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[Relationship between platelet/lymphocyte ratio and cognitive impairment in diabetic patients treated with
Insights
The platelet/lymphocyte ratio (PLR) is linked to cognitive impairment (CI) in diabetic patients undergoing maintenance hemodialysis (MHD). Higher PLR levels significantly increase the risk of developing CI in this patient group.
Area of Science:
- Nephrology
- Hematology
- Neurology
Background:
- Diabetic patients on maintenance hemodialysis (MHD) are at increased risk for cognitive impairment (CI).
- The platelet/lymphocyte ratio (PLR) is an emerging inflammatory marker with potential implications in various chronic diseases.
Purpose of the Study:
- To investigate the association between the platelet/lymphocyte ratio (PLR) and cognitive impairment (CI) in diabetic patients undergoing maintenance hemodialysis (MHD).
Main Methods:
- Cross-sectional study involving 586 diabetic MHD patients.
- Patients were assessed for cognitive impairment (CI) using the mini-mental state examination (MMSE).
- Multivariate logistic regression and ROC curve analysis were employed to determine the relationship between PLR and CI.
Main Results:
- A significant association was found between higher PLR levels and an increased risk of CI in diabetic MHD patients.
- Patients in the highest quartile of PLR (Q4) had a 2.281 times higher risk of CI compared to the lowest quartile (Q1) after adjusting for multiple clinical factors.
- The optimal PLR threshold for predicting CI was 155.3, with a sensitivity of 57.2% and specificity of 60.8%.
Conclusions:
- The platelet/lymphocyte ratio (PLR) is independently associated with cognitive impairment (CI) in diabetic patients on maintenance hemodialysis (MHD).
- PLR may serve as a potential biomarker for identifying diabetic MHD patients at risk of cognitive decline.
Abstract:
Objective: To explore the relationship between platelet/lymphocyte ratio (PLR) and cognitive impairment (CI) in diabetic patients treated with maintenance hemodialysis (MHD). Methods: The data of age, gender, underlying diseases, medication history, mini-mental state examination (MMSE) and biochemical indexes of diabetic MHD patients who were treated in 18 hemodialysis center in Guizhou Province between May and August 2019 were collected. According to whether they had CI or not, the patients were divided into CI group and control group, and the clinical characteristics between the two groups were compared. In addition, the patients were divided into four groups according to the quartile of PLR (PLR Q1, Q2, Q3 and Q4 group). Multivariate logistic regression models were used to analyze the relationship between PLR level and CI in diabetic MHD patients. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of PLR in detecting CI in diabetic MHD patients. Results: Totally, 586 diabetic MHD patients (389 males) were included, with a mean age of (63±11) years. Multivariate logistic regression analysis showed that PLR was associated with the risk of CI in diabetic MHD patients, and the risk of CI in PLR Q4 group was 3.022 times of that of PLR Q1 Group (95%CI: 1.866-4.895, P<0.001). After adjusting for gender, age, dialysis age and education level, the risk of CI in PLR Q4 group was 2.529 times of that in PLR Q1 Group (95%CI: 1.536-4.164, P<0.001). After further adjusting for hemoglobin, albumin, creatinine, leukocyte and blood glucose, the risk of CI in PLR Q4 group was 2.281 times of that in PLR Q1 group (95%CI: 1.203-4.326, P=0.012). ROC curve analysis showed that the optimal threshold for PLR to predict CI in diabetic MHD patients was 155.3, with a sensitivity of 57.2% and a specificity of 60.8%, and the area under the curve was 0.608 (95%CI: 0.561-0.644, P<0.001). Conclusion: PLR is associated with CI in diabetic MHD patients.
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