Patro Shubhransu, Sharma Vibha, Choudhary Arushi, Varuneil Yallambhotla, Arora Parmarth, Nayak Sailendra, Sahoo Jyoti Prakash
General Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Pharmacology, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Cureus. 2025 Jul 12;17(7):e87759. doi: 10.7759/cureus.87759. eCollection 2025 Jul.
Diabetic neuropathy is a common microvascular complication of type 2 diabetes mellitus (T2DM), like diabetic retinopathy and nephropathy. The neutrophil count is raised during infection and inflammation, and the lymphocyte count is decreased in immunocompromised patients. The platelet count suggests the thrombotic and inflammatory conditions. Hence, the neutrophil-lymphocyte ratio (NLR) is the ratio of absolute counts of neutrophils to lymphocytes. The systemic immune-inflammation index (SII) is the product of NLR and platelet count. These indicate the immuno-inflammatory status of the patient. There is a dearth of literature assessing the SII of individuals with diabetic neuropathy. Hence, we mapped this study to evaluate and compare complete blood count (CBC), NLR, and SII of diabetic patients with and without neuropathy. We also correlated NLR and SII values of the study population.
This cross-sectional study was conducted from April 2024 to March 2025 at Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, India. We included adult diabetic patients admitted to the KIMS medicine ward. Hemoglobin, total leucocyte count (TLC), neutrophil count, lymphocyte count, platelet count, length of T2DM, and glycated hemoglobin (HbA) were all measured shortly after their hospitalization. NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count. We obtained the SII value by multiplying the platelet count by NLR. R software version 4.4.3 (R Core Team, Vienna, Austria) was used for statistical analysis.
One hundred ninety-three diabetic patients were found eligible for this study. Their median age was 66 (55-73) years. Of them, 92 (47.7%) were women. The study population's median white blood cell (WBC) was 9.88 (8.72-11.24) × 10/L. The median counts of lymphocytes and neutrophils were 2214 (1720-2647)/µL and 6864 (5796-8256)/µL, respectively. The study population's median platelet counts were 250 (189-293) × 10/L. The study population's median HbA was 8.61 (7.57-9.31)%. The study population's median duration of diabetes mellitus was 11 (6-18) years. The study population's median SII and NLR were 755.3 (521.4-1002.2) × 10 cells/L and 2.93 (2.40-4.21), respectively. NLR and SII values were positively correlated (r = 0.92, p < 0.001). Regardless of neuropathy, the association between NLR and SII was identical among the study subjects.
Diabetes patients without neuropathy and those with neuropathy had comparable CBC, NLR, and SII values. The results of our study cannot be extrapolated due to the limited sample size and failure to account for several variables, including concurrent medications, comorbidities, and length of hospital stay.
糖尿病神经病变是2型糖尿病（T2DM）常见的微血管并发症，与糖尿病视网膜病变和肾病类似。感染和炎症期间中性粒细胞计数升高，免疫功能低下患者淋巴细胞计数降低。血小板计数提示血栓形成和炎症状态。因此，中性粒细胞与淋巴细胞比值（NLR）是中性粒细胞绝对计数与淋巴细胞绝对计数之比。全身免疫炎症指数（SII）是NLR与血小板计数的乘积。这些指标反映了患者的免疫炎症状态。目前缺乏评估糖尿病神经病变患者SII的文献。因此，我们开展本研究以评估和比较有或无神经病变的糖尿病患者的全血细胞计数（CBC）、NLR和SII。我们还对研究人群的NLR和SII值进行了相关性分析。
本横断面研究于2024年4月至2025年3月在印度布巴内斯瓦尔市的卡林加医学科学研究所（KIMS）开展。我们纳入了入住KIMS内科病房的成年糖尿病患者。患者入院后不久即测量血红蛋白、总白细胞计数（TLC）、中性粒细胞计数、淋巴细胞计数、血小板计数、T2DM病程和糖化血红蛋白（HbA）。NLR通过中性粒细胞绝对计数除以淋巴细胞绝对计数计算得出。我们通过血小板计数乘以NLR获得SII值。使用R软件4.4.3版本（R核心团队，奥地利维也纳）进行统计分析。
193例糖尿病患者符合本研究纳入标准。他们的中位年龄为66（55 - 73）岁。其中，92例（47.7%）为女性。研究人群的中位白细胞（WBC）为9.88（8.72 - 11.24）×10⁹/L。淋巴细胞和中性粒细胞的中位计数分别为2214（1720 - 2647）/µL和6864（5796 - 8256）/µL。研究人群的中位血小板计数为250（189 - 293）×10⁹/L。研究人群的中位HbA为8.61（7.57 - 9.31）%。研究人群的糖尿病中位病程为11（6 - 18）年。研究人群的中位SII和NLR分别为755.3（521.4 - 1002.2）×10⁹细胞/L和2.93（2.40 - 4.21）。NLR和SII值呈正相关（r = 0.92，p < 0.001）。无论有无神经病变，研究对象中NLR与SII之间的关联均相同。
无神经病变和有神经病变的糖尿病患者的CBC、NLR和SII值相当。由于样本量有限且未考虑包括同时使用的药物、合并症和住院时间等多个变量，我们研究的结果不能外推。
