Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio: A screening tool for diabetic nephropathy and an alternative to assessing glycemic control

ABSTRACT

Background: Diabetes mellitus is a common chronic disease with high morbidity and mortality. Chronic inflammation has been considered the potential pathogenesis responsible for the development of diabetic complications. The utility of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) is being assessed and projected as novel, inexpensive, and reliable tools of disease progression and prognostication in various diseases. Aim and Objectives: In the present study, the association of NLR and PLR levels with microalbuminuria levels in diabetic patients is studied to find utility of NLR and PLR to predict disease progression. Materials and Methods: Patients were categorized into four different groups based on their HbA1c levels as Group I – Normal (with HbA1c in range 4%?5.6%), Group II – Pre-diabetic (with HbA1c in range 5.7%?6.4%), Group III – Diabetics (with HbA1c in range 6.5?7.0), and Group IV – Diabetics (with HbA1c > 7.0). The sensitivity and specificity of NLR and PLR values as a screening tool for early nephropathy in each category were analyzed. Utility of NLR and PLR as independent markers of glycemic control was evaluated using Pearson correlation analysis. Results: In this study, Group I patients showed significant relation between NLR, PLR with creatinine, urea, and microabluminuria while in Group II, NLR and microalbuminuria showed significant relationship. In Group III and IV, no such relation was seen. Conclusion: Our study found no significant correlation of NLR and PLR levels with microalbuminuria levels in diabetic patients and also that NLR and PLR are not much useful for assessing glycemic control.