Nephropathy, but not Angiographically Proven Retinopathy, is Associated with Neutrophil to Lymphocyte Ratio in Patients with Type 2 Diabetes

Çiray, H Nadir; Aksoy, Aydın; Ulu, Nadir; CİZMECİOGLU, Ahmet; Gaipov, Abduzhappar; Solak, Yalçın

doi:10.1055/s-0035-1547257

Cited by 51 publications

(59 citation statements)

References 17 publications

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“…Bilge et al found that NLR and PLR were higher in euthyroid Hashimoto patients than healthy controls (22). Whereas, in a study by Cıray et al there was no difference among NLR between the patients with or without diabetic retinopathy (23). Also there are studies in which Hashimoto thyroiditis, which is one of the autoimmune thyroid diseases, is found to be signifi cantly higher than in the NLR and PLR control group (24) and before treatment than after levothroxine replacement (22).…”

Section: Discussionmentioning

confidence: 97%

Evaluation of neutrophil-to-lymphocyte ratio and hematologic parameters in patients with Graves’ disease

Turan¹

2019

BLL

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AIM: While the ratio of neutrophil-to-lymphocyte (NLR) increases with infl ammation, its importance in Graves' disease is not clear. The aim of this study was to evaluate NLR, a marker of chronic infl ammmation, in Graves' disease. METHODS: 86 Graves' patients (37 before treatment,49 euthyroid patients after treatment) and 112 controls were enrolled. Hematologic parameters, thyroid function tests, age and gender were recorded. NLRs were calculated. Firstly, groups were composed as Graves' group (Group1) and participants without thyroid disorder as control group (Group2). Secondly, Graves' patients before treatment were considered as Group1a, euthyroid Graves' patients after antithyroid treatment were considered as Group1b. These groups were compared with each other in terms of descriptive data and hematological parameters. RESULTS: Lymphocyte, monocyte, platelet, free T3, and free T4 levels were signifi cantly higher in Graves' group than the controls. TSH and NLR were signifi cantly lower in Graves' group Graves' than the controls. Differences among group1a and group1b for monocyte (p = 0.013), for basophil (p= 0.002), for platelet (p = 0.029), and for NLR (p = 0.029) were statistically signifi cant. CONCLUSION: Unlike other infl ammatory diseases, in Graves' disease; hematological parameters may not give information about infl ammatory state of the disease. Therefore, NLR should be evaluated with other serum infl ammatory markers in Graves' disease (Tab. 2, Fig. 1, Ref. 26).

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Section: Discussionmentioning

confidence: 97%

Evaluation of neutrophil-to-lymphocyte ratio and hematologic parameters in patients with Graves’ disease

Turan¹

2019

BLL

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“…In DN, Afsar 28 has reported that the NLR was independently associated with 24-h urine protein in 80 Turkish patients with newly diagnosed T2DM, and Ciray et al 29 also reported that NLR was positively correlated with microalbuminuria, but negatively related with e-GFR in 114 Turkish subjects with T2DM. On the other hand, in 253 Chinese subjects with T2DM, increased NLR was significantly associated with DN and the patients had a 2.088-fold increased odds of DN for every unit increase of NLR.…”

Section: Discussionmentioning

confidence: 98%

Effects of neutrophil–lymphocyte ratio on renal function and histologic lesions in patients with diabetic nephropathy

