Association of Neutrophil-Lymphocyte Ratio (NLR) with Prediabetes and Type-2 Diabetes Mellitus

Abstract

Background: Diabetes mellitus and associated complications are related to systemic inflammation and insulin resistance. Recently NLR has been used as a marker of the systemic inflammatory process in chronic diseases. NLR is a widely available inexpensivehematological parameter and can be used in the prediction of diabetes-related complications. Objectives: The present study aimed to explore the association of NLR with the glycemic status of pre-diabetes and type 2 DM in comparison to normal healthy adults. Methods: A total of 105 study subjects were included.Fasting plasma glucose (FPG), 2 hours after 75gm glucose load (2 hrs PG), HbA1c, and Complete blood count (CBC) tests were done.Then the study subjects were categorized into Group 1 (Normal healthy adult), Group 2 (Pre-diabetes), and Group 3 (Diabetes). Each group contains 35 study subjects. Data (collected in preformed proforma) were analyzed by SPSS Version 22-0. Comparison of various parameters was done by Chi-Square test, ANOVA test, and Kruskal-Wallis test followed by post-hoc test. Spearmen correlation coefficient test was done to see the correlation of NLR with glycemic status (FPG, 2 hrs PG, and HbA1c). Results: Age and sex were not statistically significant.Median values of FPG, 2hrs PG, and HbA1c were significantly higher in Group 2 and Group 3 in comparison to Group 1(p-value <0.001). Median values of NLR were significantly higher in Group 2 and Group 3 in comparison to Group 1 (p<0.001). NLR was also positively correlated with 2hrs PG and HbA1c in Group 2 and Group 3 with p values 0.034, 0.013 & 0.019, and 0.036 respectively. Group 1 showed no significant correlation with NLR. Conclusion: This study showed that NLR was higher in both pre-diabetes and type 2 DM with a positive correlation. It can be used in the prediction of dysglycemia-related complications in the future.