Abstract

Research Article

Neutrophil and platelet lymphocyte ratio in diabetes mellitus

Mehmet Özdin, Hayrullah Yazar* and Durhasan Mundan

Published: 31 October, 2022 | Volume 6 - Issue 1 | Pages: 056-059

Background: This study, it was aimed to investigate the relationship between Neutrophil Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) in Type II Diabetes Mellitus (Type II DM) patients.
Methods: The data of the study were obtained from 108 patients, 61 women and 47 men, who were diagnosed with Type II DM, who applied to the Diabetes Polyclinics of Training and Research Hospital between 01.01.2020 and 30.06.2020 and a healthy control group without Type II DM. The data of the patients were obtained retrospectively via the Hospital Information Management System (HIMS).
Results: The mean age of the Type II DM patient meeting the study criteria were 57.9 ± 12.69 years. The mean age of the control group was determined as 55.8 ± 8.81. There was no significant difference between the patient and control groups in terms of age and gender. The NLR of type II DM patients was 2.96 ± 1.15 and that of the control group was 1.91 ± 0.81. The PLR of type II DM patients was found as 179.29 ± 61.81 and the PLR of the control group was found as 121.21 ± 51.33. When NLR and PLR values of type II DM patients and the control group were compared found that it was statistically significant (p < 0.05). 
Conclusion: Although more analysis is needed to prove that NLR and PLR are associated with type II DM disease, our study’s high NLR and PLR values in Type II DM patients should suggest that these parameters are essential in the diagnosis and follow-up. Also, NLR and PLR inflammatory diseases, acute coronary syndrome, rheumatoid arthritis, etc., is higher, suggesting that this is related to unsanitary conditions rather than a specific disease.

Read Full Article HTML DOI: 10.29328/journal.aac.1001033 Cite this Article Read Full Article PDF

Keywords:

Type II diabetes mellitus; Neutrophil lymphocyte ratio; Platelet lymphocyte ratio

