In patients with diabetic kidney disease (DKD) stages G2 to G4, simple blood count inflammatory markers are associated with left ventricular hypertrophy (LVH). A study from Peking University Third Hospital shows that particularly neutrophil count and the Systemic Immune-Inflammation Index (SII) are independent risk factors for thickening of the heart muscle. The results were published in a professional journal.
Background
For patients with diabetic kidney disease, cardiovascular complications are among the most serious consequences. Left ventricular hypertrophy is considered an important predictor of cardiovascular events. At the same time, these patients often have a chronic low-grade inflammatory state that further damages both the kidneys and the cardiovascular system.
Study Design and Methods
The cross-sectional study included 419 patients with diabetic kidney disease stages G2 to G4 who were treated at Peking University Third Hospital between January 2020 and September 2025. Based on echocardiographic findings, participants were divided into a group with and a group without left ventricular hypertrophy. Using logistic regression analyses, researchers investigated the association between routinely determinable inflammatory markers (especially neutrophils and SII) and the presence of LVH.
Important findings
106 of the 419 patients had left ventricular hypertrophy. In the multivariate analysis, the following factors proved to be independent positive risk factors for LVH:
- Neutrophil count (OR 1.31)
- Systemic Immune-Inflammation Index (SII) (OR 1.01)
- Uric acid (OR 1.01)
- Urea (OR 1.02)
Researchers identified male sex (OR 0.33) and higher calcium levels (OR 0.07) as protective factors. The stage of diabetic kidney disease did not significantly influence the association between inflammatory markers and LVH.
The combination of baseline variables (sex, calcium, uric acid, urea) with neutrophils and SII significantly improved the predictive power for LVH (AUC 0.816). The optimal cut-off values were 4.14 × 10?/L for neutrophils and 491.78 × 10?/L for SII.
Significance of the Results
The study suggests that simple and inexpensive inflammatory markers derivable from blood counts, such as neutrophil count and SII, can provide indications of an increased risk for left ventricular hypertrophy in patients with diabetic kidney disease. In the future, these markers could help to identify and monitor at-risk patients more effectively.
Outlook
Further prospective studies are needed to clarify whether targeted modulation of systemic inflammation can reduce the risk of cardiovascular complications in these patients. The authors see the investigated markers as a potentially useful building block for risk-adapted care of patients with diabetic kidney disease.
FAQ
What does the study investigate?
The association between routine inflammatory markers from blood counts and the occurrence of left ventricular hypertrophy in patients with diabetic kidney disease.
Which markers are particularly relevant?
Neutrophil count and the Systemic Immune-Inflammation Index (SII) proved to be independent risk factors.
Do these markers improve prediction?
Yes. The combination with baseline values (sex, calcium, uric acid, urea) significantly increased prediction accuracy.
Are there optimal cutoff values?
Yes. The study mentions a cut-off of 4.14 × 10?/L for neutrophils and 491.78 × 10?/L for the SII.
What does this mean for practice?
The markers could help to identify patients with increased cardiovascular risk earlier and to adjust care accordingly.
