The Correlation Between Neutrophil To Lymphocyte Ratio And The Acute Cerebral Infarction In Elderly Patients With Type 2 Diabetes Mellitus

Background and Objective With Chinese urbanization,lifestyle and population age has been changed in recent years,the prevalence of elderly patients with type 2 diabetes mellitus has increased significantly,and the morbidity is rising year by year.Cerebral infarction is a common vascular disease in elderly type 2 diabetes mellitus patients,and it has high disability and fatality rate in clinical.Living quality and the health of the elderly patients could be seriously affected by this disease.It also brings tremendous mental stress and heavy financial burden to the society and the famliy at the same time.The phenomenon has become a serious problem.Neutrophil to Lymphocyte ratio(NLR)is a new inflammatory marker in recent years.Some studies have showed that NLR plays an important role in tumor,cardiovascular,and autoimmune disease,in addition,it could predict the progression and prognosis of these diseases.The relationship between NLR and diabetes mellitus is getting more and more attention.So we aim to investigate the correlation between Neutrophil to Lymphocyte ratio and the acute cerebral infarction in elderly patients with type 2 diabetes mellitus by making a retrospective analysis of 76 type 2 diabetes mellitus with acute cerebral infarction and 109 type 2 diabetes mellitus without acute cerebral infarction.In order to provide a new experimental basis for early clinical intervention.Methods According to the inclusion and exclusion criteria standards,185 elderly patients with type 2 diabetes mellitus who were hospitalized in the First Affiliated Hospital of Zhengzhou University's geriatric endocrinology,neurology and general endocrinology from January 2016 to June 2017 were retrospectively analyzed,and they were all older than 60 years old.They were divided into two groups according to whether they had acute cerebral infarction:DMCI group(type 2 diabetes mellitus with acute cerebral infarction,n=76),36 males and 40 females,the mean age was 65.53±8.26.DM group(type 2 diabetes mellitus without acute cerebral infarction,n=109),42 males and 67 females,the mean age was 65.39±5.21.Finally,according to the NHISS(National Institute of Health stroke scale)score standards,DMCI group was divided into the mild group(n=31),the moderate group(n=25),and the severe group(n=20).Collected data of each research object,including age,sex,blood pressure,and some hematological parameters,such as the total count of leukocyte,neutrophil cells count,lymphocytes count,plastocytes count,fasting plasma glucose,glycosylated hemoglobin A1 c,triglycerides,total cholesterol,high density lipoprotein,low density lipoprotein,uric acid,c-reactive protein and neutrophil to lymphocyte ratio.Analyzed and compared the dates among these groups.Results 1.Compared the general data and biochemical indexes of DMCI group and DM group.There were no significant differences in age and sex between DMCI group and DM group(P>0.05).Levels of systolic blood pressure,diastolic blood pressure were higher in DMCI group than DM group,the difference was statistically significant(P<0.05).Levels of white blood count,neutrophil cells count,Hb A1 C,TC,TG,CRP and NLR were significantly higher in DMCI group than DM group(P<0.05).While HDL-C was lower in DMCI group(P<0.05).There was no statistical significant in the residual detection indexes(P>0.05).2.Comparison of biochemical indexes in the DMCI group with different NHISS score. Levels of NLR,CRP,white blood count,uric acid and Hb A1 C in severe group were higher than those in mild group and moderate group.Then NLR,CRP,white blood count and uric acid levels in moderate group were higher than in mild group.The fasting plasma glucose level of severe group and moderate group were higher than that of mild group,the difference among three groups were statistically significant(P<0.05).3.Comparison the level of NLR with the level of other biochemical indexes in DMCI group.Pearson correlation analysis indicated that NLR level was positively correlated with CRP and uric acid(r=0.340,0.035,P<0.05).4.Logistic regression analysis of type 2 diabetes mellitus complicated with acute cerebral infarction.Regarded type 2 diabetes mellitus as a Whole,whether to merge acute cerebral infarction as dependent,systolic blood pressure,diastolic blood pressure,white blood count,plastocytes count,fasting plasma glucose,Hb A1 C,uric acid,total cholesterol,high density lipoprotein,low density lipoprotein,CRP and NLR as independent variables.Finally we concluded that DBP,Hb A1 C,CRP and NLR are risks favtor in type 2 diabetes mellitus with acute cerebral infarction(P<0.05).Conclusions 1.Levels of NLR,WBC and CRP in elderly type 2 diabetes mellitus with acute cerebral infarction were significantly higher,the result suggested that type 2 diabetes mellitus with acute cerelral may in a higher inflammatory state.2.NLR,CRP,DBP and Hb A1 C are risks factor in elderly type 2 diabetes mellitus with acute cerebral infarction,NLR and CRP have the effect to reflect the severity of neurological deficits.They could be used as detection indices and condition assessment of diabetes with acute cerebral infarction.