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.