Study On The Relationship Between PLR,MLR And Non-cardiogenic Acute Cerebral Infarction Complicated With T2DM

Objective:To analyze the changes of Platelet to Lymphocyte Ratio?PLR?,Monocyte to Lymphocyte Ratio?MLR?in patients with Non-Cardiogenic Acute Cerebral Infarction?NCACI?complicated with Type 2 Diabetes Mellitus?T2DM?,and explore the correlation between PLR,MLR and NCACI complicated with T2DM,and the value of predicting the degree of neurological impairment.Methods:?1?A retrospective analysis was made on 234 patients with NCACI diagnosed by Department of Neurology of Xiangxi Autonomous Prefecture people's Hospital from August 1,2017 to September 31,2019,and 102 healthy subjects?NC group?in the same period.These subjects were divided into simple NCACI group?ACI group,n=136?and NCACI with T2DM group?ACIDM group,n=98?.The neurological impairment of both groups was scored according to the National Institute of Health Stroke Scale?NIHSS??<5 points:mild group;?5 points:moderate to severe group?.?2?The Neutrophil to Lymphocyte Ratio?NLR?,PLR and MLR are calculated based on the information of age,sex,nationality,history of coronary heart disease,history of hypertension,history of diabetes,history of smoking and drinking,and biochemical indexes of Uric Acid?UA?,Triglyceride?TG?,Total Cholesterol?TC?,Low Density Lipoprotein Cholesterol?LDL-C?,High Density Lipoprotein Cholesterol?HDL-C?,Homocysteine?HCY?,and blood cell parameters of White Blood Cell count?WBC?,Neutrophil?NE?,Lymphocyte?LY?,Monocyte?M?,Platelet?PLT?and Platelet Distribution Width?PDW?.?3?The differences of general condition,biochemical indexes and blood cell parameters among the ACIDM group,the ACI group and the NC group were compared.Multivariate binary Logistic regression and ROC curve were used to analyze the risk factors and diagnostic value of the ACIDM group.The severity of both the ACIDM group and the ACI group was analyzed via Spearman rank correlation analysis.The data were processed using IBM SPSS 22.0 statistical software,where P<0.05indicated the statistical significance of the aforementioned differences.Results:?1?The differences in PLR,MLR and NLR among the ACIDM group,the ACI group and the NC group are statistical significant.In pairwise comparison,PLR,MLR and NLR in the ACIDM group and the ACI group were significantly higher than those in the NC group,and bote PLR and NLR in the ACIDM group were significantly higher than those in the ACI group.?2?The result of multivariate Logistic regression analysis revealed that PLR?OR=1.015,P<0.01?,NLR?OR=0.789,P<0.05?,NE?OR=1.340,P<0.05?,PDW?OR=1.155,P<0.05?,TG?OR=1.643,P<0.01?,LDL-C?OR=2.429,P<0.05?,smoking?OR=2.437,P<0.05?,and hypertension?OR=2.970,P<0.01?were the risk factors for NCACI patients with T2DM?P values were all less than 0.05?.?3?The Area Under Curve?AUC?of patients with NCACI AUC_NE=0.606,AUC_TG=0.657,AUC_LDL-C=0.636 respectively.The AUC of risk factors 0.778 indicated that the combination of NLR,PLR and other risk factors was more valuable for diagnosis.?4?In the ACIDM group,the degree of neurological impairment was positively correlated with PLR?r=0.348,P<0.001?,MLR?r=0.223,P<0.05?and NLR?r=0.307,P<0.01?,and negatively correlated with LY?r=-0.244,P<0.05?.In the ACI group,the degree of neurological impairment was positively correlated with PLR?r=0.341,P<0.001?and NLR?r=0.327,P<0.001?,and negatively correlated with LY?r=-0.298,P<0.001?.?5?The difference of PLR and NLR between the ACIDM group and the ACI group was statistically significant?P<0.05?,but the difference of MLR was not statistically significant?P>0.05?;the difference of PLR between the ACIDM group and the ACI group was statistically significant?P<0.05?,and the difference of NLR and MLR was not statistically significant?P>0.05?.Conclusions:?1?The values of PLR,MLR and NLR increased successively in the NC group,the ACI group and the ACIDM group.The degree of inflammation in the ACIDM group may be more severe than that in the ACI group.?2?PLR,NLR,NE,PDW,TG,LDL-C,smoking and hypertension are the risk factors of NCACI complicated with T2DM.These factors have certain diagnostic value and should be adopted combing with PLR,NLR and other risk factors.?3?On admission,the values of PLR,MLR and NLR are positively correlated with the neurological impairment of both the ACIDM group and the ACI group,in which the correlation between PLR and the two groups is much stronger.?4?In the same neurological impairment,the increase of PLR value is not only related to neurological impairment,but also to diabetes mellitus.