References

  1. Satman I. The update criteria and the reasons of them in diagnosis and follow up of diabetes mellitus. Turkiye Klinikleri J Int Med Sci 2007; 3:1-15.
  2. Özdin M. Tip II Diabetes Mellituslu Hastalarda Retinopati ile HbA1c Arasındaki İlişki, Balıkesir Medical Journal 2020; (2):41-45. DOI: 10.33716/bmedj.734178
  3. Sağlam H. Diyabet ve Enfeksiyonlar. Güncel Pediatri 2004; 2: 44-52.
  4. Litman GW, Cannon JP, Dishaw LJ. Reconstructing immune phylogeny: new perspectives. Nat Rev Immunol. 2005 Nov;5(11):866-79. doi: 10.1038/nri1712. PMID: 16261174; PMCID: PMC3683834.
  5. Pancer Z, Cooper MD. The evolution of adaptive immunity. Annu Rev Immunol. 2006;24:497-518. doi: 10.1146/annurev.immunol.24.021605.090542. PMID: 16551257.
  6. Yeaman MR. Platelets: at the nexus of antimicrobial defence. Nat Rev Microbiol. 2014 Jun;12(6):426-37. doi: 10.1038/nrmicro3269. PMID: 24830471.
  7. de Stoppelaar SF, van 't Veer C, Claushuis TA, Albersen BJ, Roelofs JJ, van der Poll T. Thrombocytopenia impairs host defense in gram-negative pneumonia-derived sepsis in mice. Blood. 2014 Dec 11;124(25):3781-90. doi: 10.1182/blood-2014-05-573915. Epub 2014 Oct 9. PMID: 25301709; PMCID: PMC4263985.
  8. Uslu AU, Küçük A, Şahin A, Ugan Y, Yılmaz R, Güngör T, Bağcacı S, Küçükşen S. Two new inflammatory markers associated with Disease Activity Score-28 in patients with rheumatoid arthritis: neutrophil-lymphocyte ratio and platelet-lymphocyte ratio. Int J Rheum Dis. 2015 Sep;18(7):731-5. doi: 10.1111/1756-185X.12582. Epub 2015 Apr 21. PMID: 25900081.
  9. Yazar H, Kayacan Y, Ozdin M. De Ritis ratio and biochemical parameters in COVID-19 patients. Arch Physiol Biochem. 2022 Dec;128(6):1676-1680. doi: 10.1080/13813455.2020.1788604. Epub 2020 Jul 20. PMID: 32683882.
  10. Guzey-Aras Y, Yazar H, Acar T, Kayacan Y, Acar BA, Boncuk S, Eryilmaz HA. The Role of De Ritis Ratio as a Clinical Prognostic Parameter in COVID 19 Patients. Clin Lab. 2021 Oct 1;67(10). doi: 10.7754/Clin.Lab.2021.210119. PMID: 34655209.
  11. Kayacan Y, Yazar H, Özdin M. Could the R-ratio be an indicator of acute liver injury for the treatment of covid-19? Ist Faculty Med. July 2, 2021. doi: 10.26650/IUITFD.2021.824074
  12. Pichler M, Hutterer GC, Stoeckigt C, Chromecki TF, Stojakovic T, Golbeck S, Eberhard K, Gerger A, Mannweiler S, Pummer K, Zigeuner R. Validation of the pre-treatment neutrophil-lymphocyte ratio as a prognostic factor in a large European cohort of renal cell carcinoma patients. Br J Cancer. 2013 Mar 5;108(4):901-7. doi: 10.1038/bjc.2013.28. Epub 2013 Feb 5. PMID: 23385728; PMCID: PMC3590665.
  13. Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, Gurm HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol. 2008 Sep 15;102(6):653-7. doi: 10.1016/j.amjcard.2008.05.006. Epub 2008 Jun 26. PMID: 18773982.
  14. de Jager CP, van Wijk PT, Mathoera RB, de Jongh-Leuvenink J, van der Poll T, Wever PC. Lymphocytopenia and neutrophil-lymphocyte count ratio predict bacteremia better than conventional infection markers in an emergency care unit. Crit Care. 2010;14(5):R192. doi: 10.1186/cc9309. Epub 2010 Oct 29. PMID: 21034463; PMCID: PMC3219299.
  15. Templeton AJ, Ace O, McNamara MG, Al-Mubarak M, Vera-Badillo FE, Hermanns T, Seruga B, Ocaña A, Tannock IF, Amir E. Prognostic role of platelet to lymphocyte ratio in solid tumors: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev. 2014 Jul;23(7):1204-12. doi: 10.1158/1055-9965.EPI-14-0146. Epub 2014 May 3. PMID: 24793958.
  16. Doupis J, Lyons TE, Wu S, Gnardellis C, Dinh T, Veves A. Microvascular reactivity and inflammatory cytokines in painful and painless peripheral diabetic neuropathy. J Clin Endocrinol Metab. 2009 Jun;94(6):2157-63. doi: 10.1210/jc.2008-2385. Epub 2009 Mar 10. PMID: 19276232; PMCID: PMC2690431.
  17. Fujita T, Hemmi S, Kajiwara M, Yabuki M, Fuke Y, Satomura A, Soma M. Complement-mediated chronic inflammation is associated with diabetic microvascular complication. Diabetes Metab Res Rev. 2013 Mar;29(3):220-6. doi: 10.1002/dmrr.2380. PMID: 23280928.
