sum test were used for measurement data,and chi-square test was used for qualitative data.Spearman correlation was used to analyze the correlation between the two groups.Logistic regression was used for multivariate analysis,and ROC curves were drawn to evaluate the predictive value of RDW and NLR for coronary heart disease complicated with diabetes.P < 0.05 was considered to be statistically significant.Results: the coronary heart disease with diabetes mellitus group,coronary heart disease without diabetes mellitus group and normal coronary angiography not merged diabetes control group in age,BMI,hypertension,platelet count and platelet distribution width,triglycerides,uric acid,creatinine is no statistical differences(P > 0.05),in smoking,white blood cell count,neutrophil count,lymphocyte count,glycosylated hemoglobin,fasting blood sugar and triglyceride differences,the difference was statistically significant(P < 0.05).Compared with normal coronary angiography without diabetes mellitus,coronary heart disease with diabetes mellitus and coronary heart disease without diabetes mellitus group RDW,NLR has increased significantly,and the difference is statistically significant(P < 0.05),RDW,NLR value of coronary heart disease with diabetes mellitus group was obviously higher than that of coronary heart disease without diabetes mellitus group and normal coronary angiography did not merge diabetes control group,difference has statistical significance(P < 0.01).The best cut-off value of NLR for predicting CHD complicated with diabetes was 3.78,sensitivity was 0.868,specificity was 0.638,and area under ROC curve was 0.787(95%CI: 0.71-0.865,P < 0.05).The best cut-off value of RDW for predicting coronary heart disease complicated with diabetes was 12.85,the sensitivity was 0.632,the specificity was 0.594,and the area under the ROC curve was 0.625(95%CI: 0.532～0.717,P < 0.05).Conclusion: 1.The RDW and NLR values of patients with CHD with diabetes were higher than those of patients CHD without diabetes and the control group with normal coronary angiography.2.RDW and NLR values of patients with stable coronary heart disease with diabetes were higher than those of the control group with normal coronary angiography.In patients with stable coronary heart disease,whether diabetes mellitus has little effect on RDW value,while NLR value is significantly increased in patients with diabetes mellitus.3.The RDW and NLR values of patients with ACS complicated with diabetes were higher than those of ACS patients without diabetes and the control group with normal coronary angiography.The predictive value of RDW in patients with acute coronary syndrome complicated with diabetes may be greater than that in patients with stable coronary heart disease complicated with diabetes.4.Smoking and Hb A1 c are independent risk factors for CHD complicated with diabetes,and the increase of NLR has certain predictive value for CHD complicated with diabetes.5.The detection of RDW and NLR values have certain significance in predicting coronary heart disease complicated with diabetes.