Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as novel risk markers for diabetic nephropathy in patients with type 2 diabetes

Abstract

Introduction: Diabetes mellitus causes serious complications such as diabetic nephropathy. Diabetic nephropathy is now the most common reason of chronic kidney disease. Inflammation plays a crucial role in development and progression of diabetic nephropathy. The aim of this study was to evaluate the relationship of Inflammatory markers (neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio) with diabetic nephropathy in Syrian patients. Materials and methods: A total of 158 patients with type 2 diabetes mellitus were distributed into three groups according to urinary albumin-to-creatinine ratio: Group A, type 2 diabetic patients with normoalbuminuria (urinary albumin-to-creatinine ratio <30 mg/g); Group B, type 2 diabetic patients with microalbuminuria (urinary albumin-to-creatinine ratio ¼ 30-300 mg/g); Group C, type 2 diabetic patients with macroalbuminuria (urinary albumin-to-creatinine ratio !300 mg/g). Levels of inflammatory markers (neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio) were recorded and compared among the three groups. Results: Significant differences were detected between the groups in terms of neutrophil-to-lymphocyte ratio (p ¼ 0.000) and platelet-to-lymphocyte ratio (p ¼ 0.000). Receiver operating characteristic curve analysis of inflammatory markers and microalbuminuria prediction demonstrated an area under curve (AUC) of 0.869 for neutrophil-to-lymphocyte ratio (confidence interval: 0.813-0.926, p ¼ 0.000) and 0.739 for platelet-tolymphocyte ratio (confidence interval: 0.662-0.815, p ¼ 0.000). Conclusion:Increased neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were significantly correlated with diabetic nephropathy, and high neutrophil-to-lymphocyte ratio & platelet-to-lymphocyte ratio may be served as a predictor and a prognostic risk marker of diabetic nephropathy.

Neutrophil-to-Lymphocyte Ratio as a Novel Marker for Early Detection of Hypertensive Nephropathy and as a Predictor of Worsening Renal Functions in Hypertensive Patients

“…In concordance with our results, a study of Jaaban et al (22) which studied the relationship between NLR and level of albuminuria. They reported that there was highly significant difference between their studied groups as regard systolic and diastolic blood pressure and there was no significant difference between their studied groups as regard BMI.…”

Association of systemic inflammation indices with visual field loss progression in patients with primary angle-closure glaucoma: potential biomarkers for 3P medical approaches

“…PLR, as a simple, rapid, inexpensive, stable, and reliable parameter, has been widely used to diagnose and/or predict the prognosis of various diseases. Jaaban et al [ 64 ] reported that a high PLR was significantly correlated with diabetic nephropathy and that PLR may serve as a predictor and prognostic risk marker of diabetic nephropathy. Liu et al [ 65 ] performed a meta-analysis and suggested that PLR was significantly elevated in retinal vein occlusion, with pooled mean differences of 21.49 (95% CI 10.03–32.95) and pooled area under the receiver operating characteristic curve of 0.621 (95% CI 0.452–0.741).…”

Assessment of Neutrophil to lymphocyte ratio in patients with diabetic nephropathy

“…Mean absolute lymphocyte count among the patients with and without diabetic nephropathy was 2.2 x 10 3 /µL and 2.4 x 10 3 /µL respectively. They also observed significantly higher mean total leukocyte count, absolute neutrophil count, absolute lymphocyte count and platelet count was significantly higher among the patients with diabetic nephropathy in comparison to patients without diabetic nephropathy [11] .…”

“…In a previous study conducted by Khandare SA et al mean NLR among the patients with and without diabetic nephropathy was found to be 2.83 and 1.94 respectively (p-value < 0.05). Jaaban et al in their study also reported significantly higher NLR among patient with diabetic nephropathy (2.3) in comparison to the patients without diabetic nephropathy (1.73) (p-value < 0.05) [10,11] . .66 for the LMR, the sensitivity was 44%, the specificity: 92% (the ability of the LMR to predict DN risk); 2.2 for the NLR, the sensitivity: 84%, the specificity: 98%; 207 for the PLR, the sensitivity: 72%, and the specificity: 80%.…”