先天性和适应性免疫生物标志物在1型糖尿病儿童和青少年糖尿病肾病早期检测中的作用

The role of biomarkers of innate and adaptive immunity in the early detection of diabetic nephropathy in children and adolescents with type 1 diabetes mellitus.

作者信息

Yıldırım Ayşen Türedi, Bayar Nilay Tuğçe Işık, Yiğit Yeşim, Ersoy Betül

机构信息

Manisa Celal Bayar University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology and Oncology, Manisa, Türkiye.

Manisa Celal Bayar University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Manisa, Türkiye.

出版信息

J Diabetes Complications. 2025 Sep;39(9):109090. doi: 10.1016/j.jdiacomp.2025.109090. Epub 2025 May 30.

DOI:10.1016/j.jdiacomp.2025.109090

PMID:40466519

Abstract

AIMS

Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are biomarkers linked to microvascular complications in adult diabetics. This study aimed to assess whether NLR and PLR, which increase in chronic inflammation, could aid in early detection of diabetic nephropathy (DN) in children and adolescents with Type 1 diabetes mellitus (T1DM).

METHODS

The study included 90 children and adolescents with T1DM and 30 healthy controls. Microalbuminuria, defined as urine albumin >20 μg/min, was used to indicate early DN. Participants were grouped by diabetes duration: 0-60 months, 61-120 months, and >120 months.

RESULTS

NLR was significantly higher in patients with microalbuminuria compared to controls and those without microalbuminuria (p10 years. Positive correlations were observed between urinary albumin and NLR (r = 0.274, p = 0.003) and between PLR and diabetes duration (r = 0.286, p = 0.006). For early DN diagnosis, an NLR threshold of 1.675 showed 60 % specificity and 84.2 % sensitivity.

CONCLUSIONS

NLR outperformed PLR in early DN detection and may prompt timely urine albumin testing in children with T1DM. Further studies are needed to confirm these results.

摘要

目的

中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）是与成年糖尿病患者微血管并发症相关的生物标志物。本研究旨在评估在慢性炎症中升高的NLR和PLR是否有助于早期检测1型糖尿病（T1DM）儿童和青少年的糖尿病肾病（DN）。

方法

该研究纳入了90名T1DM儿童和青少年以及30名健康对照者。尿白蛋白>20μg/min定义为微量白蛋白尿，用于指示早期DN。参与者按糖尿病病程分组：0 - 60个月、61 - 120个月和>120个月。

结果

与对照组和无微量白蛋白尿的患者相比，微量白蛋白尿患者的NLR显著更高（p<0.001）。NLR和PLR在糖尿病病程>10年的患者中显著更高。尿白蛋白与NLR之间（r = 0.274，p = 0.003）以及PLR与糖尿病病程之间（r = 0.286，p = 0.006）观察到正相关。对于早期DN诊断，NLR阈值为1.675时，特异性为60%，敏感性为84.2%。