Neutrophil–lymphocyte ratio in diabetic mellitus patients with foot ulcer – A case–control study

Abstract

Background: Diabetes mellitus (DM) is not a single entity, but a clinical syndrome characterized by hyperglycemia resulting from deficiency of insulin secretion or decreased sensitivity of the tissues to insulin. In India, on average, 40,000 legs are being amputated each year, of which 75% are neuropathic including secondary infection, which can be certainly avoided. Neutrophil-to-lymphocyte ratio (NLR) is recommended as a measure of subclinical inflammation. Hence, it could be possible to find a correlation between NLR ratio and micro and macrovascular complications of diabetes mellitus. Aims and Objectives: Primary: To study the relationship between the presence of diabetic foot ulcer (DFU) and NLR. Secondary: To study neutrophil–lymphocyte ratio as an economical and easy accessible inflammatory marker for predicting and follow-up of micro and macrovascular complications of diabetes mellitus such as foot ulcer. Materials and Methods: This study includes diabetic mellitus patients aged above 18 years with foot ulcer (cases) and without foot ulcer (controls) admitted in H.S.K hospital during the study period. Blood sample was drawn from each patient for necessary biochemical investigation. Statistical Analysis: Statistical analysis was performed using Spacecraft Plasma Interaction Software. Mean, standard deviation, proportions, and Chi-square tests were used to compare between two groups. Results: There is statistically significant correlation between DFU and NLR with a P = 0.000. Conclusion: Mean NLR was significantly higher in cases than controls. Current study proved a positive association between NLR and DFU. NLR is directly calculated from the neutrophil and lymphocyte counts and can be obtained easily from a complete blood cell count during admission and follow up. Hence, rising values of NLR during follow help prognosticate subclinical inflammation and imminent complications like DFU.