title: Is there a link between neutrophil-lymphocyte ratio and microvascular complications in geriatric diabetic patients?
abstract: BACKGROUND
  Chronic inflammation plays an important role on development and progression of Type 2 diabetes (T2DM) through immunologic inflammatory mechanisms. Neutrophil to lymphocyte ratio (NLR) is a new, simple and cheap marker of subclinical inflammation. NLR has recently been used as a systemic inflammation marker in chronic diseases as well as a predictor of prognosis in cardiovascular diseases and malignancies.
  
  
  OBJECTIVE
  The objective of the present study was to investigate the relationship between NLR and microvascular complications of diabetes mellitus (DM) in elderly population.
  
  
  METHODS
  Two hundred and forty-two patients with DM (145 diabetic patients with complications, 97 diabetic patients without complications) and 218 control subjects were enrolled in this study. NLR and microvascular complications because of DM were evaluated and compared with other inflammatory markers.
  
  
  RESULTS
  NLR was higher in the diabetic group (2.21±1.14) than in the controls (2.18±0.76). Furthermore, there was a statistically significant difference between NLR levels in diabetic patients with and without complications (2.46±1.26 vs 2.04±0.51, respectively; p<0.001). The results of themultiple logistic regression analysis depicted that NLR is also an independent predictor for microvascular complications (odds ratio 2.217; 95%confidence interval 1.086-4.526, p=0.029). Receiver operating curve analysis suggested that the optimum NLR cutoff point for microvascular complication was 2.89 with 96.72% specificity, 94.4% positive predictive value.
  
  
  CONCLUSIONS
  Increased NLR levels may be associated with microvascular complications of DM in the elderly population.
authors.affiliation: Department of Internal Medicine, Division of Geriatric Medicine, Gaziantep University, 27100 Sahinbey, Gaziantep, Turkey. zaodr79@yahoo.com.
authors.forename: Z A
authors.initials: ZA
authors.lastname: Öztürk
authors.forename: M E
authors.initials: ME
authors.lastname: Kuyumcu
authors.forename: Y
authors.initials: Y
authors.lastname: Yesil
authors.forename: E
authors.initials: E
authors.lastname: Savas
authors.forename: H
authors.initials: H
authors.lastname: Yıldız
authors.forename: Y
authors.initials: Y
authors.lastname: Kepekçi
authors.forename: S
authors.initials: S
authors.lastname: Arıoğul
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology; D048909:Diabetes Complications / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000473:pathology; D007958:Leukocyte Count; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity