The Journal of Medical Sciences

Register      Login

VOLUME 5 , ISSUE 2 ( April-June, 2019 ) > List of Articles

Original Article

Neutrophil–Lymphocyte Ratio and Platelet–Lymphocyte Ratio: Novel Markers in Diabetes Mellitus

Bhargavi K Nagabhushan, JP Geetha

Keywords : Diabetes mellitus, Neutrophil lymphocyte ratio, Platelet lymphocyte ratio

DOI: 10.5005/jp-journals-10045-00114

License: CC BY-NC 4.0

Published Online: 01-12-2019

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

Introduction: Diabetes mellitus (DM) is a chronic metabolic disorder with high morbidity and mortality. Neutrophil–lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) have emerged as novel indicators of subclinical inflammation and can be used as potential indicators of vascular complications and poorer outcome in patients with DM. This study was conducted to evaluate the role of NLR and PLR as inflammatory biomarkers of type 2 DM. Aim: The aim of this study is to assess NLR and PLR as predictive inflammatory markers in DM. Materials and methods: This was a cross-sectional study carried out in Sri Siddhartha Medical College, Tumkur, from September 2018 to November 2018. The source of data included patients attending medicine outpatient department (OPD) with type 2 DM aged between 18 years and 60 years without other comorbidities. The values of glucose parameters and HbA1c were obtained from the case files. Complete blood count (CBC) was measured using the Sysmex XN 330 automatic hematology analyzer. Results: The study was carried out on 150 diabetics and 50 subjects were used as controls. Out of 150 cases, 110 patients had well-controlled DM (HbA1c7%). Diabetic patients had a significantly higher NLR and PLR as compared to the controls (p = 0.003 and p = 0.008, respectively). Patients with poorly controlled DM had a significantly higher NLR and PLR as compared to subjects with well-controlled DM (p = 0.02 and 0.007). Conclusion: Increased levels of NLR and PLR are associated with poor glycemic control. It can be used as a disease monitoring tool during the follow-up of the diabetic patients. Clinical significance: NLR and PLR parameters are widely available, reliable, and inexpensive and are used in the prediction of diabetes-related complications in the future so that effective measures can be taken to prevent complications.


HTML PDF Share
  1. Mertoglu C, Gunay M. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as useful predictive markers of prediabetes and diabetes mellitus. Diab Met Syndr Clin Res Rev 2016;11(1):S127–S131. DOI: 10.1016/j.dsx.2016.12.021.
  2. Liu J, Liu X, et al. The association of neutrophil to lymphocyte ratio, mean platelet volume, and platelet distribution width with diabetic retinopathy and nephropathy: a meta-analysis. Bioscience rep 2018;38(3):1–15. DOI: 10.1042/BSR20180172.
  3. Moursy EY, Megallaa MH, et al. Relationship Between Neutrophil-Lymphocyte Ratio and Microvascular Complications in Egyptian Patients with Type 2 Diabetes. American J Inter Med 2015;3(6): 250–255.
  4. Verdoia M, Shaffer A, et al. Impact of diabetes on neutrophil-to-lymphocyte ratio and its relationship to coronary artery disease. Diabetes Metab J 2015;41(4):304–310. DOI: 10.1016/j.diabet.2015.01.001.
  5. Hussain M, Babar MZM, et al. Neutrophil-Lymphocyte ratio(NLR): A well assessment tool of glycemic control in Type 2 diabetic patients. Pak J Med Sci 2017;33(6):1366–1370. DOI: 10.12669/pjms.336. 12900.
  6. Abdelaziz AA, El-Sayed EM, et al. Study of neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) as a predictor inflammatory marker for diabetic nephropathy in type 2 diabetic patients. Egypt J Hosp Med 2018;72(7):4800–4807.
  7. Yagiz E, Yula E, et al. Investigation of neutrophil lymphocyte ratio and blood glucose regulation in patients with type 2 diabetes mellitus. J Int Med Res 2014;42(2):581–586. DOI: 10.1177/0300060513516944.
  8. Shiny A, Bibin Y, et al. 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):524–527. DOI: 10.1089/dia.2013.0264.
  9. Sefil F, Ulutas KT, et al. Investigation of neutrophil lymphocyte ratio and blood glucose regulation in patients with type 2 diabetes mellitus. J Int Med Res 2014;42(2):581–586. DOI: 10.1177/0300060513516944.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.