Department of Medicine, Staten Island University Hospital, Staten Island, NY, USA.
Ren Fail. 2012;34(5):571-6. doi: 10.3109/0886022X.2012.668741. Epub 2012 Mar 27.
Previous studies have demonstrated the role of inflammation in diabetic nephropathy (DN). Neutrophil to lymphocyte ratio (NLR) rather than other white cell parameters was found to be a useful inflammatory marker to predict adverse outcomes in medical and surgical conditions. Nevertheless, the value of NLR in predicting DN has not been elucidated.
An observational study included 338 diabetic patients, who were followed at our clinic between 2007 and 2009. We arranged our patients into tertiles according to their 2007 NLR. The primary outcome was continuous decrease of GFR >12 mL/min between 2007 and 2009 with the last GFR <60 mL/min.
The lowest NLR tertile had fewer patients (2.7%) with primary outcome (i.e., worsening renal function) compared with middle and highest NLR tertiles, which had more patients with primary outcomes (8.7% and 11.5%, respectively) with a significant p-value 0.0164. When other potential confounders were individually analyzed with NLR tertile, the NLR tertiles remained a significant predictor of poor GFR outcome in the presence of other variables (hemoglobin A1C, systolic blood pressure, diastolic blood pressure, age, and congestive heart failure with p-values 0.018, 0.019, 0.017, 0.033, and 0.022, respectively).
NLR predicted the worsening of the renal function in diabetic patients. Further studies are needed to confirm this result.
先前的研究已经证明了炎症在糖尿病肾病（DN）中的作用。中性粒细胞与淋巴细胞比值（NLR）而不是其他白细胞参数被发现是一种有用的炎症标志物，可以预测医学和外科条件下的不良结局。然而，NLR 在预测 DN 中的价值尚未阐明。
一项观察性研究纳入了 338 名糖尿病患者，他们于 2007 年至 2009 年在我们的诊所接受随访。我们根据他们 2007 年的 NLR 将患者分为三分位。主要结局是 2007 年至 2009 年期间 GFR 持续下降>12mL/min，最后 GFR<60mL/min。
最低 NLR 三分位组的患者（2.7%）发生主要结局（即肾功能恶化）的比例低于中值和最高 NLR 三分位组（分别为 8.7%和 11.5%），差异有统计学意义（p 值=0.0164）。当用 NLR 三分位组分别分析其他潜在混杂因素时，在存在其他变量（糖化血红蛋白、收缩压、舒张压、年龄和充血性心力衰竭）的情况下，NLR 三分位组仍然是 GFR 不良结局的显著预测因子（p 值分别为 0.018、0.019、0.017、0.033 和 0.022）。
NLR 预测了糖尿病患者肾功能的恶化。需要进一步的研究来证实这一结果。
