Abstract: Background　With the aging of the population in Shanghai，the number of patients with chronic diseases observed in the community-based physical examination is increasing year by year.However，it is rarely reported that the status of chronic diseases can be evaluated by the inflammatory indicators during the physical examination.Objective　To determine the scores of inflammatory indicators in the aged population in a community of Shanghai，and evaluate related clinical value.Methods　In this study，we collected the physical examination data of the aged population in a community of Shanghai in July 2017.The general clinical characteristics and biochemical parameters were included.Furthermore，scores of inflammatory indicators，including lymphocyte-monocyte ratio（LMR），neutrophil-lymphocyte ratio（NLR） and platelet-lymphocyte ratio（PLR） were calculated.The prevalence of hypertension，diabetes and hyperlipidemia as well as the ratios of abnormal blood pressure，blood sugar，and blood lipid levels of the aged population included in this study were collected.The differences of LMR，NLR and PLR between participants with normal and abnormal blood pressure，glucose level，and blood lipid level were analyzed.Correlations between NLR and the levels of glycosylated hemoglobin and fasting blood glucose were evaluated.Additionally，the diagnostic values of LMP，NLR and PLR for diabetes were evaluated by receiver operating characteristic（ROC） curve.Results　A total of 380 elderly people met the study criteria，including 157 males and 223 females with age（74.1±7.0）years old.In these participants，the number of cases diagnosed with hypertension was 245（accounting for 64.5% of the total number），diabetes was 81（21.3%），and hyperlipidemia was 17（4.5%）．Whereas，the number of cases with observed abnormal blood pressure was 315（82.9%），abnormal blood glucose level was 157（41.3%），and dyslipidemia was 133（35.0%）．Furthermore，we found that there were no significant differences in LMR，NLR and PLR between participants with normal and abnormal blood pressure level（P>0.05） as well as participants with normal and abnormal blood lipid level（P>0.05）．Similarly，there were no significant differences in LMR and PLR between patients with normal and abnormal blood glucose level（P>0.05）．However，NLR was significantly higher in patients with abnormal blood glucose level than those with normal blood glucose level（P<0.05）．Using Pearson correlation test，we found that NLR in the aged population was not correlated with blood glycosylated hemoglobin level（r=0.051，P=0.322）．In contrast，NLR was positively correlated with fasting blood glucose levels（r=0.151，P=0.003）．Moreover，it was showed that the area under the ROC curve（AUC） of NLR for diagnosis of diabetes was 0.580〔95%CI（0.522，0.638），P=0.008〕；the cut-off point was 1.730；the sensitivity is 59.2%；and the specificity was 55.6%.Whereas，the AUC of LMR and PLR for diagnosis of diabetes were 0.479〔95%CI（0.420，0.538），P=0.486〕 and 0.480〔95%CI（0.421，0.539），P=0.508〕 respectively.Conclusion　The incidence of chronic diseases is high among the aged population in the community.Among all the tested inflammatory indicators，there was a significant difference in NLR between patients with normal and abnormal blood glucose level.Thus，NLR has potential value in screening of diabetes in patients with abnormal blood glucose level during physical examination.

Key words: Chronic disease, Community population undergoing physical examination, Aged, Inflammatory indicators, Diabetes mellitus, Blood glucose, Hypertension, Hyerlipidemias

摘要： 背景　随着人口老龄化加剧，社区老年体检群体中慢性病患者人数逐年增加，而通过体检数据中的炎性指标评价慢性病的进展状态鲜有报道。目的　了解上海市某社区老年体检人群炎性指标情况，并分析炎性指标的临床价值。方法　选取2017年7月于上海市某社区体检的老年人的体检资料。收集老年体检者的基本资料及生化指标；并计算炎性指标〔淋巴细胞计数-单核细胞计数比值（LMR）、中性粒细胞计数-淋巴细胞计数比值（NLR）、血小板计数-淋巴细胞计数比值（PLR）〕。记录老年体检者高血压、糖尿病、高脂血症患病情况及血压、血糖、血脂异常情况，分析血压正常与异常者、血糖正常与异常者、血脂正常与异常者LMR、NLR、PLR的差异，NLR与糖化血红蛋白、空腹血糖的相关性，并绘制LMR、NLR、PLR诊断糖尿病的受试者工作特征曲线（ROC曲线）。结果　共纳入符合研究标准的老年人380例，其中男157例，女223例；年龄（74.1±7.0）岁。老年体检者中，高血压245例，占64.5%；糖尿病81例，占21.3%；高脂血症17例，占4.5%；血压异常315例，占82.9%；血糖异常157例，占41.3%；血脂异常133例，占35.0%。血压正常与异常者LMR、NLR、PLR比较，差异无统计学意义（P>0.05）。血糖正常与异常者LMR、PLR比较，差异无统计学意义（P>0.05）；血糖异常者NLR高于血糖正常者（P<0.05）。血脂正常与异常者LMR、NLR、PLR比较，差异无统计学意义（P>0.05）。Pearson相关分析结果显示，老年体检者NLR与糖化血红蛋白无直线相关关系（r=0.051，P=0.322）；NLR与空腹血糖呈正相关（r=0.151，P=0.003）。NLR诊断糖尿病的ROC曲线下面积为0.580〔95%CI（0.522，0.638），P=0.008〕，截断值为1.730，灵敏度为59.2%，特异度为55.6%。LMR、PLR诊断糖尿病的ROC曲线下面积分别为0.479〔95%CI（0.420，0.538），P=0.486〕、0.480〔95%CI（0.421，0.539），P=0.508〕。结论　社区老年体检人群中，慢性病患病率较高；炎性指标中，NLR在血糖正常和异常者中的差异较大，且其在筛查血糖异常者糖尿病患病情况中有潜在价值。

关键词: 慢性病, 社区体检人群, 老年人, 炎性指标, 糖尿病, 血糖, 高血压, 高脂血症