Aspartate aminotransferase/alanine aminotransferase ratio was associated with type 2 diabetic peripheral neuropathy in a Chinese population: A cross-sectional study

Association between AST/ALT ratio and diabetic retinopathy risk in type 2 diabetes: a cross-sectional investigation

Objective

This study aimed to explore the association between the aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT ratio) and diabetic retinopathy (DR) in patients with type 2 diabetes.

Methods

In this cross-sectional study, clinical data from 3002 patients with type 2 diabetes admitted to the Department of Endocrinology of our hospital between January 1, 2021, and December 1, 2022, were retrospectively collected. Measurements of AST and ALT were conducted and diabetes-related complications were screened. The association between AST/ALT ratio and diabetic retinopathy was assessed using multivariate logistic regression, and a generalized additive model (GAM) was used to investigate nonlinear relationships. Subgroup analyses and interaction tests were also conducted.

Results

Among the 3002 patients, 1590 (52.96%) were male and 1412 (47.04%) were female. The mean AST/ALT ratio was 0.98 ± 0.32, ranging from 0.37 (Min) to 2.17 (Max). Diabetic retinopathy was present in 40.47% of the patients. After multivariate adjustments, for each 0.1 unit increase in AST/ALT ratio, the risk of DR increased by 4% (OR = 1.04, 95% CI: 1.01-1.07, p=0.0053). Higher AST/ALT ratio quartiles were associated with Higher prevalence of DR (OR vs. Q1: Q4 = 1.34 (CI: 1.03-1.75, p=0.0303).The GAM and smoothed curve fit indicated a linear relationship between AST/ALT ratio and DR risk, with no significant interaction effects across different subgroups.

Conclusion

Our study demonstrates a positive correlation between the AST/ALT ratio and diabetic retinopathy risk in type 2 diabetes, suggesting its potential role in assessing DR risk.

Association of systemic immune-inflammation index with diabetic kidney disease in patients with type 2 diabetes: a cross-sectional study in Chinese population

Objective

Systemic immune-inflammation index (SII), a novel inflammatory marker, has been reported to be associated with diabetic kidney disease (DKD) in the U.S., however, such a close relationship with DKD in other countries, including China, has not been never determined. We aimed to explore the association between SII and DKD in Chinese population.

Methods

A total of 1922 hospitalized patients with type 2 diabetes mellitus (T2DM) included in this cross-sectional study were divided into three groups based on estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (ACR): non-DKD group, DKD stages 1-2 Alb group, and DKD-non-Alb+DKD stage 3 Alb group. The possible association of SII with DKD was investigated by correlation and multivariate logistic regression analysis, and receiver-operating characteristic (ROC) curves analysis.

Results

Moving from the non-DKD group to the DKD-non-Alb+DKD stage 3 Alb group, SII level was gradually increased (P for trend <0.01). Partial correlation analysis revealed that SII was positively associated with urinary ACR and prevalence of DKD, and negatively with eGFR (all P<0.01). Multivariate logistic regression analysis showed that SII remained independently significantly associated with the presence of DKD after adjustment for all confounding factors [(odds ratio (OR), 2.735; 95% confidence interval (CI), 1.840-4.063; P < 0.01)]. Moreover, compared with subjects in the lowest quartile of SII (Q1), the fully adjusted OR for presence of DKD was 1.060 (95% CI 0.773-1.455) in Q2, 1.167 (95% CI 0.995-1.368) in Q3, 1.266 (95% CI 1.129-1.420) in the highest quartile (Q4) (P for trend <0.01). Similar results were observed in presence of DKD stages 1-2 Alb or presence of DKD-non- Alb+DKD stage 3 Alb among SII quartiles. Last, the analysis of ROC curves revealed that the best cutoff values for SII to predict DKD, Alb DKD stages 1- 2, and DKD-non-Alb+ DKD stage 3 Alb were 609.85 (sensitivity: 48.3%; specificity: 72.8%), 601.71 (sensitivity: 43.9%; specificity: 72.3%), and 589.27 (sensitivity: 61.1%; specificity: 71.1%), respectively.

Conclusion

Higher SII is independently associated with an increased risk of the presence and severity of DKD, and SII might be a promising biomarker for DKD and its distinct phenotypes in Chinese population.

Increased Systemic Immune-Inflammation Index Was Associated with Type 2 Diabetic Peripheral Neuropathy: A Cross-Sectional Study in the Chinese Population

Background

Systemic immune-inflammation index (SII), a novel inflammatory marker, has been demonstrated to be associated with type 2 diabetes mellitus (T2DM) and its vascular complications, however, the relation between SII and diabetic peripheral neuropathy (DPN) has been never reported. We aimed to explore whether SII is associated with DPN in Chinese population.

Methods

A cross-sectional study was conducted among 1460 hospitalized patients with T2DM. SII was calculated as the platelet count × neutrophil count/lymphocyte count, and its possible association with DPN was investigated by correlation and multivariate logistic regression analysis, and subgroup analyses.

Results

Patients with higher SII quartiles had higher vibration perception threshold and prevalence of DPN (all P<0.01), and SII was independently positively associated with the prevalence of DPN (P<0.01). Multivariate logistic regression analysis showed that the risk of prevalence of DPN increased progressively across SII quartiles (P for trend <0.01), and participants in the highest quartile of SII was at a significantly increased risk of prevalent DPN compared to those in the lowest quartile after adjustment for potential confounding factors (odds rate: 1.211, 95% confidence intervals 1.045-1.404, P<0.05). Stratified analysis revealed positive associations of SII quartiles with risk of prevalent DPN only in men, people less than 65 years old, with body mass index <24 kg/m2, duration of diabetes >5 years, hypertension, dyslipidaemia, poor glycaemic control, and estimated glomerular filtration rate <90 mL/min/1.73 m2 (P for trend <0.01 or P for trend <0.05). The receiver operating characteristic curve analysis revealed that the optimal cut-off point of SII for predicting DPN was 617.67 in patients with T2DM, with a sensitivity of 45.3% and a specificity of 73%.

Conclusion

The present study showed that higher SII is independently associated with increased risk of DPN, and SII might serve as a new risk biomarker for DPN in Chinese population.