The Relationship Between Systemic Immune Inflammatory Index And Albuminuria In Patients With Type 2 Diabetes Mellitus

Objective:As a common metabolic disease,the incidence of Type 2 diabetes mellitus(T2DM)increases year by year.Diabetic kidney disease(DKD)is one of the main microvascular complications of T2 DM.Its prognosis is poor and it will endanger the life and health of Chinese residents.Inflammatory response is one of the main mechanisms of DKD development,in which many inflammatory factors and immune cells are involved.Systemic immune Inflammation index(SII)is a novel inflammatory biomarker that has attracted much attention in recent years,which can reflect systemic inflammation.Studies have shown that SII is associated with a variety of diseases and inflammatory reactions.However,there are few studies on the relationship between SII and T2 DM and its complications at home and abroad,and no correlation between SII and albuminuria in T2 DM patients has been reported.The purpose of this study was to analyze the correlation between peripheral blood inflammatory indicator SII and albuminuria in patients with T2 DM,as well as its predictive value for albuminuria in patients with T2 DM,so as to provide reference for the early detection of albuminuria in patients with T2 DM,as well as the prevention and monitoring of DKD disease in clinical work.Methods:A total of 464 patients with T2 DM hospitalized in the Department of Endocrinology of Hebei People’s Hospital from March 2021 to October2022 were retrospectively collected.According to the inclusion and exclusion criteria,a total of 181 females and 283 males were finally screened.Clinical data and relevant laboratory indicators of the subjects were recorded,and SII was calculated.According to the SII quantile,the subjects were divided into low SII(L-SII)group(L-SII < 358.06,n=155),medium SII(M-SII)group(358.06≤M-SII < 589.22,n=155)and high SII(H-SII)group(H-SII≥589.22,n=154).urinary albumin excretion rate(UAER)was also divided into three groups,namely,urinary albumin excretion group(UAER<30mg/24 h,n=243)and microalbumin excretion group(30≤UAER<300mg/24 h,n=165).Large albuminuria group(UAER≥300mg/24 h,n=56).The collected clinical data were statistically analyzed.After normality test,one-way analysis of variance was used to compare the measurement data conforming to normal distribution between groups.Kruskal-Wallis rank sum test was used to compare the measurement data that did not conform to the normal distribution.Spearman rank correlation analysis was used.Multiple linear stepwise regression was used to analyze the correlation between SII and UAER.Binary Logistic regression was used to analyze the relationship between SII and albuminuria in T2 DM patients.Receiver operating characteristic curve(ROC)was established to evaluate the value of SII in predicting albuminuria in T2 DM patients.the accuracy of the prediction value of SII for albuminuria in T2 DM patients was calculated by Area under the cure(AUC).Results:1.Compared with L-SII group,WBC,NEU,MON and PLT in M-SII group were higher than those in L-Si I group(p<0.05).Compared with L-SII group,H-SII group had higher age,male proportion,WBC,NEU,MON,PLT and UAER,while lower LYM and GFR(p<0.05).Compared with M-SII group,H-SII group had higher male proportion,WBC,NEU,PLT and UAER,while lower LYM and GFR(p<0.05).2.Compared with normal albuminuria group,patients in microalbuminuria group were older,the course of disease was longer,the proportion of hypertension,WBC,NEU,SII was higher,and GFR was lower(p<0.05).Compared with normal albuminuria group,mass albuminuria group was older,the course of disease was longer,the proportion of hypertension,BMI,BUN,SCr,WBC,NEU,MON,PLT,SII was higher,and the GFR was lower(p < 0.05).Compared with microalbuminuria group,macroalbuminuria group had longer course of disease,higher BUN,SCr and lower GFR(p < 0.05).3.Correlation analysis between UAER and various indicators in T2 DM patients.Spearman correlation analysis showed that UAER in T2 DM patients was positively correlated with age,diabetes course,hypertension,BMI,WBC,NEU,MON,PLT,SCr,BUN and SII(p< 0.05).It was negatively correlated with GFR(p<0.05).4.Linear regression analysis of SII and UAER in T2 DM patients indicated that SII and UAER in T2 DM patients were still independently positive correlated after adjusting for other confounding factors(p<0.05).5.Logistic regression analysis of influencing factors for albuminuria in T2 DM patients showed that SII increased the independent risk factors for albuminuria in T2 DM patients(p<0.05).6.Receiver operating characteristic curve(ROC)of SII in predicting albuminuria in T2 DM patients showed that the area under ROC curve of SII in T2 DM patients was 0.608(p<0.05),indicating that SII had predictive value for albuminuria in T2 DM patients.Moreover,SII combined with hypertension history,diabetes course,BMI and BUN had a higher predictive value for albuminuria in T2 DM patients.Conclusion:1.UAER and SII were independently and positively correlated in T2 DM patients.2.Elevated SII is a risk factor for albuminuria in T2 DM patients.3.SII has a certain predictive value for albuminuria in T2 DM patients,and it is expected to be a new and economical and practical inflammatory marker to predict the risk of DKD disease.