Neutrophil lymphocyte coefficient as a tool for assessing the risk of cardiac complications in elderly patients with type 2 diabetes mellitus

An elevated neutrophil-to-lymphocyte ratio (NLR) is an indicator of inflammatory processes and predicts the development of various cardiac diseases and non-cardiac disorders. Objective. To evaluate the relationship between NLR and various indices of glucose control in elderly patients with type 2 diabetes mellitus (DM2). Materials and methods. The observational study was conducted from September 2022 to February 2023. The study included 330 patients with DM2, were randomly assigned to three groups based on disease control: group 1 – glycated hemoglobin (HbA1c) level ≤7% (excellent control); group 2 – HbA1c from 7.0 to 9.0% (poor control); group 3 – HbA1c ≥9% (critical control). Patients' condition was assessed based on complete blood count and C-reactive protein levels. Results. When compared with the excellent control group (group 1), patients with the worst control (group 3) had significantly higher leukocyte (p < 0.001) and neutrophil (p < 0.003) counts, as well as lower lymphocyte (p = 0.44) levels. At the same time, no significant differences were found among patients with poor control (group 2) with patients with excellent disease control (group 1). The NLR parameter increased significantly in the worst control group (group 3) compared with the poor (group 2) and excellent (group 1) diabetes control groups: 4.3±2.8, 2.7±1.0, and 2.0±0.5, respectively (p < 0.001). NLR was found to be an independent predictor of poor diabetes control, along with fasting glucose and C-reactive protein. Conclusions. An increase in NLR is associated with an increase in HbA1c and inadequate glycemic control in patients with DM2. This indicator can serve as a useful tool for health monitoring in the process of monitoring patients with DM.