Association between routine blood count-derived inflammatory markers and left ventricular hypertrophy in diabetic kidney disease patients: a cross-sectional study.

BACKGROUND

Adverse cardiovascular events are one of the most serious complications of diabetic kidney disease (DKD), and left ventricular hypertrophy (LVH) is a reliable predictor. The low-grade inflammatory state in patients with DKD further aggravates the damage to the kidneys and cardiovascular system. This study aims to explore the relationship between routine blood count-derived inflammatory markers in the peripheral blood of DKD patients and LVH.

METHODS

In this cross-sectional study, 419 patients with DKD G2 ~ G4, who received treatment at the Peking University Third Hospital from January 2020 to September 2025 were enrolled. Based on the echocardiographic findings, the participants were categorized into two groups: those with LVH and those without. Logistic regression was employed to examine the factors associated with LVH, as well as the interactions among neutrophil, the systemic immune-inflammation index (SII), and the stages of DKD. Additionally, receiver operating characteristic (ROC) curves and the optimal cut-off values of the SII and neutrophil were generated.

RESULTS

Among the 419 participants included in the study, there were 239 males and 180 females, with a baseline age of 66 years. 106 individuals were categorized in the LVH group. Multivariate logistic regression analysis revealed that neutrophil (OR = 1.31, P = 0.011), SII (OR = 1.01, P = 0.011), uric acid (OR = 1.01, P<0.01), and urea (OR = 1.02, P = 0.002) are positive correlation factors for LVH. In contrast, male gender (OR = 0.33, P<0.01) and calcium (OR = 0.07, P = 0.001) serve as negative correlation factors for LVH. Furthermore, DKD stage did not significantly modify the effects of neutrophil (interaction P = 0.09) and SII (interaction P = 0.22). The area under the curve (AUC) for basic variables, which include gender, calcium, uric acid, and urea, when combined with neutrophil and SII, was 0.816. This AUC, along with that of basic variables combined with SII (0.810), exceeded the AUC of basic variables alone (0.782), with the difference reaching statistical significance (P < 0.05). The optimal cut-off value for neutrophil is 4.14×109/L, and the optimal cutoff value for SII is 491.78×109/L.

CONCLUSION

In DKD G2 ~ G4 patients, neutrophil, SII, uric acid and urea sever as independent positive correlation factors for LVH. In contrast, male gender and calcium serves as negative correlation factors.