在一项全国性研究中，中性粒细胞-淋巴细胞比率是糖尿病前期患者全因死亡率和心血管死亡率的预测因子。

IF 3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Pub Date : 2024-10-23 DOI:10.1007/s12020-024-04075-w

Gaiying Dong, Xiaofan Gu, Chunhua Qiu, Yanlin Xie, Zhiwen Hu, Liangliang Wu

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引用次数: 0

摘要

目的：我们旨在研究中性粒细胞-淋巴细胞比值（NLR）在预测糖尿病前期患者全因和心血管死亡风险方面的价值：本研究共纳入了 11504 名来自 2003-2016 年美国国家健康与营养调查（NHANES）的糖尿病前期患者。通过链接至2019年12月31日的国家死亡指数记录，确定了死亡率和基本死因。为了直观地显示 NLR 与死亡风险之间的关系，我们进行了限制性三次样条曲线（RCS）分析。通过最大选择秩统计法（MSRSM）计算出与生存结果相关性最显著的最佳NLR截断值。加权多变量 Cox 回归模型和亚组分析用于计算全因死亡率和心血管死亡率的 HRs 和 95% CIs：中位随访时间为 101 个月（四分位间范围为 64.0-138.0 个月），记录的死亡人数为 1654 人（14.38%），其中心血管事件和非心血管事件死亡人数分别为 422 人（3.67%）和 1232 人（10.71%）。RCS回归分析表明，NLR与全因死亡率和心血管死亡率呈正相关。使用 MSRSM 将个体分为 NLR 较低（≤2.94）和较高（>2.94）两组。在多变量调整模型中，与低NLR组相比，高NLR组的全因死亡率和心血管死亡率的HR分别为1.63（95% CI，1.38-1.93）和2.19（95% CI，1.55-3.01）：NLR是预测糖尿病前期患者全因和心血管死亡风险的重要指标。

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Neutrophil-lymphocyte ratio is a predictor for all-cause and cardiovascular mortality in individuals with prediabetes in a National study.

Purpose: We aimed to investigate the value of the neutrophil-lymphocyte ratio (NLR) in predicting the all-cause and cardiovascular mortality risk of individuals with prediabetes.

Methods: A total of 11,504 prediabetic patients from the National Health and Nutrition Examination Survey (NHANES) 2003-2016 were included in the present study. Mortality and the underlying cause of death were ascertained by linkage to National Death Index records through December 31, 2019. Restricted cubic spline (RCS) analysis was conducted to visualize the association between the NLR and mortality risk. The optimal NLR cutoff value corresponding to the most significant correlation with survival outcomes was calculated by the maximally selected rank statistics method (MSRSM). Weighted multivariable Cox regression models and subgroup analyses were used to calculate HRs and 95% CIs for all-cause and cardiovascular mortality.

Results: During a median follow-up of 101 months (interquartile range, 64.0-138.0 months), 1654 (14.38%) deaths were documented, including 422 (3.67%) and 1232 (10.71%) due to cardiovascular and non-cardiovascular events, respectively. RCS regression analysis indicated that the NLR was positively associated with all-cause and cardiovascular mortality. Individuals were divided into lower (≤2.94) and higher (>2.94) NLR groups using the MSRSM. In the multivariable-adjusted model, compared with the lower NLR group, the higher NLR group had a HR of 1.63 (95% CI, 1.38-1.93) and 2.19 (95% CI, 1.55-3.01) for all-cause and cardiovascular mortality, respectively.

Conclusions: The NLR was a valuable marker for predicting all-cause and cardiovascular mortality risk in prediabetic patients.

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来源期刊

Endocrine ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

5.40%

发文量

295

审稿时长

1.5 months

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.