Salah Nouran Yousef, Radwan Nesrine, Atif Heba Mohamed
Pediatrics Department, Pediatric and Adolescents Diabetes Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Pediatrics Department, Allergy and Immunology Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Diabetol Int. 2022 Jan 7;13(3):538-547. doi: 10.1007/s13340-021-00568-5. eCollection 2022 Jul.
Growing evidences highlight the role of the innate immune response in the pathogenesis of type 1 diabetes (T1D) vascular complications. Neutrophil lymphocytic ratio (NLR) and platelet lymphocytic ratio (PLR) are inexpensive but novel markers of chronic inflammation might have prognostic value in children with T1D.
To study NLR and PLR levels in children with T1D in comparison to matched controls and correlate them with fraction-C of glycosylated hemoglobin (HbA1C) and micro-vascular complications.
Hundred children with T1D were compared to 100 matched healthy controls. History included diabetes duration, insulin dose and frequency of hypoglycemic attacks. Fundus examination and the simple rapid neuropathy disability score were done. HbA1C, fasting lipids, urinary albumin excretion and complete blood count were measured with assessment of NLR and PLR.
NLR was significantly higher ( = 0.008) and PLR was significantly lower ( = 0.007) in children with T1D than controls. NLR was positively correlated while PLR was negatively correlated with HbA1C, diabetes duration, fasting cholesterol, triglycerides and LDL. NLR was significantly higher ( < 0.001) and PLR was significantly lower ( = 0.005) in children with microvascular complications than those without. Moreover, multivariate logistic regression revealed that microvascular complications were independently associated with NLR ( = 0.013) and PLR ( = 0.004).
Children with T1D had significantly higher NLR and lower PLR compared to controls. These changes were more evident in those with diabetic microvascular complications than those without. Furthermore, NLR was positively correlated and PLR was negatively correlated to HbA1C, diabetes duration and hyperlipidemia. Hence, NLR and PLR can be a potential indicator for the risk of development of diabetic microvascular complications in children with T1D.
越来越多的证据表明先天性免疫反应在1型糖尿病（T1D）血管并发症的发病机制中起作用。中性粒细胞淋巴细胞比率（NLR）和血小板淋巴细胞比率（PLR）是成本低廉但新型的慢性炎症标志物，可能对T1D患儿具有预后价值。
研究T1D患儿的NLR和PLR水平，并与匹配的对照组进行比较，并将它们与糖化血红蛋白（HbA1C）的分数-C和微血管并发症相关联。
将100名T1D患儿与100名匹配的健康对照进行比较。病史包括糖尿病病程、胰岛素剂量和低血糖发作频率。进行眼底检查和简单快速神经病变残疾评分。测量HbA1C、空腹血脂、尿白蛋白排泄和全血细胞计数，并评估NLR和PLR。
T1D患儿的NLR显著更高（P = 0.008），PLR显著更低（P = 0.007）。NLR与HbA1C、糖尿病病程、空腹胆固醇、甘油三酯和低密度脂蛋白呈正相关，而PLR与它们呈负相关。有微血管并发症的患儿的NLR显著更高（P < 0.001），PLR显著更低（P = 0.005）。此外，多因素逻辑回归显示微血管并发症与NLR（P = 0.013）和PLR（P = 0.004）独立相关。
与对照组相比，T1D患儿的NLR显著更高，PLR显著更低。这些变化在有糖尿病微血管并发症的患儿中比没有并发症的患儿更明显。此外，NLR与HbA1C、糖尿病病程和高脂血症呈正相关，PLR与它们呈负相关。因此，NLR和PLR可能是T1D患儿发生糖尿病微血管并发症风险的潜在指标。
