Assessment of neutrophil-lymphocyte ratio as an inflammatory marker among type 2 diabetes mellitus patients with and without diabetic nephropathy
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Date
2020-11
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Addis Abeba University
Abstract
Background: Diabetic nephropathy (DN) is one of the microvascular complications of
diabetes mellitus manifested as increased albumin in urine excretion. Total leucocyte count is
a crude, but a sensitive indicator of inflammation and studied in many non-communicable
diseases such as acute myocardial infarction, stroke, heart failure and cancer as index of
inflammation. In this study, the neutrophil-lymphocyte ratio (NLR) was evaluated between
T2DM patients with and without DN.
Objective: To assess the neutrophil-lymphocyte ratio as an inflammatory marker among Type
2 diabetes mellitus (T2DM) patients with and without diabetic nephropathy.
Methodology: A cross-sectional study was conducted to compare NLR between type 2
diabetic patients with and without DN at Bole 17 Health Center, Addis Ababa, Ethiopia from
October 15, 2019 to April14, 2020. Convenient sampling technique was used to recruit the
study participants. The data was entered in to Epi-data statistical software version 3.1 and then
exported to SPSS software version 22.0 for analysis. Simple descriptive statistics such as
mean, standard deviation, and percentages were used to present socio-demographic
characteristics and magnitude of patients with DN, without DN and NLR ratio. Appropriate
statistical tests, including student t-test, chi-square test, and Pearson correlation were done to
analyze the statistical data. The p-values < 0.05 were considered statistically significant.
Results: Out of the 199 DM patients, 22.6% and 77.4% were found with diabetic nephropathy
(albumin positive) and without diabetic nephropathy (albumin negative), respectively.
Interestingly, the mean NLR value (2.66±0.49) was found higher in diabetic patients with DN
compared to the mean NLR (1.65±0.20) of diabetes patients without DN (p <0.0001).
Conclusion: The NLR was significantly increased in T2DM patients with DN, suggesting that
inflammation and endothelial dysfunction could be an integral part in the pathogenesis of DN,
and NLR may be considered as a predictor and a prognostic biomarker of DN.
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Keywords
Diabetic nephropathy, inflammatory biomarker, Neutrophil-lymphocyte ratio, Type 2 Diabetes mellitus