2型糖尿病单核细胞/淋巴细胞比例与骨密度的非线性关系：脂肪分布的中介作用。

IF 2.4 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Clinical Endocrinology Pub Date : 2025-05-07 DOI:10.1111/cen.15267

Ying Yang, Shuyun Li, Gang Tian, Lingling Li, Jia Bai, Jinyang An, Xinsai Li, Yangyang Zhang, Zijuan Guo, Haihong Lv

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引用次数: 0

摘要

目的：探讨2型糖尿病（T2DM）患者腰椎骨矿物质密度（BMD）与单核细胞/淋巴细胞比值（MLR）的关系，并分析脂肪分布在其中的中介作用，为T2DM骨质疏松症的早期诊断提供新的指标。方法：共纳入430例50岁以上T2DM患者。根据MLR分为T1、T2、T3三组。采用调整回归模型、亚组分析、广义加性模型（GAM）、平滑曲线拟合和中介效应分析等方法。结果：T2DM患者MLR与腰椎骨密度呈显著负相关(β = -0.701；95%ci: -0.112, -0.290)。亚组分析、平滑曲线拟合和阈值效应分析表明，MLR与BMD之间存在非线性关系，MLR值为0.1266时出现最优拐点。此外，内脏脂肪面积与皮下脂肪面积之比（VSR）与腰椎骨密度呈负相关(β = -0.775；95%ci: -1.007, -0.504)。MLR与腰椎骨密度间VSR的中介效应分析显示，总效应估计值为-0.0717，直接效应估计值为-0.0524，中介效应估计值为-0.0193，中介比例占总效应的26.88%。结论：MLR与T2DM患者腰椎骨密度显著相关。较高的MLR水平与降低的骨密度相关。VSR在这一关系中起着重要的中介作用，突出了MLR在骨质疏松症诊断中的潜在效用和脂肪管理对骨骼健康的重要性。

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Nonlinear Relationship Between Monocyte-to-Lymphocyte Ratio and Bone Mineral Density in Type 2 Diabetes Mellitus: Mediating Role of Fat Distribution

Objective

The objective of study is to clarify the relationship between monocyte-to-lymphocyte ratio (MLR) and lumbar spine bone mineral density (BMD) in type 2 diabetes mellitus (T2DM), and analyse the mediating role of fat distribution, providing a new indicator for the early diagnosis of osteoporosis in T2DM.

Methods

A total of 430 T2DM patients over 50 years were included. Subjects were divided into T1, T2 and T3 three groups based on MLR. The adjusted regression models, subgroup analysis, generalised additive model (GAM), smoothed curve fitting, and mediated effects analysis methods were used.

Results

The results indicated a significant negative correlation between MLR and lumbar spine BMD in T2DM (β = −0.701; 95%CI: −0.112, −0.290). Subgroup analysis, smoothed curve fitting and threshold effect analysis showed a nonlinear relationship between MLR and BMD, with an optimal inflection point at an MLR value of 0.1266. Additionally, the ratio of visceral to subcutaneous fat area (VSR) was negatively correlated with lumbar spine BMD (β = −0.775; 95%CI: −1.007, −0.504). Mediation effect analysis of VSR between MLR and lumbar spine BMD showed that the total effect estimate was −0.0717, the direct effect estimate was −0.0524, the mediation effect estimate was −0.0193, with the mediated proportion accounting for 26.88% of the total effect.

Conclusion

MLR is significantly associated with lumbar spine BMD in T2DM. Higher MLR levels correlated with reduced BMD. VSR plays a significant mediating role in this relationship, highlighting MLR's potential utility in osteoporosis diagnosis and importance of fat management for bone health.

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来源期刊

Clinical Endocrinology 医学-内分泌学与代谢

CiteScore

6.40

自引率

3.10%

发文量

192

审稿时长

1 months

期刊介绍： Clinical Endocrinology publishes papers and reviews which focus on the clinical aspects of endocrinology, including the clinical application of molecular endocrinology. It does not publish papers relating directly to diabetes care and clinical management. It features reviews, original papers, commentaries, correspondence and Clinical Questions. Clinical Endocrinology is essential reading not only for those engaged in endocrinological research but also for those involved primarily in clinical practice.