Relationship Between Neutrophil-Lymphocyte Ratio and Microvascular Complications in Egyptian Patients with Type 2 Diabetes

Abstract

Several epidemiological studies have shown that chronic inflammation plays a central role in the pathogenesis of diabetes and its various complications. Neutrophil-lymphocyte ratio (NLR) is a novel potential marker in determining inflammation. The aim of this study was to evaluate the relationship between diabetic microvascular complications, namely diabetic retinopathy, nephropathy, neuropathy, and neutrophil-lymphocyte ratio in type 2 diabetic patients. The study took place in the Unit of Diabetes & Metabolism at the Faculty of Medicine, Alexandria University, Alexandria, Egypt, and included a total of 280 subjects, 200 male patients with type 2 diabetes, 108 of them having one or more microvascular complication, and a control group including 80 healthy age and sex-matched subjects. Results of our study showed that neutrophil-lymphocyte ratio (NLR) values were significantly higher in diabetic patients with retinopathy (p<0.001), neuropathy (p=0.025) and nephropathy (p<0.001) than those of diabetic patients without any microvascular complications and healthy control subjects. NLR levels correlated positively with body mass index (BMI) (r=0.436, p<0.001), glycosylated hemoglobin (HbA1c) (r=0.526, p=0.001) and erythrocyte sedimentation rate (ESR) (r=0.396, p=0.017). Based on the results of this study, we can conclude that neutrophil-lymphocyte ratio (NLR), which is an efficient, simple and stable marker of inflammation, can serve as an important predictor for the presence of microvascular complications in Egyptian patients with type 2 diabetes.

Neutrophil–lymphocyte ratio as an inflammatory biomarker of diabetic nephropathy among type 2 diabetes mellitus patients: A comparative cross-sectional study

“…As the age of diabetic patients increases by 1 year, the chance of developing DN increases by 3.7%, which means for 10 years increases in the duration of illness after diagnosis, the probability of developing diabetic microvascular complication increases by 1.43 times (43%). 32 On the other hand, NLR showed significant negative correlation with ALC (r = −0.770, p < 0.0001). 31 Furthermore, a study done by Azab et al indicated that NLR can be used as a prognostic marker to assess the severity of renal function.…”

The Association between Neutrophil-to-Lymphocyte Ratio and Glycemic Control in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

“…Increased interleukin levels during inflammation cause lymphopenia [ 23 ] and neutrophilia [ 24 ], together resulting in a high NLR value. It is associated with microvascular and macrovascular complications of DM and metabolic impairment [ 57 ].…”

Assessment of neutrophil and platelet-to-lymphocyte ratio as inflammatory markers in type 2 diabetes mellitus patients

“…24 Moursy et al, reported elevated NLR in diabetic patients with microvascular complications than diabetics without complications. 25 Mohammad et al, conducted a study in diabetic subjects reported that NLR is useful to assess albuminuria and carotid artery intima media thickness. 26 Abnormal insulin action in DM may lead to increased adhesion of platelets.…”