The Relationship Between Glycosylated Hemoglobin Variation Index,Platelet/lymphocyte And Diabetic Kidney Disease And Its Predictive Value

Objective In this study,patients were divided into diabetic kidney disease group and simple diabetes group according to whether they had diabetic kidney disease(DKD).At the same time,normal people in the same period were selected as the control group to compare the differences of glycosylated hemoglobin variation index(HGI),platelet to lymphocyte ratio(PLR)among the three groups,and explore the occurrence of HGI,PLR and DKD Develop the relationship,and analyze the predictive value of HGI and PLR on DKD,in order to provide new ideas for the prevention and treatment of DKD.Methods In this study,184 patients with diabetes who were hospitalized in our hospital from July 2021 to February 2023 were retrospectively included as the study subjects.According to the Chinese Guidelines for the Prevention and Treatment of Type 2 diabetes(2022 Edition),patients were divided into diabetic kidney disease group(Group A)and simple diabetes group(Group B).At the same time,normal people in the same period were selected as the control group(Group C).For patients with gender,age,course of diabetes,smoking,body mass index(BMI),fasting blood glucose(FPG),total cholesterol(TC),triglyceride(TG),low-density lipoprotein(LDL-C),high-density lipoprotein(HDL-C),uric acid(UA),white blood cell(WBC),blood creatinine(Scr),lymphocyte count(LC),neutrophil count(NC)and platelet count(PLT)The glomerular filtration rate(eGFR)and the glycosylated hemoglobin variation index(HGI),platelet/lymphocyte ratio(PLR),neutrophil/lymphocyte ratio(NLR)and other data were calculated for single factor analysis.Then,the multivariate logistic regression equation was used to further process the indicators with statistical differences,and the influencing factors of DKD in DM patients were calculated.Pearson test was used to analyze the correlation between HGI,PLR and DKD.Finally,the predictive value of HGIand PLR levels on DKD was analyzed using the subject work characteristic curve(ROC).Results(1)According to the inclusion,exclusion,termination and exclusion criteria,185 effective diabetes patients,85 diabetic kidney disease patients,99 diabetes patients and 95 normal people were collected in this study to meet the sample size requirements of this study.The results showed that there were statistically significant differences in smoking,FPG,TC,TG,LDL-C,UA,WBC,eGFR,HGI,PLR,NLR,and other indicators among the three groups(P<0.05);Among them,smoking,FPG,TC,TG,LDL-C,WBC,eGFR,HGI,PLR,NLR in the diabetic kidney disease group were significantly different from those in the diabetes group(P<0.05);Compared with the control group,FPG,LDL-C,HDL-C,UA,WBC,eGFR,HGI,PLR,NLR in the diabetic kidney disease group were significantly different(P<0.05);Compared with the control group,FPG,TC,WBC,eGFR,PLR,NLR in the diabetes group were significantly different(P<0.05).(2)The patients were divided into diabetic kidney disease group and non diabetic kidney disease group according to whether they had DKD.The results showed that there was a statistically significant difference in smoking,FPG,LDL-C,UA,WBC,eGFR,HGI,PLR,NLR and other indicators between the two groups(P<0.05);There was no significant difference in sex,age,duration of diabetes,BMI,TC,TG,HDL-C and other indicators(P>0.05).(3)Multivariate logistic regression analysis showed that FPG,WBC,HGI,PLR,NLR were risk factors for diabetic kidney disease,and the difference was statistically significant(P<0.05).(4)Pearson correlation analysis showed that FPG,HGI,PLR,NLR were positively correlated with DKD,while WBC was negatively correlated with DKD(P<0.05).(5)HGI predicts that the area under the ROC curve of DKD is 0.76(95%Cl:0.689-0.832),the best cut-off value of DKD prediction is 0.57,the sensitivity is 67.10%,and the specificity is 85.10%.PLR predicts that the area under the ROC curve of DKD is 0.71(95%Cl:0.645～0.775),the best cutoff value of DKD prediction is 89.665,the sensitivity is 67.10%,and the specificity is 67.00%.The area under the ROC curve of the joint prediction of DKD is 0.839(95%Cl:0.785～0.893),the best cutoff value of the prediction of DKD is 1.433,the sensitivity is 67.10%,and the specificity is 89.20%.Conclusion HGI and PLR are related to the increased risk of diabetic kidney disease.They have important value in predicting diabetic kidney disease and can be used as predictors of diabetic kidney disease.FPG,WBC,HGI,PLR and NLR are independent influencing factors for diabetes patients to develop diabetic kidney disease.