Comparison of Neutrophil to Lymphocyte Ratio (NLR) and Lymphocyte to Monocyte Ratio (LMR) values in controlled and uncontrolled Type 2 Diabetes Mellitus (T2DM) patient

Putu Yudi Adnyani; Ni Nyoman Mahartini; Sianny Herawati; Ni Kadek Mulyantari; Anak Agung Wiradewi Lestari

doi:10.15562/bmj.v10i2.2501

Comparison of Neutrophil to Lymphocyte Ratio (NLR) and Lymphocyte to Monocyte Ratio (LMR) values in controlled and uncontrolled Type 2 Diabetes Mellitus (T2DM) patient

Putu Yudi Adnyani ,

Ni Nyoman Mahartini ,

Sianny Herawati ,

Ni Kadek Mulyantari ,

Anak Agung Wiradewi Lestari ,

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DOI: https://doi.org/10.15562/bmj.v10i2.2501 |
Published: 2021-08-31

Abstract

Background: Inflammation is related to insulin resistance. Neutrophil to Lymphocyte Ratio (NLR) and Lymphocyte to Monocyte Ratio (LMR) are used as inflammation markers and predictors of complications associated with diabetes. This study aims to determine the differences of NLR and LMR values in controlled and uncontrolled type 2 diabetes mellitus (DM) patients.

Methods: A cross-sectional was conducted in this study at Sanglah General Hospital. Research data were taken from the Laboratory Information System (LIS) and medical records. NLR is obtained from the absolute neutrophils divided by absolute lymphocytes, LMR is obtained from absolute lymphocytes divided by absolute monocytes. Data were analyzed using SPSS version 25 for Windows.

Results: Type 2 diabetes mellitus mainly was male (58.3%) with the highest proportion at the age of 46-55 years (50.0%). The mean leukocyte count was significantly higher in the uncontrolled group (8.45±1.58 cells/µL) (p<0.05). NLR showed a significant difference in the two groups (p<0.05). However, there was no significant difference in LMR between groups (p>0.05)

Conclusion: NLR in uncontrolled type 2 DM was significantly higher than in controlled type 2 DM. Meanwhile, the LMR did not show a significant difference between the two groups.

References

Schuster DP, Duvuuri V. Diabetes mellitus. Clin Podiatr Med Surg. 2002;19(1):79-107.
Artha IMJR, Bhargah A, Dharmawan NK, Pande UW, Triyana KA, Mahariski PA, et al. High level of individual lipid profile and lipid ratio as a predictive marker of poor glycemic control in type-2 diabetes mellitus. Vasc Health Risk Manag. 2019;15:149-157.
Forbes JM, Cooper ME. Mechanisms of diabetic complications. Physiol Rev. 2013;93(1):137-188.
Mendes BB, Oliveira ACR, Alcântara KC. Comparison of the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in normoglycemic and hyperglycemic subjects. Einstein (Sao Paulo). 2019;17(1):eAO4403.
Prabawa IPY, Bhargah A, Liwang F, Tandio DA, Tandio AL, Lestari AAW, et al. Pretreatment Neutrophil-to-Lymphocyte ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) as a Predictive Value of Hematological Markers in Cervical Cancer. Asian Pac J Cancer Prev. 2019;20(3):863-868.
Wiranata S, Anjani IAW, Saputra IPGS, Sadvika IGAS, Prabawa IPY, Supadmanaba IG, et al. Pretreatment Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as a Stage Determination in Breast Cancer. Open Access Maced J Med Sci. 2020;8(B):1058-1063.
Tshikongo AK, Songela RK, Koke JK, Mawazo SS, Kalala ZL, Otshudi AL. Polynuclear Neutrophil Variation and Oxidative Stress in Type 2 Diabetics. JMR. 2018;4(1):16-19
Zhang H, Yang Z, Zhang W, Niu Y, Li X, Qin L, et al. White blood cell subtypes and risk of type 2 diabetes. J Diabetes Complications. 2017;31(1):31-37.
Sefil F, Ulutas KT, Dokuyucu R, Sumbul AT, Yengil E, Yagiz AE, et al. Investigation of neutrophil lymphocyte ratio and blood glucose regulation in patients with type 2 diabetes mellitus. J Int Med Res. 2014;42(2):581-8.
Hussain M, Babar MZM, Akhtar L, Hussain MS. Neutrophil lymphocyte ratio (NLR): A well assessment tool of glycemic control in type 2 diabetic patients. Pak J Med Sci. 2017;33(6):1366-1370.
Nurlaelatiningsih C, Sastradimaja SB, Defi IR. Correlation Between Neutrophil-Lymphocyte Ratio and Cardiac Autonomic Neuropathy in Diabetes Mellitus Type 2 Patients. International Journal of Integrated Health Sciences. 2017;5(1):15-20
Devamsh GN, Parvathi M, Madhumathi R, Raghavan L. Study of Neutrophil Lymphocyte Ratio in Patients with Type 2 Diabetes Mellitus and Its Correlation with Glycemic Control. Int J adv Med. 2019;6(5):1637-1641
Kanter JE, Hsu CC, Bornfeldt KE. Monocytes and Macrophages as Protagonists in Vascular Complications of Diabetes. Front Cardiovasc Med. 2020;7:10.
Hu YX, Xu XX, Shao Y, Yuan GL, Mei F, Zhou Q, et al. The prognostic value of lymphocyte-to-monocyte ratio in retinopathy of prematurity. Int J Ophthalmol. 2017;10(11):1716-1721.