1 徐州医科大学研究生学院，江苏 徐州 221000
2 徐州医科大学附属医院内分泌科，江苏 徐州 221000
|| 国家自然科学基金 (81701298)；徐州市重点研发计划 (KC17194)。
目的：探讨血总胆红素、中性粒细胞与淋巴细胞比值(neutrophi l-ly mphoc y te rat io，NLR)与 2型糖尿病(t y pe 2 d iabetes mel l itus，T2DM)伴冠心病(coronar y ar ter y d i sease，CAD)的相关性。方法：随机选择2016年1月至2018年1月在徐州医科大学附属医院就诊的704例患者为研究对象，其中单纯T2DM组263例，T2DM+CAD组441例。收集研究对象的临床资料，分析两组总胆红素、NLR及其他生化指标的差异。结果：与单纯T2DM组相比，T2DM+CAD组总胆红素水平明显降低，而NLR水平明显升高，差异均具有统计学意义(P<0.05)。多因素Logistic回归分析结果示：总胆红素(OR=0.806，95%CI 0.772~0.841，P<0.01)是T2DM伴CAD的独立保护因素，而NLR(OR=1.954，95%CI 1.517~2.518，P<0.01)是其独立危险因素。受试者工作特征曲线(ROC曲线)显示总胆红素、NLR诊断T2DM伴CAD风险的曲线下面积分别为0.735(95%CI 0.698~0.773)，0.713(95%CI 0.674~0.752)。结论：低总胆红素、高NLR是T2DM伴CAD的独立危险因素，有望成为一个较好的预测指标。
Correlation between total bilirubin, neutrophil-lymphocyte ratio and diabetes mellitus with coronary heart disease
This work was supported by the National Natural Science Foundation of China (81701298) and the Key Research and Development Plan of Xuzhou City (KC17194), China.
Objective: To investigate the relationship between total bilirubin, neutrophil-lymphocyte ratio (NLR) and type 2 diabetes mellitus (T2DM) with coronary artery disease (CAD). Methods: A total of 704 patients who were admitted to the Xuzhou Medical University Affiliated Hospital from January 2016 to January 2018 were randomly selected, including 263 patients with T2DM (T2DM group) and 441 patients with T2DM and CAD (T2DM+CAD group). The clinical data of the subjects were collected and the differences in total bilirubin, NLR and other biochemical indicators were analyzed. Results: Compared with the T2DM group alone, the total bilirubin level in the T2DM+CAD group was significantly lower, while the NLR level was significantly higher, and the difference was statistically significant (P<0.05). Multivariate logistic regression analysis showed that total bilirubin (OR=0.806, 95% CI 0.772–0.841, P<0.01) was an independent protective factor for type 2 diabetes with coronary heart disease, while NLR (OR=1.954, 95%CI 1.517–2.518, P<0.01) was an independent risk factor. The receiver operating characteristic curve (ROC curve) showed that the area under the curve of total bilirubin and NLR diagnosis of type 2 diabetes with coronary heart disease risk was 0.735 (95%CI 0.698–0.773), 0.713 (95%CI 0.674–0.752). Conclusion: Low total bilirubin and high NLR are independent risk factors for type 2 diabetes with coronary heart disease and are expected to be a good predictor.
type 2 diabetes; coronary heart disease; bilirubin; neutrophil to lymphocyte ratio