Background

Inflammation plays a central role in pathogenesis of diabetic nephropathy (DN), a major cause of morbidity and mortality in type 2 diabetes mellitus (T2DM). Neutrophil lymphocyte ratio (NLR) is a novel and easily available inflammatory marker that can be used to predict DN.

Objective

The objective was to evaluate NLR as a predictive and prognostic marker for DN.

Material and methods

It was an observational cross-sectional study. A total of 324 T2DM patients and 212 healthy controls (HC) were selected by consecutive sampling between June 2019 and June 2020. Complete blood count, erythrocyte sedimentation rate (ESR), renal function parameters, 24-h urinary protein, and fundoscopy were done. Appropriate statistical analysis was applied using SPSS software.

Results

Of 324 T2DM patients, 146 (45%) had DN and 178 (55%) did not. Mean NLR (± SD) for T2DM without DN, T2DM, with DN and HC was 2.73 ± 0.91, 4.85 ± 1.37, and 2.05 ± 0.73, respectively (p-value < 0.05). Positive correlation between NLR vs ESR (r = + 0.335), creatinine (r = + 0.282), and 24-h urinary protein (r = + 0.508) (p-value < 0.001) and negative correlation with hemoglobin (r = − 0.335) and estimated glomerular filtration rate (r = − 0.163) (p-value = 0.001) was observed. Receiver operating characteristic curve for NLR was highest (0.882) (Std. error − 0.019 and p-value < 0.000), and best cut-off value was 3.28 (sensitivity = 89.7% and specificity = 69.7%).

Conclusion

NLR is a better and reliable inflammatory marker compared to a frequently assayed inflammatory parameter like ESR. Thus, it can be considered as a predictive and prognostic marker for DN.

中文翻译：

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中性粒细胞比例：糖尿病肾病的可靠生物标志物？

背景

炎症在糖尿病肾病 (DN) 的发病机制中起着核心作用，这是 2 型糖尿病 (T2DM) 发病率和死亡率的主要原因。中性粒细胞淋巴细胞比率 (NLR) 是一种新型且易于获得的炎症标志物，可用于预测 DN。

客观的

目的是评估 NLR 作为 DN 的预测和预后标志物。

材料与方法

这是一项观察性横断面研究。2019年6月至2020年6月连续抽样，共选择324名T2DM患者和212名健康对照（HC），进行全血细胞计数、红细胞沉降率（ESR）、肾功能参数、24小时尿蛋白、眼底镜检查. 使用SPSS软件进行适当的统计分析。

结果

在 324 名 T2DM 患者中，146 名 (45%) 有 DN，178 名 (55%) 没有。无 DN 的 T2DM、有 DN 和 HC 的 T2DM 的平均 NLR (± SD) 分别为 2.73 ± 0.91、4.85 ± 1.37 和 2.05 ± 0.73（p值 < 0.05）。NLR 与 ESR ( r  = + 0.335)、肌酐 ( r  = + 0.282) 和 24 小时尿蛋白 ( r  = + 0.508) ( p值 < 0.001) 之间呈正相关，与血红蛋白呈负相关 ( r  = − 0.335 ) 和估计的肾小球滤过率 ( r  = − 0.163) ( p值 = 0.001) 被观察到。NLR 的接收者操作特征曲线最高 (0.882)（标准误差 - 0.019 和p-value < 0.000），最佳临界值为 3.28（灵敏度 = 89.7% 和特异性 = 69.7%）。

结论

与 ESR 等经常检测的炎症参数相比，NLR 是一种更好、更可靠的炎症标志物。因此，它可以被认为是 DN 的预测和预后标志物。