Assessment of neutrophil-lymphocyte ratio as an inflammatory marker among type 2 diabetes mellitus patients with and without diabetic nephropathy

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Addis Abeba University


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.



Diabetic nephropathy, inflammatory biomarker, Neutrophil-lymphocyte ratio, Type 2 Diabetes mellitus