【摘要】 目的探讨老年2型糖尿病(T2DM)患者中性粒细胞/淋巴细胞比值(NLR)、脂蛋白相关磷脂酶A2(LP-PLA2)与颈动脉内-中膜厚度(CIMT)的关系。方法选取2018年1月至2020年1月于泰州市人民医院老年科和内分泌科住院的老年T2DM患者276例,CIMT<1.0mm为正常组(NCIMT组,n=138);CIMT≥1.0 mm为增厚组(ACIMT组,n=138)。同期选取135名健康体检者为对照(NC)组。检测各组临床生化指标、血常规和血浆LP-PLA2。采用SPSS 20.0软件进行数据分析。分别采用单因素方差分析、Kruskal-Wallis H检验进行组间数据比较,采用偏相关分析NLR、LP-PLA2与各指标的相关性,采用多元逐步回归分析CIMT增厚的危险因素。结果和NC组相比,NCIMT组及ACIMT组NLR和LP-PLA2均升高[NLR:(2.51±0.82)和(2.78±1.01)和(2.23±0.77);LP-PLA2:(142.80±37.24)和(154.78±45.92)和(130.17±39.37) ng/ml;均P<0.05],且ACIMT组高于NCIMT组。相关分析显示,NLR与收缩压、舒张压、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、CIMT呈正相关(P<0.05);LP-PLA2与总胆固醇、低密度脂蛋白胆固醇(LDL-C)、CIMT呈正相关(P<0.01);且LP-PLA2与NLR呈正相关(P<0.01)。多元逐步回归分析显示,CIMT的影响因素为糖尿病病程、FBG、HbA1c、LDL-C、NLR、LP-PLA2(β分别为0.009、0.028、0.032、0.036、0.069、0.001,P<0.05或P<0.01)。结论 NLR和LP-PLA2是老年T2DM患者CIMT增厚的危险因素,可能与老年T2DM患者动脉粥样硬化的发生发展有关。更多还原

【Abstract】 Objective To explore the relationship between neutrophil/lymphocyte ratio(NLR) and lipoprotein-associated phospholipase A2(LP-PLA2) and carotid intima-media thickness(CIMT) in elderly patients with type 2 diabetes mellitus(T2 DM). Methods A total of 276 T2 DM patients were enrolled in this study, who admitted to geriatric and endocrine departments of Taizhou People′s Hospital from January 2018 to January 2020 and were divided into two groups: normal CIMT group(CIMT<1.0 mm, NCIMT, n=138) and abnormal CIMT group(CIMT≥1.0 mm, ACIMT, n=138). Healthy individuals were enrolled as control group(NC, n=135). Clinical biochemical index, blood routine and plasma LP-PLA2 level were measured. SPSS statistics 20.0 was used for data analysis. Depending on different data types, one-way analysis of variance or Kruskal-Wallis H test was used for comparison between groups. Partial correlation was used to analyze the correlation between NLR and LP-PLA2 and each index. Multiple stepwise regression was performed for the risk factors of CIMT in the T2 DM patients.Results NLR and LP-PLA2 levels were higher in NCIMT group and ACIMT group than in NC group [NLR:(2.51±0.82) vs(2.78±1.01) vs(2.23±0.77); LP-PLA2:(142.80±37.24) vs(154.78±45.92) vs(130.17±39.37) ng/ml; all P<0.05], and ACIMT group were higher than NCIMT group. Correlation analysis showed that NLR was positively correlated with systolic blood pressure, diastolic blood pressure, fasting blood glucose(FBG), glycosylated hemoglobin(HbA1 c), and CIMT(P<0.05); LP-PLA2 was positively correlated with total cholesterol, low-density lipoprotein cholesterol(LDL-C), and CIMT(P<0.01); LP-PLA2 was positively correlated with NLR(P<0.01). Multiple stepwise regression analysis showed that the factors affecting CIMT were course of T2 DM, FBG, HbA1 c, LDL-C, NLR and LP-PLA2(β=0.009, 0.028, 0.032, 0.036, 0.069, 0.001, respectively; P<0.05 or P<0.01). Conclusion NLR and LP-PLA2 are risk factors of CIMT in elderly T2 DM patients, and may be related to the occurrence and development of atherosclerosis in those patients.更多还原