Correlation Of Neutrophil To Lymphocyte Ratio Andplatelet To Lymphocyte Ratio In Coronary Heart Disease With Type 2 Diabetes Mellitus

BackgroundWith the development of human social and economic level,the prevalence of coronary heart disease is enhanced gradually.Cardiovascular disease becomes the primary cause of death.It is notable that abnormal glucose metabolism,including type 2 diabetes mellitus,is obviously frequent in patients with coronary heart disease.Especially,in our country,abnormal glucose metabolism is detected in nearly 90%of patients with coronary disease.The overall treatment in patients with coronary heart disease and diabetes is more complex and expensive,however,the prognosis is poorer.In recent years,a large number of studies confirm that inflammation plays an important role in the development progress of atherosclerosis and diabetes.C-reactive protein(CRP)is one of the most studied inflammatory markers,as well as the most reliable predictors for atherosclerosis at present.Furthermore,neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)are both newly proposed indicators of inflammation.Researches indicated that NLR and PLR are associated with coronary heart disease or diabetes mellitus.Nevertheless,there are few clinical reports on the change and relationship of NLR and PLR in patients with both coronary heart disease and type 2 diabetes mellitus,and are individual of most studies.Due to the easy availability of NLR and PLR,finding out their clinical value for coronary heart disease and diabetes is of great significance especially for the first-level health workers in our country.ObjectiveThrough the verification of the level change and relationship between NLR,PLR with disease,this research aim to investigate the pathophysiologic mechanism and clinical application of NLR,PLR in patients with coronary heart disease and diabetes.Methods220 patients were divided into three groups according to the results of coronary arteriography:group A(included 80 cases of cardiovascular disease with diabetes),group B(included 108 cases of cardiovascular disease without diabetes)and group C(included 32 cases of normal coronary arteriography without diabetes).Then patients in group A were divided into group A1(included 31 cases of stable coronary heart disease with diabetes)and group A2(included 49 cases of acute coronary syndrome with diabetes),patients in group B were divided into group B1(included 42 cases of stable coronary heart disease without diabetes)and group B2(included 66 cases of acute coronary syndrome without diabetes).Baseline characteristics and laboratory indicators of patients were collected.SPSS17.0 software package was used for statistics analysis,with P<0.05 for the difference is statistically significant.Results1 Compare with group C,the NLR,PLR and CRP level in group A and B were significantly increased;the NLR level was highest in group A.Differences were statistically significant(P<0.05).2 Compare with group C,the NLR and PLR level in group A1 and B1 were significantly increased;the NLR level was highest in group A1.Differences were statistically significant(P<0.05).3 Compare with group C,the NLR,PLR and CRP level in group A2 and B2 were significantly increased;the NLR level was highest in group A2.Differences were statistically significant(P<0.05).4 NLR was positively related to both PLR and CRP(P<0.001),the correlation between PLR and CRP was poor(P=0.668).5 Logistic regression analysis showed that NLR was a risk factor for coronary heart disease with diabetes,patients with coronary heart disease and diabetes had a higher proportion of women(P<0.05).Conclusions1 There are higher levels of NLR,PLR and CRP in patients with coronary heart disease and diabetes mellitus.2 Peripheral blood NLR and PLR level is associated with the occurrence of coronary heart disease.3 CRP level increased significantly in patients with acute coronary syndrome,while the change in patients with stable coronary heart disease has no statistical difference.4 NLR is an independent risk factor for coronary heart disease with diabetes mellitus,and there is a significantly positive correlation between NLR and CRP,which is worth further studies on its clinical application value.5 PLR may not be a risk factor for coronary heart disease with diabetes,however,more researches and discussions are needed to explain its role in the development progress of diabetes mellitus.