Assessment of Neutrophil Lymphocyte ratio, Platelet Lymphocyte Ratio and Albuminuria in Type 2 Diabetes Mellitus – a reliable predictive marker in a resource-limited country: Observational Case-control study (Preprint)

BACKGROUND Diabetic nephropathy is a common microangiopathic complication in patients with Diabetes Mellitus (DM) leading to End Stage Renal Disease. Inflammation and albuminuria have a crucial place in the development and progression of nephropathy in type 2 DM. OBJECTIVE This study aims to know the association of inflammatory markers such as Neutrophil Lymphocyte ratio (NLR) and Platelet Lymphocyte ratio (PLR) with progressive albuminuria in type 2 DM. METHODS A total of 110 patients were studied all diagnosed cases of type 2 DM and were divided into three subgroups based on urinary albumin levels: Group I - type 2 DM with Normoalbuminuria; Group II - type 2 DM with Microalbuminuria; Group III - type 2 DM with Macroalbuminuria. Levels of inflammatory markers (NLR and PLR) were recorded and compared in these subgroups. RESULTS Significant differences were detected between the groups in terms of NLR (p=0.000) and PLR (p=0.000). Multiple Logistic Regression Analysis showed NLR is significantly influenced by Haemoglobin in g/dL (p=0.001) and Microalbuminuria (p=0.001). Multiple Logistic Regression Analysis also showed Haemoglobin significantly influences PLR in g/dL (p=0.001) and Microalbuminuria (p=0.004). CONCLUSIONS NLR and PLR were significantly increased in parallel to albuminuria levels. Therefore, NLR and PLR may serve as a cost-effective and readily accessible marker of Diabetic Nephropathy.