A Cross Sectional Study to Assess Neutrophil Leucocyte Ratio as Predictor of Microvascular Complications in Diabetes Mellitus Type II

Abstract

Background: Neutrophil-to-lymphocyte ratio (NLR) is a marker/indicator for detecting sub-clinically present inflammatory process which is related to increase in microvascular complications. This increase in NLR has been associated with nephrological and cardiovascular diseases and metabolic syndrome.

Aim:  The aim of this study was to assess neutrophil-leukocyte ratio as predictor of microvascular complications in type II diabetes.

Materials and Methods:  This cross-sectional and prospective study was carried out on 100 diabetic patients with inclusion criteria of a) fulfilling ADA criteria and b) age above 18 years. Exclusion criteria for this study were- Patients diagnosed with an acute infection, leukocytosis, leukocytopenia, chronic types of cardiac, renal or hepatic disorders, auto-immune diseases, malignancy or hematological diseases and those on anti-inflammatory or immunosuppressive therapy. Blood-related parameters such as- neutrophil-leukocyte ratio on total leukocytic count were analyzed. Microvascular changes like were examined using ultrasound imaging. Statistical analysis was performed using descriptive statistics, t test, Chi-square and ANOVA tests. ROC curve analysis was performed for predicting correlation between NLR and cIMT. Results: Diabetics with vascular changes showed high glycosylated hemoglobin; high fasting blood glucose, LDL-C, triglycerides, serum creatinine/blood urea nitrogen, estimated glomerular filteration rate (eGFR) and Neutrophil/lymphocyte (N/L) ratio levels that has statistical significance, though less statistical significance for HDL-C was noted. ROC analysis proved NLR as a diagnostic marker for microvascular changes.

Conclusion: It can be concluded from this study that Neutrophil-lymphocyte ratio may be used as an indicator for assessing microvascular complications in patients with diabetes mellitus.