Diagnostic value of serum interleukin-6 and monocyte count/high-density lipoprotein cholesterol ratio in elderly patients with type 2 diabetes complicated with heart failure with preserved ejection fraction

CHU Hong-wei; ZHANG Hong; SU Jin-hao

doi:10.3969/j.issn.1672-5301.2025.10.009

Abstract：Objective To explore the diagnostic value of serum interleukin-6(IL-6)and monocyte count/high-density lipoprotein cholesterol ratio(MHR)in elderly patients with type 2 diabetes complicated with heart failure with preserved ejection fraction(HFpEF).Methods From August 2023 to August 2024,145 elderly patients with type 2 diabetes admitted to Cangzhou Hospital of Integrated Traditional and Western Medicine were included as the diabetes group,145 elderly patients with type 2 diabetes combined with HFpEF were selected as the diabetes combined with HFpEF group,and in the meantime,145 healthy people who were examined in our hospital were selected as the control group.According to the heart function classification of New York Heart Association(NYHA),the diabetes combined with HFpEF group was assigned into 49 cases of NYHAⅡ,57 cases of NYHAⅢ and 39 cases of NYHAⅣ.All the subjects underwent cardiac ultrasound and the left ventricular ejection fraction(LVEF),left atrial diameter(LAD)and left ventricular diameter(LVD)were recorded.Enzyme linked immunosorbent assay was applied to detect the serum IL-6,brain natriuretic peptide(BNP)and cardiac troponin I(cTnI)level.Absolute number of the monocytes and high-density lipoprotein cholesterol were measured and the MHR was calculated.Spearman correlation was used to analyze the correlation between the serum IL-6,MHR levels and heart function grading in the diabetes combined with HFpEF group.Logistic regression was used to analyze the influencing factors of HFpEF in elderly patients with type 2 diabetes.The diagnostic efficacy of serum IL-6 and MHR in elderly type 2 diabetes patients with HFpEF was analyzed by receiver operating characteristic(ROC)curve.Results The levels of serum IL-6[(30.65±8.69)ng/L vs.(76.32±20.42)ng/L vs.(108.75±27.39)ng/L]and MHR[(0.32±0.09)%,(0.75±0.19)%,(0.97±0.24)%]in control group,diabetes group and diabetes combined with HFpEF group increased in turn(all P<0.05).The serum levels of IL-6[(91.92±20.35)ng/L vs.(108.83±23.51)ng/L vs.(129.76±26.32)ng/L]and MHR[(0.75±0.18)%vs.(0.98±0.24)%vs.(1.24±0.31)%]in NYHA grade Ⅱ,grade Ⅲ and grade Ⅳ diabetes combined with HFpEF patients increased in turn(all P<0.05).Serum IL-6 and MHR levels were positively correlated with heart function grading in diabetes combined with HFpEF group(rs=0.629,0.546,P<0.05).There were differences in coronary heart disease history,heart rate,absolute number of monocytes,fasting blood glucose(FPG),total cholesterol(TC),glycosylated hemoglobin(HbA1c),serum BNP,cTnI,LAD and LVD between the control group,diabetes group and diabetes combined with HFpEF group(P<0.05).Logistic regression analysis showed that the history of coronary heart disease,heart rate,absolute number of monocytes,FPG,TC,HbA1c,serun BNP,IL-6 and MHR levels were the risk factors for HFpEF in elderly patients with type 2 diabetes(P<0.05).ROC curve showed that the area under the curve(AUC)of serum IL-6,MHR and their combined diagnosis for elderly type 2 diabetes with HFpEF was 0.821,0.833 and 0.921,respectively;the AUC of the combination of the two in the diagnosis was higher than that of IL-6 and MHR alone(P<0.05).Conclusion The serum levels of IL-6 and MHR in elderly type 2 diabetes patients with HFpEF are elevated,and the combination of the two was more effective in diagnosing elderly type 2 diabetes patients with HFpEF.