Evaluation of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) as inflammatory markers in patients with type 2 diabetes mellitus

Abstract

Diabetes Mellitus (DM), chronic metabolic disease and its complications are diabetic nephropathy, retinopathy, and neuropathy. Systemic inflammation play a significant role and could lead to insulin resistance. This study aimed to investigate NLR and PLR in T2DM patients in comparison with healthy controls. This prospective study, conducted in SRVS Government Medical College, Shivpuri, Madhya Pradesh, India. In this study, a total of 220 subjects were involved, among them 110 were T2DM patients were cases and 110 healthy subjects were controls. Demographic details, physical and clinical examination were done for all the study subjects. Under aseptic conditions, five ml of fasting venous blood sample was collected and aliquoted into plain (3ml) and EDTA (2 ml) tubes and allowed to clot and centrifuged at 3000 rpm for 10 minutes. The obtained serum sample was used for the estimation of fasting and post-prandial glucose, renal profile, lipid profile using commercially available autoanalyzer kits. Whole blood sample was used for the Complete Blood Count (CBC) in EDTA vials. Neutrophil to Lymphocyte Ratio (NLR) and Platelet to Lymphocyte (PLR) were calculated. Whole blood sample was used for the estimation of HbA1c and BMI was calculated.The variables were represented in Mean±SD. Categorical variables were represented in percentage. Spearman’s correlation was applied. The p value <0.05 considered as significant.In the current study, mean age 60.2±4.2 yrs, BMI 27.1±2.4 (kg/m), Systolic blood pressure 132.1±12.3 mmHg, Diastolic blood pressure 90.2±10.5 mmHg, fasting blood sugar (FBS) 169.7±19.3 mg/dl, Post-Prandial blood sugar 238.1±39.5 mg/dl, HbA1c 7.9±0.8 %, Serum Urea 36.1±7.1 mg/dl, Creatinine 1.0±0.3 mg/dl, UA 6.5±2.3 mg/dl, Serum Total Cholesterol 241.1±30.5 mg/dl, Serum Triglycerides 170.0±16.2 mg/dl, Serum low density lipoprotein cholesterol (LDLC) 176.4±35.2 mg/dl, Serum very low density lipoprotein cholesterol (VLDL) 34.1±3.2 mg/dl, Lymphocytes 17.2±4.1 %, NLR 6.7±2.3 and PLR 19.1±6.9 were significantly increased in Type 2 Diabetes Mellitus (T2DM) cases whereas high low density lipoprotein cholesterol (HDLC) 30.7±3.9 mg/dl was significantly decreased in T2DM cases.The present study results may conclude that increased NLR and PLR may be used as a markers for inflammation in T2DM. These may serve as an alternative to the other costly inflammatory markers.