Mohammed Abdul Muqeeth, Khaleel Mohammed, R M Padmaja, Jalily Qader A, Dhanekula Kalyani, Dinesh Eshwar Mummareddi
Clinical Biochemistry, Mahavir Institute of Medical Sciences, Vikarabad, IND.
Microbiology, Mahavir Institute of Medical Sciences, Vikarabad, IND.
Cureus. 2024 Feb 29;16(2):e55227. doi: 10.7759/cureus.55227. eCollection 2024 Feb.
Introduction Diabetes is a chronic disease that causes dysregulation of blood glucose. Type 2 diabetes mellitus (T2DM) could result in long-term inflammatory conditions that affect different organs of the body. Despite the availability of diagnostic markers like glycated hemoglobin (HbA1c) for T2DM, it is essential to find an appropriate marker that could predict long-term complications. This study evaluates the potential role of neutrophil-to-lymphocyte ratio (NLR) in predicting disease progression and treatment responses. Methods This case-control study was carried out among 160 T2DM patients and 132 non-diabetic persons. Blood samples were collected from each participant and were processed for hemoglobin, HbA1c, iron, ferritin, and complete blood picture (NLR). Results The study showed that there was a significant variation in the serum levels of ferritin (264.8±611.6 ng/ml versus 168.3±364.7 ng/ml, p=0.392), iron (4.095±8.851 mcg/dl versus 55.20±37.62 mcg/dl, p=0.0111), and HbA1c (8.169±1.635% versus 5.668±0.5260% p<0.0001) among T2DM patients compared to non-diabetic persons. The NLR values (4.189±4.154 versus 4.095±8.851, p=0.009) among patients with T2DM significantly varied with that of non-diabetic persons. A significant negative correlation was noticed between the serum levels of iron and NLR (r=-0.17, p=0.014) and a positive correlation was noticed between HbA1c and NLR (r=0.19, p=0.014). The serum levels of iron revealed a significant positive correlation with the serum levels of ferritin (r=0.24, p=0.002) and hemoglobin percentage (r=0.41, p=0.008). HbA1c revealed a significant positive correlation with NLR (r=0.19, p=0.014). Additionally, a significant negative correlation was observed between iron with NLR (r=-0.17, p=0.029) and hemoglobin percentage with NLR (r=-0.30, p=0.005). However, no such correlation was demonstrated among non-diabetic persons. With an accuracy of 89.85% and high sensitivity and specificity, NLR showed diagnostic accuracy like HbA1c. Conclusions NLR demonstrated equivalent efficacy to HbA1c in predicting glycemic control. Since diabetes affects different organs of the body, evaluating NLR probably predicts inflammation. Therefore, NLR could be useful in the management of T2DM and in predicting long-term complications.
引言 糖尿病是一种导致血糖调节异常的慢性疾病。2型糖尿病（T2DM）可引发长期炎症状态，影响身体的不同器官。尽管有糖化血红蛋白（HbA1c）等用于T2DM的诊断标志物，但找到一个能够预测长期并发症的合适标志物至关重要。本研究评估中性粒细胞与淋巴细胞比值（NLR）在预测疾病进展和治疗反应中的潜在作用。
方法 本病例对照研究在160例T2DM患者和132名非糖尿病患者中进行。从每位参与者采集血样，并对血红蛋白、HbA1c、铁、铁蛋白和全血细胞计数（NLR）进行检测。
结果 研究表明，与非糖尿病患者相比，T2DM患者血清中铁蛋白水平（264.8±611.6 ng/ml对168.3±364.7 ng/ml，p = 0.392）、铁水平（4.095±8.851 mcg/dl对55.20±37.62 mcg/dl，p = 0.0111）和HbA1c水平（8.169±1.635%对5.668±0.5260%，p<0.000）存在显著差异。T2DM患者的NLR值（4.189±4.154对4.095±8.851，p = 0.009）与非糖尿病患者有显著差异。血清铁水平与NLR之间存在显著负相关（r = -0.17，p = 0.01），HbA1c与NLR之间存在正相关（r = 0.19，p = 0.01）。血清铁水平与血清铁蛋白水平（r = ）和血红蛋白百分比（r = 0.41，p = 0.008）呈显著正相关。HbA1c与NLR呈显著正相关（r = 0.19，p = 0.01）。此外，观察到铁与NLR之间存在显著负相关（r = -0.17，p = 0.029），血红蛋白百分比与NLR之间存在负相关（r = -0.30，p = 0.005）。然而，在非糖尿病患者中未发现此类相关性。NLR的诊断准确性与HbA1c相当，准确率为89.85%，具有高敏感性和特异性。
结论 NLR在预测血糖控制方面显示出与HbA1c相当的疗效。由于糖尿病会影响身体的不同器官，评估NLR可能预测炎症。因此，NLR在T2DM的管理和预测长期并发症方面可能有用。
