| Objective To investigate the correlation between Hb A1 c and TG,NLR in elderly patients with type 2 diabetes,and explore its effect on diabetic nephropathy,and to provide auxiliary inspection indicators for the early detection,diagnosis and treatment of diabetic nephropathy.Methods A total of 332 ageing patients with type 2 diabetes(age≥60 years)from the Department of Endocrinology,General Hospital of Ningxia Medical University were recruited during January 1,2018 to December 31,2019.The general clinical data was collected and including patients’ gender,age,height,weight,blood pressure,course of disease,glycosylated hemoglobin(Hb A1c),fasting blood glucose(FBG),serum creatinine(SCr),urea(UREA),triglyceride(TG),total cholesterol(TC),microalbumin(MALB),urinary creatinine(UCr),the ratio of urinary microalbumin / creatinine(ACR).The ratio of neutrophil / lymphocyte(NLR)= neutrophil count / lymphocyte count was calculated from the data of routine blood tests.e GFR was calculated according to the CKD-EPI formula recommended in the Chinese Clinical Guidelines for the Prevention and Treatment of Diabetic Kidney Disease.According to the results of Hb A1 c levels,the patients were divided into two groups: Hb A1c≤7.5% for good blood glucose controlled group and Hb A1 c > 7.5% for poorly blood glucose controlled group.According to the age classification standard formulated by the United Nations World Health Organization,the age group of 60-74 years old was early ageing group,and the age group of 75 years old and over was ageing group.Statistical analysis uses SPSS24.0 software and uses Graphpad Prism software for drawing.Results(1)There was no significant difference in gender composition,age,course of disease,height,UCR,UREA and e GFR between the two groups(P > 0.05).There was statistical significance in body weight,BMI,SBP,DBP,MALB,ACR,FBG,TG,TC,SCr and NLR between the two groups(P < 0.05).(2)Hb A1 c was significantly positively correlated with body weight,BMI,MALB,ACR,FBG,TG,TC,UREA,SCR and NLR(P < 0.05,r=0.214,0.306,0.306,0.334,0.589,0.248,0.162,0.162,0.108,0.147).There was no significant correlation between Hb A1 c and age,disease course,height,SBP,DBP,UCr and e GFR(P > 0.05).(3)With Hb A1 c as the dependent variable and body weight,BMI,MALB,ACR,UREA,SCr,FBG,TG and TC as independent variables,multiple linear regression analysis was conducted,suggesting that FBG,NLR and TC were risk factors for Hb A1 c.(4)The overall prevalence of elderly diabetic nephropathy in the study population was 47.89%,20.19% in the group with good blood glucose control,and 60.52% in the group with poor blood glucose control.(5)There were significant statistical significance in ACR,e GFR and NLR between early ageing groups and ageing group(P < 0.05).Age was positively correlated with ACR and NLR(P < 0.05,r=0.134,0.173).Age was negatively correlated with e GFR(P< 0.05,r=-0.355).(6)In elderly patients with type 2 diabetes,with the increase of coexisting abnormal indicators(Hb A1 c,FBG,NLR,TC),the prevalence of diabetes nephropathy was gradually increased,and there was a statistical difference among all groups(P < 0.001).(7)The ROC curve of NLR showed AUC = 0.663,95%CI: 0.605-0.721,P < 0.001.When the NLR cutoff value was set at 2.290,the diagnostic efficiency was the highest,the sensitivity was 47.8%,and the specificity was 78.6%.Conclusion(1)Body weight,BMI,SBP,DBP,MALB,ACR,FBG,TG,TC,SCR and NLR were significantly increased in ageing patients with poor glycemic control of type 2diabetes mellitus.(2)FBG,NLR and TC were the risk factors for Hb A1 c.(3)Relatively stable Hb A1 c level in elderly patients with type 2 diabetes was an important factor to delay the occurrence and development of DN.(4)Age was positively correlated with ACR and NLR,and negatively correlated with e GFR.The prevalence of diabetic nephropathy in elderly patients with type 2 diabetes was increasing with age.(5)In ageing patients with type 2diabetes mellitus,early examination combined with Hb A1 c,FBG,NLR and TC can help early detection and prevention of diabetic nephropathy.(6)NLR can be used as an early auxiliary screening index for elderly type 2 diabetes mellitus complicated with diabetic nephropathy. |
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