NEUTROPHIL-LYMPHOCYTE RATIO: A PREDICTOR OF COMPLICATIONS IN TYPE 2 DIABETES MELLITUS PATIENTS

Abstract

Background: Chronic inflammation plays a potential role in development of diabetes related complications in type 2 diabetes mellitus (T2DM). Neutrophil-lymphocyte ratio (NLR) is one of the potential markers of systemic inflammation. The objective of this study was to examine an association between NLR and T2DM associated complications. Methods: A cross sectional study was conducted at Sheikh Zayed Medical College & affiliated hospital in Rahim Yar Khan from June - September 2022. About 360 patients were divided in to three groups. Group A were comprised of T2DM patients without diabetic complications while group B and C were T2DM patients with micro- and macro-vascular complications respectively. Micro- and macrovascular complications were assessed by history, physical examination and medical records. Association of diabetes related compilations with NLR value was done using regression analysis with SPSS version 25. Results: The baseline demographic characteristics of three study groups did not show statistically significant difference. However TLC count is significantly elevated in group B (with microvascular complications) and group C T2DM with macrovascular complications (P<0.001) respectively compared to control group A. Similarly NLR ratio was significantly higher (4.8±2.0 & 5.0±1.8) in group B and group C respectively, compared to group A (2.2±0.8 with P<0.001). Regression analysis showed that NLR was positively correlated with diabetes related micro and macrovascular complications (OR: 4.62, 95% CI: 2.51-7.26, p<0.001) along with HbA1c (OR: 1.732, 95% CI: 1.82-2.22, P=0.002). Conclusion: High NLR ratio is associated with diabetes related micro and macro vascular complications. It should be routinely measured in T2DM patients for prevention of diabetes related complications.