Department of Nephrology, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-Sen University, Jiangmen, Guangdong, China.
Department of Endocrinology, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-Sen University, Jiangmen, Guangdong, China.
Sci Rep. 2023 Aug 12;13(1):13136. doi: 10.1038/s41598-023-40429-6.
The role of inflammation and the correlation between inflammatory markers and type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) have been studied. In clinical work, a large number of T2DM patients complicated with CKD, but the cause of CKD was not clear. Our study aimed to evaluate the relationship between monocyte-to-lymphocyte ratio (MLR) and mortality in T2DM patients with CKD. The data from Medical Information Mart for Intensive Care III was analyzed. The primary outcome was 90-day all-cause mortality; the secondary outcomes were the length of ICU stay, hospital mortality and 30-day all-cause mortality. Cox regression was used to evaluate the association between MLR and 90-day mortality. We performed subgroup analyses to determine the consistency of this association, and used Kaplan-Meier survival curve to analysis the survival of different levels of MLR. A total of 1830 patients were included in study retrospectively. The length of ICU stay, 30-day all-cause mortality, and 90-day all-cause mortality in the MLR > 0.71 group were significantly higher than those in the MLR < 0.28 and 0.28 ≤ MLR ≤ 0.71 group. In Cox regression analysis, high MLR level was significantly associated with increased greater risk of 90-day all-cause mortality. The adjusted HR (95%CIs) for the model 1, model 2, and model 3 were 2.429 (1.905-3.098), 2.070 (1.619-2.647), and 1.898 (1.478-2.437), respectively. Subgroup analyses also showed the consistency of association between MLR and 90-day all-cause mortality. The Kaplan-Meier survival curve analysis revealed that MLR > 0.71 had worst prognosis. In T2DM patients with CKD in the intensive care unit, high MLR was significantly associated with increased risk 90-day all-cause mortality.
炎症的作用以及炎症标志物与 2 型糖尿病（T2DM）和慢性肾脏病（CKD）之间的相关性已经得到研究。在临床工作中，大量 T2DM 患者并发 CKD，但 CKD 的病因尚不清楚。本研究旨在评估单核细胞与淋巴细胞比值（MLR）与 CKD 的 T2DM 患者死亡率之间的关系。分析了医疗信息集市重症监护 III 数据库的数据。主要结局为 90 天全因死亡率；次要结局为 ICU 住院时间、医院死亡率和 30 天全因死亡率。Cox 回归用于评估 MLR 与 90 天死亡率之间的关系。我们进行了亚组分析以确定这种关联的一致性，并使用 Kaplan-Meier 生存曲线分析不同 MLR 水平的生存情况。回顾性纳入了 1830 例患者进行研究。MLR>0.71 组的 ICU 住院时间、30 天全因死亡率和 90 天全因死亡率明显高于 MLR<0.28 和 0.28≤MLR≤0.71 组。在 Cox 回归分析中，高 MLR 水平与 90 天全因死亡率增加的风险显著相关。模型 1、模型 2 和模型 3 的调整 HR（95%CI）分别为 2.429（1.905-3.098）、2.070（1.619-2.647）和 1.898（1.478-2.437）。亚组分析也表明 MLR 与 90 天全因死亡率之间的关联具有一致性。Kaplan-Meier 生存曲线分析显示 MLR>0.71 的预后最差。在 ICU 中患有 CKD 的 T2DM 患者中，高 MLR 与 90 天全因死亡率增加的风险显著相关。
