Prognostic nutrition index, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio combined detection, superior to single detection correlates with prognosis of patients with chronic hepatitis C-associated cirrhosis complicated by T2DM

Abstract

AbstractBackgroundPrognostic nutrition index (PNI), Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) have been studied widely in cancer diseases. However, their correlation with chronic hepatitis C-associated cirrhosis complicated by T2DM mellitus is unknown.AimTo investigate the correlation of PNI, NLR and PLR with chronic hepatitis C-associated cirrhosis complicated by T2DM.They were associated with the prognosis of patients.MethodsWe investigated 226 patients. Of the patients, 56 cases were with chronic hepatitis C-associated cirrhosis complicated by T2DM mellitus patients (group A), 85 cases were with chronic hepatitis C-associated cirrhosis patients (group B), and 85 cases were with T2DM patients (group C). According to the prognosis of chronic hepatitis C-associated cirrhosis complicated by T2DM after 6 months of treatment, patients were divided into poor prognosis (23 cases) and good prognosis (33 cases). The baseline data and of all patients were analyzed. All data were collected from the database of the hospital patient electronic medical record system.ResultsA comparison of baseline data among the three groups showed significant differences in age (Pvalue=0.008). The levels of PNI were obvious difference in three groups (Pvalue < 0.01). The level of NLR in the group A was significantly lower than in the group C. The level of NLR in the group B was significantly lower than in the group C and the group A. The level of PNI in the group A was significantly lower than in the group C. The level of PNI in the group A was significantly lower than in the group B. The level of PLR in the group A was significantly lower than in the group C. The level of PLR in the group B was significantly higher than in the group C. NLR, PNI, PLR were significantly different in the good prognosis group and the poor prognosis group (Pvalue < 0.05). We calculated AUC for combined determination of PNI, NLR and PLR, and it showed excellent diagnostic performance (AUC = 0.911,95% CI 0.741-0.985, Sensitivity = 80.00 %, and Specificity = 88.89%).ConclusionsPNI, NLR and PLR were closely related to the prognosis of chronic hepatitis C-associated cirrhosis complicated by T2DM, and their combined detection had the highest specificity and sensitivity for early prediction of the poor prognosis of chronic hepatitis C-associated cirrhosis complicated by T2DM, which had important clinical value.