Neutrophil/lymphocyte and platelet/lymphocyte ratios in diabetic patients with or without renal dysfunction
DOI:
https://doi.org/10.15448/1980-6108.2018.3.30376Keywords:
type 2 diabetes mellitus, biomarkers, renal function.Abstract
AIMS: To compare the neutrophil/lymphocyte ratio (NLR) and the platelet/lymphocyte ratio (PLR) between patients with and without type 2 diabetes mellitus and between diabetic patients with and without renal dysfunction.
METHODS: A cross-sectional retrospective study was performed at the Laboratory of Clinical Analyzes of the Hospital das Clínicas of the Federal University of Goiás between January and December 2016. Data from patients aged 40 years or older were included in the study. Those with a blood glucose ≥200 mg / dL and/or glycated hemoglobin ≥6.5% formed the diabetic group, and those who did not present these criteria for diabetes formed the control group, being matched by age and sex. The diabetic group was classified in one group with renal damage and another without renal damage, according to the 24-hour microalbuminuria. Calculations for NLR and PLR were performed from the absolute number of neutrophils, lymphocytes and platelets, and the medians were compared.
RESULTS: A total of 122 subjects were included in the study, among which 52.5% were between 40 and 64 years of age and 63.9% were male. The median NLR was 2.1 (min 0.8 - max 5.3) in the diabetic group and 1.9 (min 0.6 - max 6.2) in the control group (p=0.16). The median PLR was 120.5 (min 63.5 - max 206.6) in the diabetic group and 119.7 (min 40.4 - max 215.1) in the control group (p=0.19). Considering the age group, there was no difference in the median NLR or PLR among the diabetic group and the control group; however, the NLR was higher for individuals 65 years of age or older, regardless of whether they were diabetic (median 2.2, min 1.0 - max 3.8, p=0.01) or not (median 2.4, min 0.9 - max 3.6, p=0.001). Among the participants, 38 patients presented renal damage, 24 (63.1%) of the diabetic group and 14 (36.9%) of the control group. The median NLR and PLR were similar among diabetic patients with renal damage, diabetics without renal damage and control group.
CONCLUSIONS: NLR and PLR were similar between the diabetic group and the control group, as well as among diabetics with or without renal damage. RNL was higher for individuals 65 years of age or older, regardless of whether they were diabetic or not.
Downloads
References
Kahraman C, Kahraman NK, Cosgun S, Gulcan E. The relationship between neutrophil-to-lymphocyte ratio and albuminuria in type 2 diabetic patients: a pilot study. Arch Med Sci. 2016;12(3):571-5. https://doi.org/10.5114/aoms.2016.59931
Liang S, Li Q, Zhu H, Zhou J, Ding R, Chen X, Cai G. Clinical factors associated with the diagnosis and progression of diabetic nephropaty. Cell Biochem Biophys. 2014;70:9-15. https://doi.org/10.1007/s12013-014-9892-9
Wada J, Makino H. Inflammation and the pathogenesis of diabetic nephropathy. Clin Sci. 2013;124:139-52. https://doi.org/10.1042/CS20120198
Huang W, Huang J, Liu Q, Lin F, He Z, Zeng Z, He L. Neutrophil-lymphocyte ratio is a reliable predictive marker for early-stage diabetic nephropathy. Clin Endocrinol. 2015;82:222-33. https://doi.org/10.1111/cen.12576
Yodying H, Matsuda A, Miyashita M, Matsumoto S, Sakurazawa N, Yamada M, Uchida E. Prognostic significance of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in oncologic outcomes of esophageal cancer: A systematic review and meta-analysis. Ann Surg Oncol. 2016;23(2):646-54. https://doi.org/10.1245/s10434-015-4869-5
Sefil F, Ulutas KT, Dokuyucu R, Sumbul AT, Yengil E, Yagiz AE, Yula E, Ustun I, Gokce C. Investigation of neutrophil lymphocyte ratio and blood glucose regulation in patients with type 2 diabetes mellitus. J Int Med Res. 2014;42(2):581-8. https://doi.org/10.1177/0300060513516944
Chittawar S, Dutta D, Qureshi Z, Surana V, Khandare S, Dubey TN. Neutrophil-lymphocyte ratio is a novel reliable predictor of nephropathy, retinopathy, and coronary artery disease in Indians with type-2 diabetes. Indian J Endocrinol Metab. 2017;21(6):864-70. https://doi.org/10.4103/ijem.IJEM_197_17
Shiny A, Bibin YS, Chantirani CS, Regin BS, Anjana RM, Balasubramanyam M, Jebarani S, Mohan V. Association of neutrophil-lymphocyte ratio with glucose intolerance: An indicator of systemic inflammation in patients with type 2 diabetes. Diabetes Technol Ther. 2014;16(8):524-30. https://doi.org/10.1089/dia.2013.0264
Sociedade Brasileira de Diabetes. Métodos e critérios para o diagnóstico. In: Diretrizes da Sociedade Brasileira de diabetes, 2015-2016. Rio de Janeiro: Sociedade Brasileira de Diabetes; 2015.
American Diabetes Association. Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 2014;37(Suppl 1):S81-90. https://doi.org/10.2337/dc14-S081
Li J, Chen Q, Luo X, Hong J, Pan K, Lin X, Liu X, Zhou L, Wang H, Xu Y, Li H, Duan C. Neutrophil-to-lymphocyte ratio positively correlates to age in healthy population. J Clin Lab Anal. 2015;29(6):437-43. https://doi.org/10.1002/jcla.21791
Ruggiero C, Metter EJ, Cherubini A, Maggio M, Sen R, Najjar SS, Windham GB, Ble A, Senin U, Ferrucci L. White blood cell count and mortality in the baltimore longitudinal study of aging. J Am Coll Cardiol. 2007;49(18):1841-50. https://doi.org/10.1016/j.jacc.2007.01.076
Yilmaz H, Ucan B, Sayki M, Unsal I, Sahin M, Ozbek M, Delibasi T. Usefulness of the neutrophil-to-lymphocyte ratio to prediction of type 2 diabetes mellitus in morbid obesity. Diabetes Metab Syndr. 2015;9(4):299-304. https://doi.org/10.1016/j.dsx.2014.04.009
Demirtas L, Degirmenci H, Akbas EM, Ozcicek A, Timuroglu A, Gurel A, Ozcicke F. Association of hematological indicies with diabetes, impaired glucose regulation and microvascular complications of diabetes. Int J Clin Exp Med. 2015;8:11420-7.
Lou M, Lou P, Tang R, Peng Y, Yu S, Huang W, He L. Relationship between neutrophil-lymphocyte ratio and insulin resistance in newly diagnosed type 2 diabetes mellitus patients. BMC Endocr Disord. 2015;15:1-6. https://doi.org/10.1186/s12902-015-0002-9
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2018 Scientia Medica
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright
The submission of originals to Scientia Medica implies the transfer by the authors of the right for publication. Authors retain copyright and grant the journal right of first publication. If the authors wish to include the same data into another publication, they must cite Scientia Medica as the site of original publication.
Creative Commons License
Except where otherwise specified, material published in this journal is licensed under a Creative Commons Attribution 4.0 International license, which allows unrestricted use, distribution and reproduction in any medium, provided the original publication is correctly cited.
