Neutrophil-to-lymphocyte ratio and microvascular complications in subjects with type 2 diabetes: Pakistan’s perspective

Abstract

Background/aim: The aim of this study is to find the association between diabetic microvascular complications and the neutrophil-to-lymphocyte ratio (NLR) in subjects with type 2 diabetes. Materials and methods: This was a retrospective study based on hospital data records from January 2005 to May 2016 at the Baqai Institute of Diabetology and Endocrinology. The eligibility criteria included subjects with type 2 diabetes with their latest complete blood count while subjects with conditions such as chronic inflammation, cancer, heart failure, and end-stage renal disease were not eligible for inclusion. Subjects were divided into two groups: one with any microvascular complications and the other with no microvascular complications. Body mass index, anthropometric measurements, and blood pressure were measured. Results: Out of 5620 type 2 diabetic subjects, 3202 (57%) were male and (2418) 43% were female. Among these, 3374 diabetic subjects had one or more microvascular complications and 2246 had no microvascular complications. The NLR was found to be 1.14 times higher in diabetic subjects with at least one microvascular complication as compared to diabetic subjects without any complications (4.34 ± 3.32 vs. 3.36 ± 2.67; P < 0.0001). Factors likely associated with microvascular complications were high levels of NLR, HbA1c, serum creatinine, and systolic blood pressure and longer duration of diabetes. Conclusion: According to the results, the NLR is an efficient, cheaper, and readily available marker of inflammation and it is known as an important predictor for the existence of microvascular complications in subjects with type 2 diabetes.

Association between Diabetic Neuropathy and Neutrophil Lymphocyte Ratio amongst Type 2 Diabetics

“…Our findings were contrasting to the finding of Fawad et al, in which a significant correlation was observed between NLR and HbA1c whereas no such correlation was observed in our study [18]. Poor glycemic control is indicated by HbA1c levels and thus increased HbA1c levels may correlate withincreased risk of complications but no such correlation was observed in our study.…”

“…Our study demonstrated that NLR were significantly higher in patients with diabetic neuropathy and patients with longer duration of diabetes (p<0.05) and also mean NLR was significantly higher in patients with diabetic neuropathy (p<0.05).The findings of preset study were supported by findings of Chittawar et al, where number of microvascular complications were significantly higher in patients with a longer duration of diabetes and raised [17]. Fawad et al, also reported findings similar to our study [18]. The findings of our study were also supported by an Egyptian study by Moursy et al, in which significant increase was found in NLR between diabetic subjects with and without neuropathy [19].…”

Association of serum liver enzyme Alanine Aminotransferase (ALT) in patients with type 2 diabetes

“…HbA1c was measured by HPLC method on a Bio-Rad D-10. 10 Height was measured to the nearest of 0.1cm, while individual standing in erect posture and weight was measured with portable weighing scale nearest of 0.1 kilogram (kg). Body Mass Index (BMI) was measured as the ratio of weight (kg) to height squared (m 2 ).…”

The Predictive Value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Levels of Diabetic Peripheral Neuropathy

“…24 A Japanese study showed that NLR might be a potential factor for evaluating diabetic patients with a higher degree of albuminuria, 25 suggesting that NLR may predict the existence of microvascular complications. 26 In diabetic patients, abnormal insulin action may lead to increased platelet adhesion.…”