Department of Metabolism & Endocrinology, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, China.
Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education; National Clinical Research Center for Metabolic Diseases, Changsha, Hunan, China.
BMC Endocr Disord. 2020 Oct 22;20(1):158. doi: 10.1186/s12902-020-00597-2.
A growing body of evidence supports neutrophils as having an active role in the development of diabetic kidney disease (DKD). However, the clinical relevance of neutrophils and DKD in autoimmune diabetes remains unknown. This study aimed to investigate the relationship between circulating neutrophils and DKD in autoimmune diabetes.
Patients with type 1 diabetes (T1D, n = 226) and latent autoimmune diabetes in adults (LADA, n = 79) were enrolled and stratified according to the urinary albumin to creatinine ratio (ACR). Circulating levels of white blood cells (WBCs), including neutrophils, were measured in a central laboratory, and the neutrophil-to-lymphocyte ratio (NLR) was calculated. The risk factors associated with DKD were analysed by logistic regression.
In T1D and LADA patients, the peripheral neutrophil counts increased in parallel with DKD advancement. The neutrophil counts in the patients with macroalbuminuria were significantly higher than those in the patients with normoalbuminuria for each type of diabetes. Furthermore, neutrophil counts positively correlated with ACR in T1D. In addition, neutrophils were independently associated with DKD in T1D in the logistic regression analysis, when various well-known risk factors, including age, gender, disease duration, hypertension, dyslipidemia and smoking status, were adjusted.
Neutrophil counts are closely associated with DKD in patients with autoimmune diabetes, suggesting that neutrophil-mediated inflammation may be involved in the pathogenesis of DKD in patients with autoimmune diabetes.
越来越多的证据表明中性粒细胞在糖尿病肾病（DKD）的发展中具有积极作用。然而，自身免疫性糖尿病中中性粒细胞与 DKD 的临床相关性尚不清楚。本研究旨在探讨自身免疫性糖尿病患者循环中性粒细胞与 DKD 之间的关系。
纳入 226 例 1 型糖尿病（T1D）和 79 例成人隐匿性自身免疫性糖尿病（LADA）患者，并根据尿白蛋白与肌酐比值（ACR）进行分层。在中心实验室测量白细胞（WBC），包括中性粒细胞的循环水平，并计算中性粒细胞与淋巴细胞比值（NLR）。采用 logistic 回归分析与 DKD 相关的危险因素。
在 T1D 和 LADA 患者中，外周中性粒细胞计数随 DKD 的进展而平行增加。在每种类型糖尿病中，有大量白蛋白尿的患者的中性粒细胞计数明显高于有正常白蛋白尿的患者。此外，中性粒细胞计数与 T1D 中的 ACR 呈正相关。此外，在调整了年龄、性别、病程、高血压、血脂异常和吸烟状况等多种已知危险因素后，logistic 回归分析表明中性粒细胞在 T1D 中与 DKD 独立相关。
中性粒细胞计数与自身免疫性糖尿病患者的 DKD 密切相关，提示中性粒细胞介导的炎症可能参与了自身免疫性糖尿病患者 DKD 的发病机制。
