Study Of The Relationship Between Vascular Complications And Neutrophil To Lymphocyte Ratio In Type 2 Diabetes

Objective:To explore the correlation between the neutrophil to lymphocyte ratio(NLR)and type 2diabetic peripheral vasculopathy,type 2 diabetes combined with peripheral vascular and microangiopathy,and to further investigate the predictive value of NLR for type 2 diabetes mellitus(T2DM)vasculopathy.Methods:A cross-sectional study method was used to statistically analyze the correlation between NLR and vascular complications of T2 DM.A total of 150 patients with T2 DM treated in the inpatient endocrine unit of the Affiliated Hospital of Inner Mongolia Medical University from January 2021 to September 2022 were included.They were divided into three groups: 41 patients with simple T2 DM in group A,54 patients with peripheral vascular lesions of T2 DM in group B,and 55 patients with T2 DM combined with both peripheral vascular and microvascular lesions in group C.The clinical data of patients were collected,including gender,disease duration,history of hypertension,history of smoking,body mass index,age,blood lipids(triglycerides,total cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol),renal function(blood creatinine),islet function-related indexes(fasting glucose and fasting C-peptide),and blood routine(white blood cell count,neutrophil count,lymphocyte count).The islet β-cell function index,estimated glomerular filtration rate and NLR were calculated using the above laboratory indexes,and the strength of the association between NLR and T2 DM vascular complications was investigated using logistic regression analysis,and the ROC curve was used to explore the value of NLR as an aid to the auxiliary diagnosis of T2 DM vascular complications.To explore the relationship between NLR levels and T2 DM combined with both peripheral vascular and microvascular lesions.Results:(1)Comparison of clinical data of three groups: 1)Compared with group A,groups B and C had lower e GFR and LY,older age and higher NLR.2)Compared with groups B and A,group C had lower islet β-cell function index,longer disease duration and higher Hb A1 c,NEUT and Scr.3)Group C had a higher proportion of hypertension than group A,group C had a higher white blood cell count than group B.All of these differences were statistically significant(P <0.05).4)There were no statistical differences between groups A,B and C in terms of gender,TC,TG,BMI,LDL-C and HDL-C,and smoking(P > 0.05).(2)Multifactorial logistic stepwise regression analysis showed that NLR(OR=7.42,95% CI:1.96-28.04),age(OR=1.09,95% CI:1.03-1.14)were risk factors for peripheral vascular lesions in T2DM(P<0.05).Hb A1c(OR=5.27,95% CI:1.89-14.64),NLR(OR=12.70,95%CI:2.57-62.64),disease duration(OR=1.48,95%CI:1.19-1.85),and Scr(OR=1.08,95%CI:1.01-1.17)were risk factors for T2 DM combined with both peripheral vascular and microvascular lesions(P<0.05).(3)Adjunctive diagnostic value of NLR for peripheral vascular lesions in T2 DM,NLR(AUC=0.72,95%CI:0.62-0.82),sensitivity 63.0%,specificity 73.2%,and Yordon index 0.36.Adjunctive diagnostic value of NLR for T2 DM combined with both peripheral vascular and microvascular lesions,NLR(AUC=0.82.95CI%:0.73-0.92),with a sensitivity of 69.1%,a specificity of 80.5%,and a Jorden index of 0.49.(4)Correlation analysis between NLR and clinical indicators: there was a positive correlation between NLR and disease duration and Scr,and a negative correlation between NLR and e GFR.(5)The proportion of T2 DM combined with both peripheral vascular and microvascular lesions was also higher in the group with higher median NLR.Conclusions:(1)NLR is a risk factor for T2 DM vascular lesions(including T2 DM peripheral vascular lesions,T2 DM combined with peripheral vascular and microvascular lesions),and can be used as an auxiliary diagnostic index for T2 DM vascular lesions.(2)As the median NLR increases,the proportion of T2 DM with combined peripheral vascular and microvascular lesions increases.