Clinical significance of homocysteine and neutrophil-to-lymphocyte ratio in patients with nonalcoholic fatty liver disease and type 2 diabetes mellitus
10.3969/j.issn.1001-5256.2021.10.019
- VernacularTitle:非酒精性脂肪性肝病合并2型糖尿病患者同型半胱氨酸水平和中性粒细胞与淋巴细胞比值的临床意义
- Author:
Peiru LEI
1
;
Yingjie LI
1
;
Jing LI
1
Author Information
1. Department of Gastroenterology, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning 121000, China
- Publication Type:Original articles_Other liver diseases
- Keywords:
Non-Alcoholic Fatty Liver Disease;
Diabetes Mellitus, Type 2;
Cysteine;
Neutrophil;
Lymphocytes
- From:
Journal of Clinical Hepatology
2021;37(10):2352-2356
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the levels and clinical significance of homocysteine (Hcy) and neutrophil-to-lymphocyte ratio (NLR) in patients with nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM). Methods A total of 528 patients with NAFLD who were treated in Department of Endocrinology, The First Affiliated Hospital of Jinzhou Medical University, from January to December 2019 were enrolled, and according to the presence or absence of T2DM, they were divided into non-T2DM group and T2DM group. A total of 79 T2DM patients without NAFLD were selected randomly. General data and laboratory markers were recorded for the three groups. A one-way analysis of variance was used for comparison of normally distributed continuous data between groups, and the chi-square test was used for comparison of categorical data between groups; a binary logistic regression analysis was used to determine risk factors, and odds ratio ( OR ) and its 95% confidence interval ( CI ) were used to represent relative risk; the receiver operating characteristic (ROC) curve was used to evaluate predictive efficiency. Results The T2DM group had significantly higher systolic blood pressure (SBP), diastolic blood pressure, and body mass index than the non-T2DM group (all P < 0.05), and there were significant differences between any two of the three groups in Hcy, NLR, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, uric acid, and fasting blood glucose (all P < 0.05). There were significant differences in neutrophil count, lymphocyte count, and high-density lipoprotein cholesterol (HDL-C) between the T2DM group and the non-T2DM group (all P < 0.05), and there was a significant difference in total cholesterol between the T2DM group and the simple T2DM group and between the non-T2DM group and the simple T2DM group ( P < 0.05). SBP ( O R =1.040, 95% C I : 1.015-1.065), HDL-C ( OR =0.040, 95% CI : 0.007-0.228), NLR ( OR =6.285, 95% C I : 1.504-27.108), and Hcy ( O R =1.291, 95% C I : 1.127-1.423) were independent risk factors for NAFLD with T2DM. Hcy had an area under the ROC curve (AUC) of 0.741 (95% CI : 0.698-0.783, P < 0.01) in predicting NAFLD with T2DM, with a Youden index of 0.394, a sensitivity of 69.6%, and a specificity of 69.8% at the optimal cut-off value of 15.31 μmol/L. NLR had an AUC of 0.782 (95% C I : 0.744-0.820, P < 0.01) in predicting NAFLD with T2DM, with a Youden index of 0.443, a sensitivity of 72.1%, and a specificity of 72.2% at the optimal cut-off value of 2.12. Hcy combined with NLR had an AUC of 0.845 (95% C I : 0.812-0.878, P < 0.01) in predicting NAFLD with T2DM, with a Youden index of 0.549, a sensitivity of 71.8%, and a specificity of 83.1%. Conclusion Hcy and NLR are risk factors for NAFLD with T2DM and have a certain predictive value. Combined measurement of Hcy and NLR can improve the diagnostic efficiency of NAFLD with T2DM and help clinicians with diagnosis in the early stage.
