Neutrophil count as a reliable marker for diabetic kidney disease in autoimmune diabetes
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RESEARCH ARTICLE
Open Access
Neutrophil count as a reliable marker for diabetic kidney disease in autoimmune diabetes Yao Yu1,2†, Qiuqiu Lin1,2†, Dewei Ye3, Yanfei Wang4, Binbin He1,2, Yanhua Li1,2, Gan Huang1,2, Zhiguang Zhou1,2 and Yang Xiao1,2*
Abstract Background: A growing body of evidence supports neutrophils as having an active role in the development of diabetic kidney disease (DKD). However, the clinical relevance of neutrophils and DKD in autoimmune diabetes remains unknown. This study aimed to investigate the relationship between circulating neutrophils and DKD in autoimmune diabetes. Methods: Patients with type 1 diabetes (T1D, n = 226) and latent autoimmune diabetes in adults (LADA, n = 79) were enrolled and stratified according to the urinary albumin to creatinine ratio (ACR). Circulating levels of white blood cells (WBCs), including neutrophils, were measured in a central laboratory, and the neutrophil-to-lymphocyte ratio (NLR) was calculated. The risk factors associated with DKD were analysed by logistic regression. Results: In T1D and LADA patients, the peripheral neutrophil counts increased in parallel with DKD advancement. The neutrophil counts in the patients with macroalbuminuria were significantly higher than those in the patients with normoalbuminuria for each type of diabetes. Furthermore, neutrophil counts positively correlated with ACR in T1D. In addition, neutrophils were independently associated with DKD in T1D in the logistic regression analysis, when various well-known risk factors, including age, gender, disease duration, hypertension, dyslipidemia and smoking status, were adjusted. Conclusions: Neutrophil counts are closely associated with DKD in patients with autoimmune diabetes, suggesting that neutrophil-mediated inflammation may be involved in the pathogenesis of DKD in patients with autoimmune diabetes. Keywords: Neutrophil, Autoimmune diabetes, Type 1 diabetes, Latent autoimmune diabetes in adults, Diabetic kidney disease
* Correspondence: [email protected] † Yao Yu and Qiuqiu Lin contributed equally to this work. 1 Department of Metabolism & Endocrinology, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Changsha 410011, Hunan, China 2 Key Laboratory of Diabetes Immunology (Central South University), Ministry of Education; National Clinical Research Center for Metabolic Diseases, Changsha, Hunan, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included i
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