The Relationship Between Neutrophil/Lymphocyte Ratio (NLR) and Mean Platelet Volume (MPV) with Microalbuminuria in Participants with Different Glucose Tolerances

Yıl 2022, , 72 - 84, 14.01.2022

Hasan Sözel , Fatih Yılmaz

https://doi.org/10.20515/otd.956318

Öz

Neutrophil/lymphocyte ratio (NLR) is a simple and inexpensive marker of subclinical inflammation for chronic diseases. Mean platelet volume (MPV) is a platelet function index. This study aimed to evaluate the relationship of NLR and MPV with microalbuminuria in participants with different glucose tolerances. 951 patients (male/female=302/649) were divided into five groups according to their oral glucose tolerance test (OGTT) results: group 1=normal glucose tolerance (NGT), group 2=impaired fasting glucose (IFG), group 3=isolated impaired glucose tolerance (IGT), group 4=both IFG and IGT, and group 5=type 2 diabetes mellitus (DM). Additionally, patients were divided into three groups according to their glycated hemoglobin (HbA1c) results: group 1=NGT, group 2=prediabetes, and group 3=type 2 DM. Outcomes were compared between groups. According to the OGTT, HbA1c, and OGTT+HbA1c criteria, there was a significantly positive correlation of microalbuminuria with MPV and NLR in all DM patients (p<0.001). Additionally, according to the OGTT, HbA1c, and OGTT+HbA1c criteria, there was a significantly positive correlation between MPV and microalbuminuria in all NGT patients (p<0.001). According to the OGTT and OGTT+HbA1c criteria, there was no significant correlation between NLR and microalbuminuria in prediabetic patients (p>0.05); however, there was a significantly positive correlation between NLR and microalbuminuria in the group with HbA1c 5.7–6.49 (p<0.001). Except isolated IFG and IGT, there was a significantly positive correlation between MPV and microalbuminuria in all prediabetic patients according to the OGTT, HbA1c, and OGTT+HbA1c criteria (p<0.001). NLR and MPV levels may be reliable predictive markers for the detection of microalbuminuria in prediabetes and DM.

Anahtar Kelimeler

Neutrophil/Lymphocyte Ratio, Mean Platelet Volume, Microalbuminuria, Prediabetes, Diabetes Mellitus

Farklı Glukoz Toleranslarına Sahip Katılımcılarda Nötrofil/Lenfosit Oranı (NLO) ve Ortalama Trombosit Hacmi (MPV) ile Mikroalbüminüri Arasındaki İlişki

Öz

Nötrofil/lenfosit oranı (NLO), kronik hastalıklar için subklinik inflamasyonun basit ve ucuz bir belirtecidir. Ortalama trombosit hacmi (MPV) bir trombosit fonksiyon indeksidir. Bu çalışma, farklı glukoz toleranslarına sahip katılımcılarda NLO ve MPV'nin mikroalbüminüri ile ilişkisini değerlendirmeyi amaçladı. 951 hasta (erkek / kadın = 302/649) oral glukoz tolerans testi (OGTT) sonuçlarına göre beş gruba ayrıldı: grup 1 = normal glikoz toleransı (NGT), grup 2 = bozulmuş açlık glikozu (BAG), grup 3 = izole bozulmuş glukoz toleransı (BGT), grup 4 = hem BAG hem de BGT ve grup 5 = tip 2 diabetes mellitus (DM). Ek olarak, hastalar glikolize hemoglobin (HbA1c) sonuçlarına göre üç gruba ayrıldı: grup 1 = NGT, grup 2 = prediyabet ve grup 3 = tip 2 DM. Sonuçlar gruplar arasında karşılaştırıldı. OGTT, HbA1c ve OGTT + HbA1c kriterlerine göre tüm DM hastalarında mikroalbüminüri ile MPV ve NLO arasında anlamlı pozitif korelasyon vardı (p <0.001). Ayrıca OGTT, HbA1c ve OGTT + HbA1c kriterlerine göre tüm NGT hastalarında MPV ile mikroalbüminüri arasında anlamlı pozitif korelasyon vardı (p <0.001). OGTT ve OGTT + HbA1c kriterlerine göre prediyabetik hastalarda NLO ile mikroalbüminüri arasında anlamlı bir ilişki yoktu (p> 0.05); ancak HbA1c 5,7–6,49 olan grupta NLO ile mikroalbüminüri arasında anlamlı pozitif korelasyon vardı (p <0,001). İzole BAG ve BGT dışında OGTT, HbA1c ve OGTT + HbA1c kriterlerine göre tüm prediyabetik hastalarda MPV ile mikroalbüminüri arasında anlamlı pozitif korelasyon vardı (p <0,001). NLO ve MPV seviyeleri prediyabet ve DM'de mikroalbüminüri tespiti için güvenilir prediktif belirteçler olabilir.

Anahtar Kelimeler

Nötrofil/Lenfosit Oranı, Ortalama Trombosit Hacmi, Mikroalbüminüri, Prediyabet, Diabetes Mellitus

Destekleyen Kurum

Çalışmamıza herhangi bir kurum desteği olmamıştır.

