Application of combined detection of red blood cell distribution width, ratio of C-reactive protein to albumin and albumin-to-creatinine ratio in predicting complications of type 2 diabetes

Objective To explore the value of combined detection of red blood cell distribution width (RDW), C-reactive protein-to-albumin ratio (CAR) and albumin-to-creatinine ratio (UACR) in the prediction of complications of type 2 diabetes mellitus (T2DM).

Methods A total of 104 T2DM patients with complications and 104 T2DM patients without complications were selected as study subjects, and were included in observation group and control group respectively. The differences in general data, RDW, CAR and UACR levels between the two groups were compared. The predictive efficacy of RDW, CAR and UACR alone or their combination for T2DM complications was analyzed by receiver operating characteristic (ROC) curve.

Results Compared with the control group, the levels of 2-hour postprandial blood glucose(2 hPG), glycosylated hemoglobin(HbAlc), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), RDW, CAR and UACR in the observation group were higher, and the level of HDL-C was lower (P < 0.05). Correlation analysis showed that RDW was positively correlated with 2 hPG, HbAlc, TC, LDL-C, and negatively correlated with HDL-C; CAR was positively correlated with 2 hPG, HbAlc, TC, LDL-C and negatively correlated with HDL-C; UACR was positively correlated with PPG, HbAlc, TC, LDL-C and negatively correlated with HDL-C. Logistic regression analysis showed that RDW, CAR and UACR were the influencing factors of T2DM patients complicated with diabetic retinopathy (DR), diabetic kidney disease (DKD), diabetic peripheral neuropathy (DPN), coronary artery disease (CAD) (P < 0.05). ROC curve analysis showed that the area under curve (AUC) of RDW, CAR and UACR alone and their combination were 0.753, 0.858, 0.885 and 0.915, respectively. Compared with RDW, CAR and UACR alone, the combination of the three indicators had higher predictive efficacy for T2DM complications (Z=3.221, 2.605 and 2.334, P < 0.05).

Conclusion The increased levels of RDW, CAR and UACR are closely related to the occurrence of complications in patients with T2DM. Detection of RDW, CAR or UACR alone has a certain predictive value for the complications of T2DM, but their combination has a higher predictive efficacy.