The relationship between systemic immune inflammation index、hemoglobin variation index and early renal tubular injury in type 2 diabetes mellitus patients
Objective To investigate the relationship between systemic immune inflammation index(SII),Glycated hemoglobin variation index(HGI)and early renal tubular injury in patients with type 2 diabetes mellitus(T2DM).Methods A total of 309 T2DM patients were included and divided into normal albuminuria group(Normo group)and microalbuminuria group(Micro group)according to the ratio of urinary microalbuminuria to urinary creatinine(UACR).General clinical data and laboratory test results were collected after admission,and SII,HGI and UACR were calculated.All patients were divided into three groups according to the SII and HGI quantiles.The influencing factors of UACR ≥30 mg/g and urinary α1 microglobulin(α1-MG)＞12.0 mg/L in T2DM patients were evaluated by multifactorial logistic regression analysis.Receiver operating characteristic curve(ROC)was used to analyze the predictive value of each index.Results SII,Neutrophil-lymphocyte ratio(NLR),HGI,hemoglobin A1c(HbA1c),α1-MG,urea nitrogen(BUN),systolic blood pressure(SBP)in Micro group were higher than those in Normo group(P＜0.05).Urine albumin-to-creatinine ratio(UACR)and α1-MG in LSIIR group,MSIIR group and HSIIR group were increased successively.The proportion of patients with UACR ≥30 mg/g in HSIIR group was higher than that in LSIIR and MSIIR groups(P＜0.05).α1-MG and UACR in LHGIR group,MHGIR group and HHGIR group were increased successively.The proportion of patients with UACR≥30 mg/g in HHGIR group was higher than that in LHGIR group and MHGIR group,and BMI in HHGIR group was lower than that in MHGIR group.BMI,SII,HGI,α1-MG and SBP were the influencing factors of UACR≥ 30 mg/g in T2DM patients.Both SII and HGI were the influencing factors ofα1-MG＞12.0 mg/L in T2DM patients(P＜0.05).The area under the curve(AUC)of the combined prediction of UACR≥30 mg/g by SII,HGI,α1-mg,SBP and BMI was higher than that predicted by the five indexes alone,and the sensitivity and specificity of the combined prediction were higher.SII and HGI predicted α1-MG＞12.0 mg/L AUC were higher than those predicted by the two indexes alone,and the sensitivity and specificity of the combined prediction were higher.Conclusion SII and HGI are valuable in predicting early renal tubular injury in patients with T2DM
Type 2 diabetes mellitusRenal tubular injury biomarkersSystemic immune inflammation indexGlycat-ed hemoglobin variation index
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NSTL
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