Kaynakça

• Wild S, Roglic G, Green A, et al. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047-53.
• Petersmann A, Müller-Wieland D, Müller UA, et al. Definition, classification and diagnosis of diabetes mellitus. Exp Clin Endocrinol Diabetes. 2019;127(1):1-7.
• Cho NH, Shaw JE, Karuranga S, et al. IDF diabetes atlas: global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract. 2018;138:271-281.
• Ritz E, Rychlik I, Locatelli F, et al. End-stage renal failure in type 2 diabetes: a medical catastrophe of worldwide dimensions. Am J Kidney Dis 1999;34(5):795-808.
• Juutilainen A, Lehto S, Rönnemaa T, et al. Similarity of the impact of type 1 and type 2 diabetes on cardiovascular mortality in middle-aged subjects. Diabetes Care. 2008;31(4):714-9.
• Wang T, Wang Q, Wang Z, et al. Diagnostic value of the combined measurement of serum hcy, serum cys c, and urinary microalbumin in type 2 diabetes mellitus with early complicating diabetic nephropathy. ISRN Endocrinol. 2013;407452.
• Kampoli A-M, Tousoulis D, Briasoulis A, et al. Potential pathogenic inflammatory mechanisms of endothelial dysfunction induced by type 2 diabetes mellitus. Curr Pharm Des. 2011;17(37):4147-4158.
• Cebeci E, Cakan C, Gursu M, et al. The main determinants of serum resistin level in type 2 diabetic patients are renal function and inflammation not presence of microvascular complication, obesity and insulin resistance. Exp Clin Endocrinol Diabetes. 2019;127(4):189-194.
• Mei Z, Shi L, Wang B, et al. Prognostic role of pretreatment blood neutrophil-to-lymphocyte ratio in advanced cancer survivors: a systematic review and meta-analysis of 66 cohort studies. Cancer Treat Rev. 2017;58:1–13.
• Woziwodzka K, Dziewierz A, Pawica M, et al. Neutrophil-to-lymphocyte ratio predicts long-term all-cause mortality in patients with chronic kidney disease stage 5. Folia Med Cracov. 2019;59(4):55–70.
• Liu CC, Ko HJ, Liu WS, et al. Neutrophil-to-lymphocyte ratio as a predictive marker of metabolic syndrome. Medicine (Baltimore). 2019;98(43):e17537.
• Afari ME and Bhat T. Neutrophil to lymphocyte ratio (NLR) and cardiovascular diseases: an update. Expert Rev Cardiovasc Ther. 2016;14(5):573-577.
• Okyay GU, Inal S, Oneç K, et al. Neutrophil to lymphocyte ratio in evaluation of inflammation in patients with chronic kidney disease. Ren Fail. 2013;35(1):29-36.
• Wu C-C, Sytwu H-K, and Lin Y-F. Cytokines in diabetic nephropathy. Adv Clin Chem. 2012;56:55–74.
• Diaz-Martinez J, Campa A, Delgado-Enciso I, et al. The relationship of blood neutrophil-to-lymphocyte ratio with nutrition markers and health outcomes in hemodialysis patients. Int Urol Nephrol. 2019;51(7):1239-1247.
• Khandare SA, Chittawar S, Nahar N, et al. Study of neutrophil-lymphocyte ratio as novel marker for diabetic nephropathy in type 2 diabetes. Indian J Endocrinol Metab. 2017;21(3):387-392.
• Bessman JD, Gilmer PR, and Gardner FH. Use of mean platelet volume improves detection of platelet disorders. Blood Cells. 1985;11(1):127-135.
• Coban E, Bostan F, and Ozdogan M. The mean platelet volume in subjects with impaired fasting glucose. Platelets. 2006;17(5):67–69.
• Coban E, Kucuktag S, and Basyigit S. Platelet activation in subjects with impaired glucose tolerance. Platelets. 2007;18(8):591–594.
• Ünübol M, Ayhan M, and Güney E. The relationship between mean platelet volume with microalbuminuria and glycemic control in patients with type II diabetes mellitus. Platelets. 2012;23(6):475-480.
• Dell’omo G, Penno G, Giorgi D, et al. Association between high-normal albuminuria and risk factors for cardiovascular and renal disease in essential hypertensive men. Am J Kidney Dis. 2002;40(1):1-8.
• Garg JP and Bakris GL. Microalbuminuria: marker of vascular dysfunction, risk factor for cardiovascular disease. Vasc Med. 2002;7(1):35–43.
• Levey AS, Stevens LA, Schmid CH, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150(9):604-612.
• Wang XL, Lu JM, Pan CY, et al. A comparison of urinary albumin excretion rate and microalbuminuria in various glucose tolerance subjects. Diabet Med. 2005;22(3):332–335.
• Zaccardi F, Rocca B, Pitocco D, et al. Platelet mean volume, distribution width, and count in type 2 diabetes, impaired fasting glucose, and metabolic syndrome: a meta-analysis. Diabetes Metab Res Rev. 2015;31(4):402–410.
• Patil P, Darshan A, Ao S, et al. Association of mean platelet volume with acute ischemic cerebrovascular accident among patients with type 2 diabetes mellitus: a hospital-based study. J Assoc Physicians India. 2018;66(8):44–47.
• Özer S, Yılmaz R, Sönmezgöz E, et al. Simple markers for subclinical inflammation in patients with familial mediterranean fever. Med Sci Monit. 2015;21:298-303.
• Razak MKA, Akif AM, Nakeeb N, et al. The relationship between mean platelet volume and albuminuria in patients with type 2 diabetes mellitus. Diabetes Metab Syndr. 2019;13(4):2633–2639.
• Shiny A, Bibin YS, Shanthirani CS, et al. Association of neutrophil-lymphocyte ratio with glucose intolerance: an indicator of systemic inflammation in patients with type 2 diabetes. Diabetes Technol Ther. 2014;16(8):524-530.
• Assulyn T, Khamisy-Farah R, Nseir W, et al. Neutrophil-to-lymphocyte ratio and red blood cell distribution width as predictors of microalbuminuria in type 2 diabetes. J Clin Lab Anal. 2020;34(7):1–8.
• Solak Y, Yilmaz MI, Sonmez A, et al. Neutrophil to lymphocyte ratio independently predicts cardiovascular events in patients with chronic kidney disease. Clin Exp Nephrol. 2013;17(4):532-540.