Kalinga institute of Medical Sciences, Bhubaneswar.
J Assoc Physicians India. 2022 Apr;70(4):11-12.
Diabetes mellitus (DM) is a systemic disease having serious microvascular and macrovascular complications. DM is one of the most common causes of chronic kidney disease CKD, end-stage renal disease (ESRD). Chronic inflammation has an important role in the development and progression of type 2 diabetes through immunologic inflammatory mechanisms. Simple new inexpensive inflammatory markers may contribute to the detection of microalbuminuria. Our aim is to study the correlation of neutrophil-to-lymphocyte ratio (NLR) and red blood cell distribution width (RDW) with microalbuminuria in type 2 diabetic patients.
This was a single-center, cross-sectional study and was conducted from November 2020 to October 2021 in a tertiary care center in Eastern Odisha. Study subjects were patients with type 2 Diabetes Mellitus. A total of 90 patients with type 2 diabetes mellitus were classified into gender- and BMI-matched three groups according to hemoglobin A1c and microalbuminuria: Group A: 30 patients with controlled diabetes, without microalbuminuria Group B: 30 patients with uncontrolled diabetes, without microalbuminuria, and Group C: 30 patients with uncontrolled diabetes with microalbuminuria. Levels of NLR and RDW between the study groups were examined and compared.
A significant difference in NLR was found between Group C and groups A and B (P <.001, P =.008, respectively). A statistically significant difference in RDW was found between groups B and C (P =.015). Receiver operating characteristic curve analysis of inflammatory markers and microalbuminuria prediction showed an area under the curve (AUC) of 0.69 for NLR and 0.61 for RDW.
NLR and RDW have a positive correlation with urine ACR and have PPV for microalbuminuria in diabetic patients. NLR and RDW are cheap and inexpensive methods for detecting nephropathy early in diabetes patients.
糖尿病（DM）是一种全身性疾病，具有严重的微血管和大血管并发症。DM 是慢性肾脏病（CKD）、终末期肾病（ESRD）的最常见原因之一。慢性炎症通过免疫炎症机制在 2 型糖尿病的发生和发展中起重要作用。简单的新的廉价炎症标志物可能有助于检测微量白蛋白尿。我们的目的是研究中性粒细胞与淋巴细胞比值（NLR）和红细胞分布宽度（RDW）与 2 型糖尿病患者微量白蛋白尿的相关性。
这是一项单中心、横断面研究，于 2020 年 11 月至 2021 年 10 月在东奥里萨邦的一家三级保健中心进行。研究对象为 2 型糖尿病患者。根据糖化血红蛋白和微量白蛋白尿，将 90 例 2 型糖尿病患者分为性别和 BMI 匹配的三组：A 组：30 例血糖控制良好，无微量白蛋白尿；B 组：30 例血糖控制不佳，无微量白蛋白尿；C 组：30 例血糖控制不佳，有微量白蛋白尿。检查并比较了研究组之间 NLR 和 RDW 的水平。
C 组与 A 组和 B 组的 NLR 差异有统计学意义（P <.001，P =.008）。B 组和 C 组的 RDW 差异有统计学意义（P =.015）。炎症标志物和微量白蛋白尿预测的受试者工作特征曲线分析显示，NLR 的曲线下面积（AUC）为 0.69，RDW 的 AUC 为 0.61。
NLR 和 RDW 与尿 ACR 呈正相关，对糖尿病患者的微量白蛋白尿有阳性预测值。NLR 和 RDW 是检测糖尿病患者早期肾病的廉价方法。
