Huang Xiyi, Yang Shaomin, Zhao Qiang, Chen Xinjie, Pan Jialing, Lai Shaofen, Ouyang Fusheng, Deng Lingda, Du Yongxing, Li Xiaohong, Hu Qiugen, Guo Baoliang, Liu Jiemei
Department of Clinical Laboratory, The Affiliated Shunde Hospital of Guangzhou Medical University, Foshan, China.
Department of Radiology, The Affiliated Shunde Hospital of Guangzhou Medical University, Foshan, China.
Front Cardiovasc Med. 2022 Jun 20;9:927768. doi: 10.3389/fcvm.2022.927768. eCollection 2022.
Patients with diabetes have an increased risk of developing vulnerable plaques (VPs), in which dyslipidemia and chronic inflammation play important roles. Non-high-density lipoprotein cholesterol (non-HDL-C) and neutrophil-lymphocyte ratio (NLR) have emerged as potential markers of both coronary artery VPs and cardiovascular prognosis. This study aimed to investigate the predictive value of non-HDL-C and NLR for coronary artery VPs in patients with type 2 diabetes mellitus (T2DM).
We retrospectively enrolled 204 patients with T2DM who underwent coronary computed tomography angiography between January 2018 and June 2020. Clinical data including age, sex, hypertension, smoking, total cholesterol, low-density lipoprotein cholesterol, HDL-C, triglyceride, non-HDL-C, glycated hemoglobin, neutrophil count, lymphocyte count, NLR, and platelet count were analyzed. Multivariate logistic regression was used to estimate the association between non-HDL-C, NLR, and coronary artery VPs. Receiver operating curve analysis was performed to evaluate the value of non-HDL-C, NLR, and their combination in predicting coronary artery VPs.
In our study, 67 patients (32.84%) were diagnosed with VPs, 75 (36.77%) with non-VP, and 62 (30.39%) with no plaque. Non-HDL-C and NLR were independent risk factors for coronary artery VPs in patients with T2DM. The areas under the ROC curve of non-HDL-C, NLR, and their combination were 0.748 [95% confidence interval (CI): 0.676-0.818], 0.729 (95% CI: 0.650-0.800), and 0.825 (95% CI: 0.757-0.887), respectively.
Either non-HDL-C or NLR could be used as a predictor of coronary artery VPs in patients with T2DM, but the predictive efficiency and sensitivity of their combination would be better.
糖尿病患者发生易损斑块（VPs）的风险增加，其中血脂异常和慢性炎症起重要作用。非高密度脂蛋白胆固醇（non-HDL-C）和中性粒细胞与淋巴细胞比值（NLR）已成为冠状动脉VPs和心血管预后的潜在标志物。本研究旨在探讨非HDL-C和NLR对2型糖尿病（T2DM）患者冠状动脉VPs的预测价值。
我们回顾性纳入了2018年1月至2020年6月期间接受冠状动脉计算机断层扫描血管造影的204例T2DM患者。分析了包括年龄、性别、高血压、吸烟、总胆固醇、低密度脂蛋白胆固醇、HDL-C、甘油三酯、非HDL-C、糖化血红蛋白、中性粒细胞计数、淋巴细胞计数、NLR和血小板计数在内的临床数据。采用多因素逻辑回归分析非HDL-C、NLR与冠状动脉VPs之间的关联。进行受试者工作特征曲线分析，以评估非HDL-C、NLR及其组合在预测冠状动脉VPs中的价值。
在我们的研究中，67例（32.84%）患者被诊断为VPs，75例（36.77%）为非VPs，62例（30.39%）无斑块。非HDL-C和NLR是T2DM患者冠状动脉VPs的独立危险因素。非HDL-C、NLR及其组合的ROC曲线下面积分别为0.748 [95%置信区间（CI）：0.676-0.818]、0.729（95% CI：0.650-0.800）和0.825（95% CI：0.757-0.887）。
非HDL-C或NLR均可作为T2DM患者冠状动脉VPs的预测指标，但其组合的预测效率和敏感性更佳。
