Introduction: Neutrophil Lymphocyte Ratio (NLR) is a novel marker of chronic inflammation that exhibits a balance of two interdependent components of the immune system and can be used to predict microvascular complications in diabetes. Aim: To study the NLR in type 2 diabetes patients and its association with microvascular complications in these patients. Materials and Methods: This was a cross-sectional study conducted over 18 months at Safdarjung Hospital, New Delhi. Eighty patients of type 2 Diabetes Mellitus (DM) were selected for the study. Detailed history was taken including duration of DM, symptoms suggestive of any complications or co-morbidity and treatment history. Physical examination (height and weight) and systemic examination was performed to check for presence of any diabetic complications. NLR was obtained from the complete blood counts by dividing the absolute number of neutrophils to the absolute number of lymphocytes. Data recorded were analysed using Statistical Package for Social Sciences (SPSS) software version 21.0 Logistic regression analysis and Receiver Operating Curve (ROC) curve were used. Results: Total 38.7% (31) of the patients had high NLR, with mean±Standard Deviation (SD) of NLR being 3.29±1.49. There was a statistically significant association between poorly controlled diabetes HbA1C >7%, high-sensitivity C-Reactive Protein (hs-CRP) levels and NLR. NLR was found to be the best predictor of diabetic neuropathy and diabetic nephropathy. NLR was also significantly higher in DM patient having more than one microvascular complication. Conclusion: NLR can be used as a simple parameter to predict presence of diabetic microvascular complications. Thus, an early diagnosis and subsequently targeting inflammatory pathways could possibly be a component of the strategies to prevent and control diabetes related complications.
Association of neutrophil-gelatinase-associated lipocalin with microvascular complications in patients with type 2 diabetes: a cross-sectional study
