The Predictive Value Of SII And NLR For Type 2 Diabetes With Intracranial Artery Stenosis

ObjectiveTo investigate the predictive value of systemic immune inflammatory index（SII）and neutrophil to lymphocyte ratio（NLR）for intracranial artery stenosis（ICAS）in patients with type 2 diabetes mellitus（T2DM）,and to compare the goodness of the two predictive effects.MethodsThe clinical data of 289 patients with T2 DM admitted to the Department of Neurology,Fuyang People’s Hospital Affiliated to Anhui Medical University from March 2019 to March 2021 were collected.According to the results of computed tomography angiography（CTA）,the patients with ICAS were divided into vascular stenosis group（ICAS group,176 cases）and non-ICAS group（NS group,113 cases）.According to the test results,the SII value（SII=platelet count×neutrophil count/lymphocyte count）,NLR value（NLR=neutrophil count/lymphocyte count）and PLR value（PLR=platelet count/lymphocyte count）were calculated,and the differences in clinical data and test results between the two groups were compared.The influencing factors of ICAS in T2DM patients were analyzed by constructing a logistic regression model.The goodness of fit test of Hosmer-Lemeshow was used to evaluate the fitting degree of the model,and the receiver operating characteristic（ROC）curve was used to analyze the predictive value of the model.ResultsRetrospective analysis of 289 patients with T2DM,including 162 males（56.1%）,127 females（43.9%）,including 176 cases with ICAS（61.90%）,the average age（63.32±8.20）years old;there were 113 cases（39.10%）without ICAS,with an average age of（60.73±10.36）years old.There was no significant difference in age,sex,smoking,BMI,TC,TG,HDL-C and LDL-C between the two groups（P>0.05）.The prevalence of hypertension,coronary heart disease,glycosylated hemoglobin（Hb A1c）,neutrophil-lymphocyte ratio（NLR）,platelet-lymphocyte ratio（PLR）and SII in ICAS group were higher than those in NS group,and the differences were statistically significant（P<0.05）.The results of multivariate logistic regression model showed that SII and NLR were the risk factors of T2DM combined with ICAS,and the fitting degree of the model was（Hosmer-Lemeshow?~2=3.253,P=0.197）.The receiver operating characteristics（ROC）curve analysis results showed that the area under the curve（AUC）predicted by SII for ICAS in T2DM was 0.983,[95%confidence interval（CI）was 0.969–0.997,P<0.001],and the optimal cutoff point was 450.930,the sensitivity was 89.70%,and the specificity was 98.50%.The AUC predicted by NLR for ICAS in T2DM was 0.900,[95%confidence interval（CI）was0.853–0.948,P<0.001],and the optimal cutoff point was 2.255.The sensitivity and specificity were 74.70%and 91.00%,respectively.ConclusionPatients with T2DM have been in abnormal blood glucose fluctuations for a long time.Vascular endothelial cells are often damaged by immune inflammatory response and platelet and microembolic effects.At the same time,a large number of immune mediators,inflammatory factors and platelets can accelerate the pathological process of ICAS through different mechanisms,leading to increased cerebral ischemia.Therefore,SII and NLR have predictive value for T2DM merging ICAS,and the predictive efficiency of SII is better than that of NLR.