Department of Endocrinology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Beijing University of Chinese Medicine, Beijing, China.
Front Endocrinol (Lausanne). 2024 Apr 25;15:1345293. doi: 10.3389/fendo.2024.1345293. eCollection 2024.
The activation of platelets in individuals with type 2 diabetes mellitus (T2DM) triggers inflammation and hemodynamic abnormalities, contributing to the development of diabetic kidney disease (DKD). Despite this, research into the relationship between plateletcrit (PCT) levels and DKD is sparse, with inconsistent conclusions drawn regarding the connection between various platelet parameters and DKD. This highlights the necessity for comprehensive, large-scale population studies. Therefore, our objective is to explore the association between PCT levels and various platelet parameters in relation to DKD.
In this cross-sectional study, hematological parameter data were collected from a cohort of 4,302 hospitalized Chinese patients. We analyzed the relationships between PCT, platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (P-LCR), and DKD, along with the urinary albumin-to-creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR). Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the diagnostic potential of these parameters.
DKD patients exhibited significantly higher PCT levels compared to those without DKD. Multivariate regression analysis identified elevated PCT and PLT levels as potential independent risk factors for both DKD and UACR, while lower MPV levels might serve as independent protective factors for eGFR. The areas under the ROC curve for PCT in relation to DKD and UACR (≥30 mg/g) were 0.523 and 0.526, respectively. The area under the ROC curve for PLT in relation to UACR (≥30 mg/g) was 0.523.
PCT demonstrates a weak diagnostic value for T2DM patients at risk of developing DKD and experiencing proteinuria, and PLT shows a similarly modest diagnostic utility for detecting proteinuria. These insights contribute to a deeper understanding of the complex dynamics involved in DKD. Additionally, incorporating these markers into routine clinical assessments could enhance risk stratification, facilitating early interventions and personalized management strategies.
2 型糖尿病（T2DM）患者的血小板活化会引发炎症和血液动力学异常，从而导致糖尿病肾病（DKD）的发生。尽管如此，关于血小板crit（PCT）水平与 DKD 之间的关系的研究还很匮乏，关于各种血小板参数与 DKD 之间的联系，得出的结论也不一致。这凸显了进行全面、大规模人群研究的必要性。因此，我们的目的是探讨 PCT 水平与与 DKD 相关的各种血小板参数之间的关系。
在这项横断面研究中，我们从 4302 名住院中国患者的队列中收集了血液学参数数据。我们分析了 PCT、血小板计数（PLT）、平均血小板体积（MPV）、血小板分布宽度（PDW）、血小板大细胞比率（P-LCR）与 DKD 以及尿白蛋白与肌酐比值（UACR）和估计肾小球滤过率（eGFR）之间的关系。进行了受试者工作特征（ROC）曲线分析以评估这些参数的诊断潜力。
与无 DKD 的患者相比，DKD 患者的 PCT 水平显著更高。多变量回归分析确定了升高的 PCT 和 PLT 水平是 DKD 和 UACR 的潜在独立危险因素，而较低的 MPV 水平可能是 eGFR 的独立保护因素。PCT 与 DKD 和 UACR（≥30mg/g）的 ROC 曲线下面积分别为 0.523 和 0.526。PLT 与 UACR（≥30mg/g）的 ROC 曲线下面积为 0.523。
PCT 对处于发生 DKD 和蛋白尿风险的 T2DM 患者具有较弱的诊断价值，PLT 对检测蛋白尿也具有类似的诊断效用。这些发现有助于深入了解 DKD 中涉及的复杂动态。此外，将这些标志物纳入常规临床评估可以增强风险分层，促进早期干预和个性化管理策略。
