Neutrophil-lymphocyte ratio correlates with limited joint mobility of hand in patients with type 2 diabetes

Abstract

Limited joint mobility (LJM) of hand, which is one of the complications of diabetic hand, is associated with diabetic micro- and macroangiopathy although the precise pathogenesis is not completely understood. Neutrophil-lymphocyte ratio (NLR), a simple and novel inflammatory marker, has been reported to have a predictive effect to some diabetic complications in recent years. However, it is not elucidated about the relationship between LJM of hand and NLR in patients with type 2 diabetes. We evaluated the relationships between LJM of hand and NLR in 335 consecutive patients with type 2 diabetes in this cross-sectional study. LJM of hand was diagnosed by a 'prayer sign' or 'table test'. LJM of hand was present in 80 patients. The patients with LJM of hand had significantly older age, longer duration of diabetes, worse renal function, and higher proportion of diabetic neuropathy, retinopathy and nephropathy. NLR in patients with LJM of hand was higher than that in patients without LJM of hand (2.54 ± 1.46 vs. 2.11 ± 1.04, p = 0.004). Multivariate logistic regression analysis revealed that LJM of hand was positively correlated with NLR (odds ratio, 1.31; 95% confidence interval 1.03-1.69, p = 0.027) after adjustment for age, sex, duration of diabetes, body mass index, hemoglobin A1c, hypertension and dyslipidemia. Our results demonstrate a positive relation between LJM of hand and NLR in patients with type 2 diabetes.

Relationship between neutrophil to lymphocyte ratio and diabetic peripheral neuropathy: a systematic review and meta-analysis

“…Initially, 486 records were identified through a combination of database searches and a manual review of article citations. Following the removal of duplicate entries and irrelevant records, a total of 15 studies [3,5,[16][17][18][19][20][21][22][23][24][25][26][27][28] were deemed suitable for inclusion in the systematic review and subsequent meta-analysis. These studies collectively encompassed 4575 patients diagnosed with type 2 diabetes, of which 1708 individuals developed DPN.…”

“…This meta-analysis included 15 studies, of whom seven were conducted in East Asia [3,17,18,20,[26][27][28], three in Egypt [5,16,22], three in India [21,23,25], and two in turkey [19,24]. Regarding the language used in the documents, they were all authored in the English language.…”

“…The general features of the studies, as well as their quality ratings, are shown in Table 1. In total, 14 research compared NLR levels of diabetic patients with and without DPN [5,[16][17][18][19][20][21][22][23][24][25][26][27][28] and five studies reported diagnostic value of NLR in DPN, based on ROC curve analysis [3,16,18,23,26]. NOS score of included studies ranged between 6 and 7.…”

“…Because the included articles were statistically heterogeneous [5,[16][17][18][19][20][21][22][23][24][25][26][27][28] (I 2 = 82.9%, p < 0.001) the random-effect model was utilized in the analysis (Fig. 2).…”

“…Thus, analyzing the relationship between NLR and diabetic neuropathy makes sense. Recent studies have reported significant elevated Neutrophil to lymphocyte ratio (NLR) levels in DPN patients compared to T2D patients without DPN [3,5,[16][17][18][19][20][21][22][23][24][25][26][27][28]. NLR has been used as a novel biomarker and diagnostic tool to test for chronic inflammation.…”