  18. Milner JD, Ward JM, Keane-Myers A, Paul WE. Lymphopenic mice reconstituted with limited repertoire T cells develop severe, multiorgan, Th2-associated inflammatory disease. Proc Natl Acad Sci U S A. 2007 Jan 9;104(2):576-81. doi: 10.1073/pnas.0610289104. Epub 2007 Jan 3. PMID: 17202252; PMCID: PMC1761908.
  19. Kayabaşı S, Gül F. Pfapa sendromunda yeni öngörücü parametreler: nötrofil lenfosit oranı ve trombosit lenfosit oranı. Ortadogu Tıp Derg 2019; 11(3):231-34. DOI: 10.21601/ortadogutipdergisi.456084
  20. Atan D, Özcan KM, Köseoğlu S, İkincioğulları A, Çetin MA, Ensari S, Dere H. Nazal polipte yeni öngörücü parametreler: Nötrofil lenfosit oranı ve trombosit lenfosit oranı [New predictive parameters of nasal polyposis: neutrophil to lymphocyte ratio and platelet to lymphocyte ratio]. Kulak Burun Bogaz Ihtis Derg. 2015;25(2):97-101. Turkish. doi: 10.5606/kbbihtisas.2015.01947. PMID: 25935061.
  21. Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, Gurm HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol. 2008 Sep 15;102(6):653-7. doi: 10.1016/j.amjcard.2008.05.006. Epub 2008 Jun 26. PMID: 18773982.
  22. Liu Y, Du X, Chen J, Jin Y, Peng L, Wang HHX, Luo M, Chen L, Zhao Y. Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. J Infect. 2020 Jul;81(1):e6-e12. doi: 10.1016/j.jinf.2020.04.002. Epub 2020 Apr 10. PMID: 32283162; PMCID: PMC7195072.
  23. Kilic E, Rezvani A, Toprak AE, Erman H, Ayhan SK, Poyraz E. Romatoid Artritte Nötrofil/Lenfosit ve Platelet/Lenfosit Oranlarının Değerlendirilmesi. Dicle Tıp Dergisi. 2016; 43(2):241-47. DOI: 10.5798/diclemedj.0921.2016.02.0674
  24. Chung JH, Lim J, Jeong JH, Kim KR, Park CW, Lee SH. The significance of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in vestibular neuritis. Laryngoscope. 2015 Jul;125(7):E257-61. doi: 10.1002/lary.25204. Epub 2015 Feb 13. PMID: 25677212.
  25. Feng JF, Huang Y, Chen QX. Preoperative platelet lymphocyte ratio (PLR) is superior to neutrophil lymphocyte ratio (NLR) as a predictive factor in patients with esophageal squamous cell carcinoma. World J Surg Oncol. 2014 Mar 19;12:58. doi: 10.1186/1477-7819-12-58. PMID: 24641770; PMCID: PMC3973187.
  26. Boilard E, Nigrovic PA, Larabee K, Watts GF, Coblyn JS, Weinblatt ME, Massarotti EM, Remold-O'Donnell E, Farndale RW, Ware J, Lee DM. Platelets amplify inflammation in arthritis via collagen-dependent microparticle production. Science. 2010 Jan 29;327(5965):580-3. doi: 10.1126/science.1181928. PMID: 20110505; PMCID: PMC2927861.
  27. Kulaksızoğlu S, Merter AA. Kolorektal Kanser Hastalarında Nötrofil/Lenfosit, Trombosit/Lenfosit ve Trombosit Büyük Hücre Oranı Değerlerinin Tanıdaki Yeri. F.Ü. Sağ. Bil. Tıp. Derg. 2019; 33(3):169-73.
  28. Turan Y, Turan E. Neutrophil-to-lymphocyte ratio independently predicts the epicardial fat thickness in diabetic patients. Cukurova Med J 2019; 44(4): 1333-1338.
  29. Mertoglu C, Gunay M. Neutrophil-Lymphocyte ratio and Platelet-Lymphocyte ratio as useful predictive markers of prediabetes and diabetes mellitus. Diabetes Metab Syndr. 2017 Nov;11 Suppl 1:S127-S131. doi: 10.1016/j.dsx.2016.12.021. Epub 2016 Dec 12. PMID: 28017281.
  30. Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. N Engl J Med. 1999 Feb 11;340(6):448-54. doi: 10.1056/NEJM199902113400607. Erratum in: N Engl J Med 1999 Apr 29;340(17):1376. PMID: 9971870.
  31. Ozdin M, Kaya H, Gulacti U, Lok U, Kafadar H, Yucetas C. The diagnostic value of neutrophil to lymphocyte ratio in determining the severity of COVID-19. IMC J Med Sci 2022;16(1):001
  32. Doğan A. The relationship between residual SYNTAX score and neutrophil/lymphocyte ratio in ST segment elevation myocardial infarction pat. Ann Med Res 2020; 27(9):2433-2437. DOI: 10.5455/annalsmedres.2020.05.456
  33. Özdin M. Sjögren Sendromu olan Hastalarda Nötrofil/Lenfosit ve Trombosit/Lenfosit Oranlarının Araştırılması. Balıkesir Medical Journal, 2021; 5(1):23-28. DOI: 10.33716bmedj.855386

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