Study On Relationship Between Mean Platelet Volume To Lymphocyte Ratio And Early Type 2 Diabetic Kidney Disease

Objective(s):Mean platelet volume to lymphocyte ratio(MPVLR)is a new inflammatory index.To explore the relationship between mean platelet volume to lymphocyte ratio(MPVLR)and early type 2 diabetic kidney disease by comparing the changes of MPVLR in patients with early type 2 diabetic kidney disease,patients with simple type 2 diabetes mellitus and healthy people.And to explore the risk factors of early diabetic kidney disease.Methods:497 patients with type 2 diabetes admitted to the Department of Endocrinology,the Second Affiliated Hospital of Kunming Medical University from January 2018 to December 2019 were retrospectively collected,and then divided into two groups according to the urinary albumin creatinine ratio(UACR):251 patients with early type 2 diabetic kidney disease were DKD group(30mg/g<UACR<300mg/g),246 patients with simple type 2 diabetes were DM group(UACR<30mg/g),and 249 healthy people selected from the physical examination center of our hospital at the same time were in the control group.We collected the general medical history data of the patients:gender age,nationality,smoking history,menstrual history,family history of diabetes,course of diabetes,BMI value,and recorded the laboratory indicators:Fasting plasma glucose(FPG),Glycosylated hemoglobin(HbAlc),Scrum creatinine(Scr),Uric acid(UA),Total cholesterol(TC),Triglyceride(TG),Low-density lipoprotein(LDL),High-density lipoprotein(HDL),Cystatin-C(Cys-C),homocysteine(Hcy),neutrophil count(NC),lymphocyte count(LC),platelet count(PC),and mean platelet volume(MPV).Neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),mean platelet volume to lymphocyte ratio(MPVLR)were calculated respectively,the eGFR was calculated according to CKD-EPI in 2009.The data were collected and analyzed by SPSS software to explore the relationship between MPVLR and early type 2 diabetic kidney disease.Results:(1)There was no significant difference among the three groups in nationality,gender and menstrual history(P>0.05);there were significant differences in smoking history and family history of diabetes among the three groups(P<0.001);(2)The course of diabetes in DKD group was significantly higher than that in DM group(P<0.05);(3)The age and BMI of DKD group were higher than DM group and control group,and DM group was higher than control group,the differences were statistically significant(P<0.05);(4)There were significant differences in FPG,HbAlc,TG,Hcy,MPV,NLR,PLR and MPVLR among the three groups(P<0.05),the values of DKD group were significantly higher than those of DM group and control group;(5)Among the three groups,HDL was the lowest in DKD group,and there was no significant difference compared with DM group(P>0.05);(6)TC,LDL,UA,Scr,Cys-C,eGFR,NC in DKD group were significantly different from those in DM group and control group(P<0.05),but there was no significant difference between DM group and control group(P>0.05);(7)By logistic regression analysis,smoking history,course of diabetes,FPG,TG,PLR,MPVLR and NLR were all risk factors for the occurrence and development of early type 2 diabetic kidney disease;(8)Spearman correlation analysis showed that MPVLR had no significant correlation with BMI;TC,LDL,NC,eGFR(P>0.05),and other indexes had correlation with MPVLR(P<0.05),UACR was positively correlated with MPVLR(r=0.48,P<0.001);(9)The ROC curves of NLR,PLR,MPV and MPVLR were drawn.,by calculating the area under the curve,the results were as follows:AUC=0.84,P<0.001,sensitivity=72%,specificity=82%,critical value=1.94;AUC=0.81,P<0.001,sensitivity=76%,specificity=73%,critical value=114.65;AUC=0.63,P<0.001,sensitivity=61%,specificity=52%,critical value=11.15,AUC=0.87,P<0.001,sensitivity=83%,specificity=85%,critical value=4.07.Conclusion(s):1.MPVLR has a high predictive value for early diagnosis of DKD,when the cut-off value is 4.07,the diagnostic value is the highest,the sensitivity is 83%,and the specificity is 85%.2.MPVLR has a positive correlation with UACR,suggesting that with the increase of MPVLR,urinary protein increased in type 2 diabetic patients.3.Smoking history,high fasting plasma glucose,high triglyceride,long course of diabetes,high PLR,high MPVLR and high NLR were all risk factors of early type 2 diabetic kidney disease.