Systemic immune indicators for predicting renal damage in newly diagnosed type 1 diabetic children.

backgroundEarly kidney damage is a significant complication in children with newly diagnosed type 1 diabetes mellitus (T1DM). Systemic inflammation plays a key role in the development of diabetic nephropathy. Several inflammatory markers, including the systemic immune inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), have been proposed as potential indicators of diabetic complications.

aimTo investigate the association between SII, NLR, PLR, and early kidney damage in newly diagnosed T1DM children without pre-existing albuminuria, assessing their utility as predictive biomarkers.

methodsA longitudinal cohort study was conducted on 102 children aged 3-18 years with newly diagnosed T1DM [baseline urinary albumin-to-creatinine ratio (UACR) < 30 mg/g] recruited between January 2020 and June 2023. Participants were followed biannually for up to three years. Demographic, clinical, and laboratory data, including inflammatory markers (SII, NLR, PLR), were collected at baseline and follow-up. Logistic regression and receiver operating characteristic analyses were used to evaluate the predictive utility of these markers for early kidney damage, defined as UACR ≥ 30 mg/g.

resultsSII emerged as a significant independent predictor of early kidney damage [odds ratio = 1.002, 95% confidence interval (CI): 1.0008-1.0033,

conclusionSII is a reliable biomarker for early kidney damage in T1DM children, offering high specificity for identifying at-risk patients. Combining SII with NLR and PLR enhances diagnostic precision, supporting its integration into clinical practice. Longitudinal monitoring of these markers may facilitate early interventions to mitigate renal complications in pediatric T1DM.