Association between complete blood count-derived inflammatory indices and lower extremity atherosclerotic lesions in patients with type 2 diabetes mellitus

doi:10.3877/cma.j.issn.2095-5820.2025.03.005

Abstract

Abstract:

Objective

To investigate the relationship between complete blood count-derived inflammatory indices and lower extremity atherosclerotic disease (LEAD) in patients with type 2 diabetes mellitus (T2DM).

Methods

This cross-sectional study enrolled 227 T2DM patients without LEAD (T2DM group), 127 T2DM patients with LEAD (T2DM+LEAD group), and 100 healthy controls. Demographic and clinical data were collected. Absolute counts of WBC, neutrophils, lymphocytes, monocytes, and PLT were measured. Inflammatory indices including systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), derived NLR (d-NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and neutrophil-to-monocyte ratio (NMR) were calculated. Statistical analyses were performed to evaluate the associations between these indices and T2DM and T2DM-LEAD patients.

Results

Compared with the T2DM group, the T2DM+LEAD group exhibited significantly higher SII, NLR, d-NLR, and PLR values (all P<0.05), while LMR was significantly lower (P<0.05). Multivariate regression analysis identified age (β=0.124, OR=1.132, P<0.001), SII (β=0.004, OR=1.004, P<0.001), NLR (β=0.426, OR=1.531, P=0.027), and PLR (β=0.003, OR=1.003, P=0.032) as independent risk factors for LEAD in T2DM patients. Receiver operating characteristic (ROC) curve analysis revealed an area under the curve of 0.749 (95% CI: 0.700~0.793) for SII and 0.682 (95% CI: 0.631~0.731) for NLR.

Conclusion

The SII may serve as a significant biomarker for predicting LEAD in T2DM patients, demonstrating moderate predictive efficacy.

Key words: systemic immune-inflammation index, type 2 diabetes mellitus, lower extremity atherosclerotic disease, inflammation indexes

Longbin Cao, Yuansi Lu, Xin Qiu, Qi Ye. Association between complete blood count-derived inflammatory indices and lower extremity atherosclerotic lesions in patients with type 2 diabetes mellitus[J]. Chinese Journal of Clinical Laboratory Management(Electronic Edition), 2025, 13(03): 159-165.

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Figures/Tables 7

炎症指数	公式
SII	$PLT × NEU LYM$
NLR	$NEU LYM$
d-NLR	$WBC － NEU LYM$
PLR	$PLT LYM$
LMR	$LYM MON$
NMR	$NEU MON$

炎症指数	公式
SII	$PLT × NEU LYM$
NLR	$NEU LYM$
d-NLR	$WBC － NEU LYM$
PLR	$PLT LYM$
LMR	$LYM MON$
NMR	$NEU MON$

指标	对照组（n=100）	T2DM（n=227）	T2DM+LEAD（n=127）	t/χ²/F值	P值
年龄/岁，M（Q₁，Q₃）	56（45，76）	57（49，66）	73（60，79）	64.190	<0.001
性别/男，n（%）	56（56）	131（57.7）	54（42.5）	7.965	0.613
BMI/M（Q₁，Q₃）	24.2（22.3，26.7）	24.1（22.5，26.2）	24.0（22.2，26.6）	0.566	0.757
病程/年，M（Q₁，Q₃）	-	9（6，16）	18（9，21）	33.125	<0.001
SBP/mmHg， $x ¯ ± s$	123.7±10.4	125.4±10.2	124.0±10.8	1.527	0.466
DBP/mmHg， $x ¯ ± s$	77.3±6.7	77.8±7.1	77.3±5.8	0.359	0.840

指标	对照组（n=100）	T2DM（n=227）	T2DM+LEAD（n=127）	t/χ²/F值	P值
年龄/岁，M（Q₁，Q₃）	56（45，76）	57（49，66）	73（60，79）	64.190	<0.001
性别/男，n（%）	56（56）	131（57.7）	54（42.5）	7.965	0.613
BMI/M（Q₁，Q₃）	24.2（22.3，26.7）	24.1（22.5，26.2）	24.0（22.2，26.6）	0.566	0.757
病程/年，M（Q₁，Q₃）	-	9（6，16）	18（9，21）	33.125	<0.001
SBP/mmHg， $x ¯ ± s$	123.7±10.4	125.4±10.2	124.0±10.8	1.527	0.466
DBP/mmHg， $x ¯ ± s$	77.3±6.7	77.8±7.1	77.3±5.8	0.359	0.840

指标	对照组（n=100）	T2DM（n=227）	T2DM+LEAD（n=127）	t/χ²/F值	P值
WBC/（×10⁹/L）	6.44（5.27，7.96）	7.17（5.91，8.52）	7.46（6.20，9.85）	17.143	0.071
NEU/（×10⁹/L）	3.78（3.03，4.71）	4.59（3.52，5.95）	5.05（3.85，6.87）	30.911	0.054
LYM/（×10⁹/L）	1.94（1.53，2.41）	1.80（1.41，2.21）	1.65（1.26，2.12）	11.142	0.064
MON/（×10⁹/L）	0.38（0.28，0.44）	0.40（0.30，0.49）	0.43（0.33，0.56）	8.065	0.065
PLT/（×10⁹/L）	260.00（211.00，307.00）	234.00（194.00，287.00）	244.00（197.00，292.00）	4.794	0.380
SII	487.32（377.83，706.05）	590.79（414.88，883.86）	733.756（502.53，1 210.84）	25.717	<0.001
NLR	1.95（1.49，2.67）	2.61（1.88，3.50）	2.98（2.12，4.58）	40.936	<0.001
d-NLR	1.31（1.23，1.39）	1.32（1.24，1.43）	1.36（1.26，1.53）	10.439	0.021
PLR	129.84（104.38，169.60）	130.99（101.74，180.95）	149.04（105.71，209.77）	7.072	0.019
LMR	5.15（4.14，6.50）	4.61（3.61，6.03）	4.00（2.75，5.46）	22.038	0.007
NMR	10.29（8.51，12.60）	11.67（9.42，15.11）	11.74（9.34，16.07）	13.824	0.694

项目	β值	SE值	Wald值	OR值	Lower值	Upper值	P值
病程/年	0.070	0.039	3.302	0.932	0.864	1.006	0.069
年龄/岁	0.124	0.023	29.812	1.132	1.083	1.183	<0.001
SII	0.004	0.001	24.705	1.004	1.002	1.005	<0.001
NLR	0.426	0.147	10.326	1.531	1.549	2.757	0.027
d-NLR	0.269	0.736	0.134	1.309	0.309	5.542	0.715
PLR	0.003	0.001	4.602	1.003	1.000	1.005	0.032
LMR	0.056	0.090	0.379	1.057	0.886	1.262	0.538

可变因素	AUC	灵敏度/%	特异性/%	Cut-off	95%CI	P值
SII+NLR	0.769	74.8	66.3	-	0.721~0.811	<0.001
SII	0.749	70.7	68.3	546.13	0.700~0.793	<0.001
NLR	0.682	66.9	55.0	2.71	0.631~0.731	<0.001
d-NLR	0.574	45.7	67.4	1.39	0.521~0.626	0.023

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