Department of Nephrology, Jiangmen Central Hospital, Jiangmen, China.
Department of Nephrology, The First Affiliated Hospital of Nanchang University, Nanchang, China.
Ren Fail. 2023 Dec;45(1):2224893. doi: 10.1080/0886022X.2023.2224893.
The glucose-to-lymphocyte ratio (GLR), a glucose metabolism and systemic inflammatory response parameter, is associated with an adverse prognosis for various diseases. However, the association between serum GLR and prognosis in patients undergoing peritoneal dialysis (PD) is poorly understood.
In this multi-center cohort study, 3236 PD patients were consecutively enrolled between 1 January 2009 and 31 December 2018. Patients were divided into four groups according to the quartiles of baseline GLR levels (Q1: GLR ≤ 2.91, Q2:2.91 < GLR ≤ 3.91, Q3:3.91 < GLR < 5.59 and Q4: GLR ≥ 5.59). The primary endpoint was all-cause and cardiovascular disease (CVD) related mortality. The correlation between GLR and mortality was examined using Kaplan-Meier and multivariable Cox proportional analyses.
During the follow-up period of 45.93 ± 29.01 months, 25.53% (826/3236) patients died, of whom 31% (254/826) were in Q4 (GLR ≥ 5.59). Multivariable analysis revealed that GLR was significantly associated with all-cause mortality (adjusted HR 1.02; CI 1.00 ∼ 1.04, = .019) and CVD mortality (adjusted HR 1.02; CI 1.00 ∼ 1.04, = .04). Compared with the Q1 (GLR ≤ 2.91), placement in Q4 was associated with an increased risk of all-cause mortality (adjusted HR: 1.26, 95% CI: 1.02 ∼ 1.56, = .03) and CVD mortality (adjusted HR 1.76; CI 1.31 ∼ 2.38, < .001). A nonlinear relationship was found between GLR and all-cause or CVD mortality in patients undergoing PD ( = .032).
A higher serum GLR level is an independent prognostic factor for all-cause and CVD mortality in patients undergoing PD, suggesting that more attention should be paid to GLR.
葡萄糖与淋巴细胞比值（GLR）是葡萄糖代谢和全身炎症反应的参数之一，与各种疾病的不良预后相关。然而，血清 GLR 与腹膜透析（PD）患者预后之间的关系尚不清楚。
本多中心队列研究连续纳入了 2009 年 1 月 1 日至 2018 年 12 月 31 日期间的 3236 名 PD 患者。根据基线 GLR 水平的四分位数（Q1：GLR ≤ 2.91、Q2：2.91<GLR ≤ 3.91、Q3：3.91<GLR < 5.59 和 Q4：GLR ≥ 5.59）将患者分为四组。主要终点是全因和心血管疾病（CVD）相关死亡率。使用 Kaplan-Meier 和多变量 Cox 比例分析来检查 GLR 与死亡率之间的相关性。
在 45.93±29.01 个月的随访期间，25.53%（826/3236）的患者死亡，其中 31%（254/826）在 Q4（GLR≥5.59）。多变量分析显示，GLR 与全因死亡率（调整 HR 1.02；95%CI 1.001.04，=0.019）和 CVD 死亡率（调整 HR 1.02；95%CI 1.001.04，=0.04）显著相关。与 Q1（GLR≤2.91）相比，Q4（GLR≥5.59）与全因死亡率（调整 HR：1.26，95%CI：1.021.56，=0.03）和 CVD 死亡率（调整 HR 1.76；95%CI 1.312.38，<0.001）风险增加相关。在 PD 患者中，GLR 与全因或 CVD 死亡率之间存在非线性关系（=0.032）。
血清 GLR 水平升高是 PD 患者全因和 CVD 死亡的独立预后因素，提示应更加关注 GLR。
