Evaluation of Systemic Immune-Inflammation Index in Type 2 Diabetes Mellitus Patients with Urinary Tract Infections

Öz

Urinary system infections are frequently seen and may cause abnormal renal functions in diabetic patients. Inflammation and the immune response may have the role in the pathophysiology of this disease. Many mechanisms that trigger infections and inflammation in diabetes have been elucidated. But the relation between a novel inflammation marker, systemic immune-inflammation index (SII) ,and diabetic patients with positive urinary culture hasn’t been evaluated yet. Our study aimed to investigate the estimated relation with SII and type 2 diabetes mellitus (T2DM) with culture positive urinary infections (UTI). Fourty-eight diabetic patients with UTI and fourty-two diabetic patients without UTI were included. Complete blood count analysis was done and hsCRP levels were recorded. SII was calculated. High sensitive C-reactive protein (hsCRP) and SII were statistically significantly higher in DM with UTI group than DM without UTI (p<0.01, for both). Additionally, SII statistically significantly and positively correlated with hsCRP in patients group (p=0.001). Then, receiver operating characteristic (ROC) curve analysis was performed and presented that SII predicted UTI in T2DM group using a cut-off level of 746.25 with 63% sensitivity and 78% specificity. In this study, we evaluated the use of SII to predict the presence of UTI in T2DM patients with UTI and compared it with hsCRP, a valuable biomarker of infection and inflammation. Our results suggest that high SII acceptance may be useful in detecting UTI in T2DM patients.

Anahtar Kelimeler

• Urinary tract infections
• diabetes mellitus
• inflammation
• high sensitive C-reactive protein
• systemic immune-inflamation index

ÜRİNER SİSTEM ENFEKSİYONU OLAN TİP 2 DİABETES MELLİTUS HASTALARINDA SİSTEMİK İMMÜN-İNFLAMASYON İNDEKSİNİN DEĞERLENDİRİLMESİ

Öz

Üriner sistem enfeksiyonları diyabetik hastalarda sıklıkla görülmekte ve anormal böbrek fonksiyonlarına neden olabilmektedir. İnflamasyon ve immün yanıt bu hastalığın patofizyolojisinde rol oynamaktadır. Diyabette enfeksiyonu ve inflamasyonu tetikleyen birçok mekanizma aydınlatılmıştır. Ancak yeni bir inflamasyon belirteci olan sistemik immün-inflamasyon indeksi (SII) ile idrar kültürü pozitif olan diyabetik hastalar arasındaki ilişki henüz değerlendirilmemiştir. Çalışmamızda SII ve tip 2 diyabetes mellitus (T2DM) ile kültür pozitif üriner enfeksiyonlar (ÜSE) arasındaki tahmini ilişkinin araştırılması amaçlanmıştır. Bu çalışmaya ÜSE olan 48 diyabetik hasta ve ÜSE olmayan 42 diyabetik hasta dahil edildi. Tam kan sayımı parametreleri ve hsCRP düzeyleri kaydedildi ve SII hesaplandı. Yüksek duyarlı C-reaktif protein (hsCRP) ve SII, ÜSE olan DM'de ÜSE olmayan DM'ye göre istatistiksel olarak anlamlı derecede yüksek bulundu (her ikisi için p<0.01). İlaveten SII, hasta grubunda hsCRP ile istatistiksel olarak anlamlı ve pozitif korelasyon gösterdi (p=0.001). Ardından, "receiver operating characteristic" (ROC) eğrisi analizi yapıldı ve SII'nin %63 duyarlılık ve %78 özgüllük ile 746.25'lik bir kesim seviyesi kullanarak T2DM grubunda ÜSE varlığını tahmin ettiği gösterildi. Bu çalışmada, ÜSE'li T2DM hastalarında ÜSE varlığının tahmin edilmesi için SII'nin kullanımı değerlendirilmiş ve değerli bir enfeksiyon ve inflamasyon biyobelirteci olan hsCRP ile karşılaştırılmıştır. Çalışma sonuşlarımıza göre T2DM hastalarında yüksek SII kabulünün ÜSE saptamada faydalı olabileceği düşünülmüştür.

Anahtar Kelimeler

• Üriner sistem enfeksiyonları
• diabetes mellitus
• enflamasyon
• yüksek duyarlılıkta C-reaktif protein
• sistemik immün-inflamasyon indeksi

Kaynakça

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