Zhang

Wang

et al. 2019

Nephrology

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Aim Chronic low‐grade inflammation related to diabetic nephropathy (DN) may affect the serum neutrophil–lymphocyte ratio (NLR). We aimed to examine the cross‐sectional relationships of NLR with renal function and structural lesions of DN in patients with type 2 diabetes mellitus (T2DM). Methods The study retrospectively included 247 patients with T2DM and biopsy‐proven DN. The severity of different pathological lesions was evaluated based on the criteria of Renal Pathology Society. The patients were divided into two groups based on the median (2.42) of NLR level, group 1: NLR < 2.42 (n = 122) and group 2: NLR ≥ 2.42 (n = 125). Renal dysfunction was defined by estimated glomerular filtration rate less than 60 mL/min per 1.73 m2. The influence of NLR on renal dysfunction was evaluated using logistic regression analysis. Results The spearman's rank‐correlation test indicted that NLR was positively correlated with interstitial fibrosis and tubular atrophy (r = 0.170, P = 0.007) and serum fibrinogen (r = 0.261, P < 0.001), whereas negatively related with estimated glomerular filtration rate (r = −0.233, P < 0.001). However, the NLR level demonstrated no association with glomerular lesions, interstitial inflammation and arteriolar hyalinosis. A multivariate logistic regression analysis showed that higher level of NLR (≥2.42) was significantly associated with renal dysfunction when adjusting for some important baseline clinical and pathological variables (odds ratio, 2.46; 95% confidence interval, 1.21–4.97; P = 0.012). Conclusion Increased NLR affects renal function and histologic lesions in patients with T2DM and may be an important factor for the progression of DN.

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“…6 Ciray et al also reported that the NLR was positively correlated with microalbuminuria but negatively correlated with the eGFR in 114 Turkish subjects with T2D. 7 Akbas et al showed that in 200 Turkish patients with T2D, the albuminuria levels increased as the NLR increased, and the NLR was found to be independently associated with albuminuria. Kahraman et al also showed significant correlations among albuminuria, the glomerular filtration rate and the NLR in 112 patients with T2D.…”

Section: Discussionmentioning

confidence: 96%

“…Clinical studies have found that peripheral total WBCs, neutrophils, and the neutrophil-to-lymphocyte ratio (NLR) are independently associated with DKD in T2D. [3][4][5][6][7][8][9][10][11] However, the association between these factors and autoimmune diabetes such as type 1 diabetes (T1D) and latent autoimmune diabetes in adults (LADA) patients has not yet been explored.…”

Section: Introductionmentioning

confidence: 99%

Neutrophil Count as a Reliable Marker of Diabetic Kidney Disease in Autoimmune Diabetes

Lin

et al. 2019

Preprint

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Background A growing body of evidence supports neutrophils as an active player in the development of diabetic kidney disease (DKD). However, the clinical relevance of neutrophils and DKD in autoimmune diabetes remains unknown. This study aims to investigate the relationship between circulating neutrophils and DKD in autoimmune diabetes.Methods Patients with type 1 diabetes (T1D, n=226) and latent autoimmune diabetes in adults (LADA, n=79) were enrolled and stratified according to the urinary albumin to creatinine ratio (ACR). Circulating levels of white blood cells (WBCs), including neutrophils, were measured in a central laboratory, and the neutrophil-to-lymphocyte ratio (NLR) was calculated. The risk factors associated with DKD were analysed by logistic regression.Results In T1D and LADA patients, the peripheral neutrophil counts increased in parallel with DKD advancement. The neutrophil counts in the patients with macroalbuminuria were significantly higher than those in the patients with normoalbuminuria for each type of diabetes. Furthermore, neutrophil counts positively correlated with the ACR. In addition, neutrophils were independently associated with DKD in T1D in the logistic regression analysis, when various well-known risk factors, including disease duration, sex, and smoking status, were adjusted as continuous variables.Conclusions Neutrophil counts are closely associated with DKD in patients with autoimmune diabetes, suggesting neutrophil-mediated inflammation may be involved in the pathogenesis of DKD in patients with autoimmune diabetes.

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Nephropathy, but not Angiographically Proven Retinopathy, is Associated with Neutrophil to Lymphocyte Ratio in Patients with Type 2 Diabetes

Abstract: NLR and diabetic nephropathy have an independent association between them whereas there was no independent association between NLR with retinopathy in type 2 diabetic patients.

Cited by 51 publications

References 17 publications

Evaluation of neutrophil-to-lymphocyte ratio and hematologic parameters in patients with Graves’ disease

Evaluation of neutrophil-to-lymphocyte ratio and hematologic parameters in patients with Graves’ disease

Effects of neutrophil–lymphocyte ratio on renal function and histologic lesions in patients with diabetic nephropathy

Neutrophil Count as a Reliable Marker of Diabetic Kidney Disease in Autoimmune Diabetes

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