STUDY OF NEUTROPHILS TO LYMPHOCYTE RATIO(NLR) AS A MARKER OF DIABETIC NEPHROPATHY IN TYPE 2 DIABETES MELLITUS
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 7, Pages 9984-9991
AbstractAIM: To correlate relationship of NLR Ratio in Type 2 DM patients having raised Albumin in urine/ elevated UACR and no Albuminuria / normal UACR.
MATERIAL & METHODS: Analytical Cross Sectional study involving data from 96 patients visitng JSS Hospital OPD and Inpatients of JSS Hospital, Mysuru over a period of 18 months. General physical examination was done which included weight, body mass index, height, heart rate, blood pressure, any cyanosis, clubbing, pallor, yellowish discoloration of sclera. Routine Investigations such as Complete Hemogram, Glycated hemoglobin (HbA1c) ,Hepatic function tests (LFTs), Renal function (RFT), Urine microscopy and routine, Chest Xray & specific investigation such as spot urine Albumin(Protein) to creatinine(UACR) ratio was done.
RESULTS: The majority of subjects with and without nephropathy were among the age group of 51 to 60 years & majority of subjects with and without nephropathy were males. There was no correlation between gender and nephropathy (P = 1.0). The mean FBS levels were significantly higher among subjects with diabetic nephropathy compared to their normal counterparts (P= 0.038). The mean HbA1c levels among subjects with and without diabetic nephropathy were almost similar (P = 0.878) and was not significant. It was observed that, the median spot UACR, mean N/L ratio, mean blood urea, mean serum creatinine & GFR(glomerular filtration rate) was higher among subjects with diabetic nephropathy(DN) compared to their normal counterparts and p value was found to be significant.
CONCLUSION: The study revealed that elevated NLR was associated with the development of DN(diabetic nephropathy), suggesting that inflammation and the dysfunction of the endothelium could be contributing factors to this condition. The NLR test is an easy-to-use and inexpensive way and can be calculated using differential leukocyte count. The NLR test will allow researchers to gain a deeper understanding of role of inflammation in the development of DN and how it could be used as a prognostic and predictive marker of diabetic nephropathy especially in areas with limited resources.
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