Background Type 2 diabetes mellitus is associated with chronic low grade inflammation. One of the novel inflammatory markers is hemogram derived neutrophil to lymphocyte ratio (NLR). Objective We aimed to compare NLR levels of diabetic subjects and healthy controls and to observe possible correlation between NLR and HbA1c. Methods Medical data of type 2 diabetic subjects admitted to out-patient clinics of our institution between April to July in 2017 were obtained from database and retrospectively analyzed. Control group was chosen from healthy subjects who visited our institution for a routine check-up. Anthropometric measures, laboratory data, including, HbA1c, NLR were recorded. Results Median NLR of the type 2 DM group 2.44 (1.9) was significantly elevated when compared to healthy controls (1.5 (0.9), (p<0.001). In addition, a Pearson's correlation test revealed that NLR was strongly correlated with age (r=0.26, p=0.008), fasting plasma glucose (r=0.38, p<0.001), and HbA1c (r=0.49, p<0.001). Conclusion Elevated NLR in otherwise healthy subjects may be indicative of underlying impaired glucose metabolism and moreover, NLR should be used as a marker of diabetic control level in addition to HbA1c in type 2 diabetic subjects.

Aim: Despite it has some disadvantages, the most important marker of diabetic control is glycated hemoglobin (HbA1c). Uric acid to HDL cholesterol ratio (UHR) is a promising marker in metabolic syndrome. We aimed to compare UHR levels of well and poorly controlled type 2 diabetic male subjects, as well as healthy men, and to observe its correlation with other metabolic parameters. Methods: Male patients with T2DM that showed up in outpatient internal medicine clinics of our hospital were enrolled to the study. Diabetic subjects divided into two groups according to the level of HbA1c: well-controlled T2DM group (HbA1c < 7%) and poorly controlled T2DM group (HbA1c 7%). Third group was consisted of healthy subjects without any chronic diseases. UHR levels of the groups were compared. Results: The UHR levels of well and poorly controlled diabetics and control subjects were 12%±5%, 17%±6% and 9%±3%, respectively (p<.001). The UHR was significantly and inversely correlated with GFR and was significantly and positively correlated with waist circumference, body weight, body mass index, serum creatinine, fasting plasma glucose (FPG) and HbA1c levels. Conclusion: UHR could serve as a promising predictor of diabetic control in men with T2DM, since it has significant association with HbA1c and FPG levels.

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Background. Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that is associated with sub-clinical inflammation. Some hemogram parameters are thought to be novel inflammatory markers. Objectives. We aimed to study novel inflammatory markers derived from hemograms and to compare them to those in healthy subjects. Material and methods. The platelet distribution width (PDW), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) of patients with IBS were gathered from a database and compared to those in a healthy population.Results. The PLR of the IBS group (144 ± 50%) was higher than the PLR of the control group (111 ± 32%; p < 0.001). The PDW of the IBS group (16.3 [1%]) was higher than the PDW of the control group (15.4 [2.4%]; p < 0.001). The NLR of the IBS group (2.2 [1.1%]) was higher than the NLR of the control group (1.8 [0.7%]; p < 0.001). The MLR of the IBS group (0.25 [0.14%]) was higher than the MLR of the control group (0.2 [0.12%]; p < 0.001). Conclusions. We think that PDW, NLR, PLR, and MLR could all serve as diagnostic tools for IBS. Although the diagnosis of IBS is based on history and clinical findings, the simplicity and low cost of these hemogram tests could provide laboratory support in establishing a diagnosis, especially in suspected cases.

SUMMARY OBJECTIVE Association between type 2 diabetes mellitus and inflammation is well-established. We aimed to study platelet-to-lymphocyte ratio (PLR), a novel inflammatory index derived from hemogram, in diabetic patients in comparison to those in healthy volunteers. METHODS Medical data of type 2 diabetics that showed up in general outpatient medical clinics of our institution between February 2017 and August 2017 were recorded and analyzed. RESULTS Median PLR of type 2 diabetic patients was significantly higher than the PLR of healthy controls (p=0.001). Moreover, PLR was significantly and positively correlated with HbA1c (p<0.001, r=0.58), fasting plasma glucose (p<0.001, r=0.49), and c-reactive protein (p=0.003, r=0.30) levels. Type 2 diabetic subjects with proteinuria had significantly higher PLR levels than that of diabetic subjects without proteinuria. CONCLUSION As an inexpensive and easy to use index, PLR may be useful in predicting the development and control levels of type 2 diabetes mellitus. However, its correlation with HbA1c needs to be validated by larger prospective studies.

Summary Background Results are conflicting with respect to the renal effects of anti‐viral agents used for hepatitis B virus infection. Aim To compare short and long‐term renal effects in real‐life settings and to determine risk factors for renal impairment during treatment. Methods 2221 treatment‐naïve patients were enrolled. Among these, 895 (302 lamivudine, 27 telbivudine, 282 entecavir, 273 tenofovir and 11 adefovir initiated patients) had ‘repeated measures’ of creatinine (baseline, 1st, 6th, 12th and 24th month of treatment). Telbivudine and adefovir groups were excluded from further analysis because of the low number of patients. We calculated the glomerular filtration rate (GFR) using the Modification of Diet in Renal Disease (MDRD) formula at each time point. Hypophosphataemia was also recorded. Risk factors for renal impairment were analysed. Results Tenofovir caused a decline in GFR at each time point when compared to baseline levels. However, lamivudine and entecavir did not change GFR. GFR‐shifting from ≥90 to 60–89 mL/min/1.73 m2 was comparable among groups. The proportion of patients whose baseline creatinine increased more than 25% was comparable among all anti‐virals. GFR showed a decline in patients who switched from entecavir to tenofovir. One patient with compensated cirrhosis needed to change from tenofovir because of renal safety. Seven and three patients developed transient hypophosphataemia in the tenofovir and lamivudine groups, respectively. Conclusions Although tenofovir caused a decline in GFR, differences between the anti‐viral agents do not appear to be so impressive. In patients with and without renal risk factors at baseline, there is no impact of anti‐virals, including tenofovir.

SUMMARY OBJECTIVE Metabolic syndrome (MS) is a clinical entity that associated with increased risk of type 2 Diabetes Mellitus (DM) and cardiovascular diseases. Serum uric acid levels are correlated MS criteria. We hypothesized whether a uric acid to HDL-cholesterol ratio (UHR) could predict diabetic regulation and presence of MS in type 2 diabetic subjects. METHODS Admissions of the subjects with type 2 DM to outpatient clinics of our institution were retrospectively analyzed. Study population grouped into well-controlled and poorly controlled diabetics according to the HbA1c level (cut off 7%) and further grouped into type 2 DM with and without MS according to the presence of MS. UHR of study groups compared. RESULTS A hundred diabetic subjects enrolled. Mean UHR was significantly lower in well-controlled diabetics (9.7 ± 3.7%) compared to poorly controlled subjects (14 ± 5.4%) (p<0.001). Median UHR of diabetics with MS (13 (6-29) %) was greater than that of the diabetics without MS (9 (3-16) %) (p<0.001). UHR greater than 11% has 77% sensitivity and 60% specifity in predicting worse diabetic control (AUC: 0.752, p<0.001) and a UHR greater than 10.6% has 83% sensitivity and 71% specifity in predicting MS (AUC: 0.839, p<0.001). Sensitivity and specifity of UHR in predicting MS were better than most of the sensitivities and specifities of the five criteria of MS. CONCLUSION We suggest utilization of UHR in diagnosis of MS as a novel criteria. Nevertheless, prospective studies with larger population may make a better scientific evidence in that issue.

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