May Neutrophil Lymphocyte Ratio Be A Predictor of Neuropathy in Diabetic Patients?

Öz

It is known that there are immunological inflammatory mechanisms that play a role in the pathogenesis of type 2 diabetes mellitus (DM), which is a common metabolic disease in adults. Chronic inflammation plays a role in the development of chronic microvascular complications. Neutrophil-lymphocyte ratio (NLR) is a new marker of inflammation that is inexpensive and easy to administer. NLR is accepted as a marker of systemic inflammation and is used as a prognostic marker in patients with heart diseases and malignancies. The aim of this study is to examine whether there is a relationship between NLR and neuropathy, one of the microvascular complications, in patients with type 2 diabetes mellitus in adults. One hundred and nine diabetic patients (40 without microvascular complications and 69 with microvascular complications) were included in the study. Microvascular complications from DM were evaluated with NLR and compared with different inflammatory markers. NLR was higher in patients with diabetic complications compared to the group without (20.40±14.79 vs 5.56±3.46, respectively; p<0.001). Spearmens's correlation analysis revealed NLR was significantly positively correlated with ESR (r:0.633, p:<0.001) and CRP (r: 0.387, p:<0.001). Increased NLR levels may be associated with neuropathy in type 2 diabetic patients.

Anahtar Kelimeler

• Type 2 diabetes mellitus
• neutrophil lymphocyte ratio
• neuropathy
• microvascular complication

Kaynakça

1. 1. IDF Diabetes Atlas 2021, 10th edition https://diabetesatlas.org/atlas/tenth-edition/ (Accessed on January 17, 2022).
2. 1. IDF Diabetes Atlas 2021, 10th edition https://diabetesatlas.org/atlas/tenth-edition/ (Accessed on January 17, 2022).
3. 2. Xu G, Liu B, Sun Y, et al. Prevalence of diagnosed type 1 and type 2 diabetes among US adults in 2016 and 2017: population based study. BMJ 2018; 362:k1497.
4. 2. Xu G, Liu B, Sun Y, et al. Prevalence of diagnosed type 1 and type 2 diabetes among US adults in 2016 and 2017: population based study. BMJ 2018; 362:k1497.
5. 3. Chatterjee, S.; Khunti, K.; Davies, M.J. Type 2 diabetes. Lancet 2017, 389, 2239–2251.) (NCD Risk Factor Collaboration. Worldwide trends in diabetes since 1980: A pooled analysis of 751 population-based studies with 4.4 million participants. Lancet 2016, 387, 1513–1530.
6. 3. Chatterjee, S.; Khunti, K.; Davies, M.J. Type 2 diabetes. Lancet 2017, 389, 2239–2251.) (NCD Risk Factor Collaboration. Worldwide trends in diabetes since 1980: A pooled analysis of 751 population-based studies with 4.4 million participants. Lancet 2016, 387, 1513–1530.
7. 4. Stumvoll, M.; Goldstein, B.J.; van Haeften, T.W. Type 2 diabetes: Principles of pathogenesis and therapy. Lancet 2005, 365, 1333–1346.
8. 4. Stumvoll, M.; Goldstein, B.J.; van Haeften, T.W. Type 2 diabetes: Principles of pathogenesis and therapy. Lancet 2005, 365, 1333–1346.

9. 5. Weyer, C.; Bogardus, C.; Mott, D.M.; Pratley, R.E. The natural history of insulin secretory dysfunction and insulin resistance in the pathogenesis of type 2 diabetes mellitus. J. Clin. Investig. 1999, 104, 787–794.
10. 5. Weyer, C.; Bogardus, C.; Mott, D.M.; Pratley, R.E. The natural history of insulin secretory dysfunction and insulin resistance in the pathogenesis of type 2 diabetes mellitus. J. Clin. Investig. 1999, 104, 787–794.
11. 6. Defronzo, R.A. From the triumvirate to the ominous octet: A new paradigm for the treatment of type 2 diabetes mellitus. Diabetes 2009, 58, 773–795.
12. 6. Defronzo, R.A. From the triumvirate to the ominous octet: A new paradigm for the treatment of type 2 diabetes mellitus. Diabetes 2009, 58, 773–795.
13. 7. Schwartz, S.S.; Epstein, S.; Corkey, B.E.; Grant, S.F.; Gavin, J.R., 3rd; Aguilar, R.B. The Time Is Right for a New Classification System for Diabetes: Rationale and Implications of the beta-Cell-Centric Classification Schema. Diabetes Care 2016, 39, 179–186.
14. 7. Schwartz, S.S.; Epstein, S.; Corkey, B.E.; Grant, S.F.; Gavin, J.R., 3rd; Aguilar, R.B. The Time Is Right for a New Classification System for Diabetes: Rationale and Implications of the beta-Cell-Centric Classification Schema. Diabetes Care 2016, 39, 179–186.
15. 8. Strasser, B. Physical activity in obesity and metabolic syndrome. Ann. N. Y. Acad. Sci. 2013, 1281, 141–159.
16. 8. Strasser, B. Physical activity in obesity and metabolic syndrome. Ann. N. Y. Acad. Sci. 2013, 1281, 141–159.
17. 9. Koca I, Tutoglu A, Boyacı A, Pehlivan Y, Yıldız H, Turkbeyler I, Sarıcicek E, Taysi S, Onat AM. An evaluation of oxidative stress and antioxidant capacity in patients with myofascial pain syndrome. Mod Rheumatol. 2014 Nov;24(6):992-6. doi: 10.3109/14397595.2014.886984. Epub 2014 Mar 26. PMID: 24670130.
18. 9. Koca I, Tutoglu A, Boyacı A, Pehlivan Y, Yıldız H, Turkbeyler I, Sarıcicek E, Taysi S, Onat AM. An evaluation of oxidative stress and antioxidant capacity in patients with myofascial pain syndrome. Mod Rheumatol. 2014 Nov;24(6):992-6. doi: 10.3109/14397595.2014.886984. Epub 2014 Mar 26. PMID: 24670130.
19. 10. Zengin O, Onder ME, Sarica MA, Turkbeyler IH, Kimyon G, Demir ZH, Yildiz H, Kisacik B, Onat AM. Systemic vasculitis in a patient with rhupus syndrome. Reumatismo. 2015 Dec 23;67(4):161-4. doi: 10.4081/reumatismo.2015.858. PMID: 2721518.
20. 10. Zengin O, Onder ME, Sarica MA, Turkbeyler IH, Kimyon G, Demir ZH, Yildiz H, Kisacik B, Onat AM. Systemic vasculitis in a patient with rhupus syndrome. Reumatismo. 2015 Dec 23;67(4):161-4. doi: 10.4081/reumatismo.2015.858. PMID: 2721518.