title: Association of epicardial adipose tissue, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with diabetic nephropathy.
abstract: BACKGROUND
  The relationship between diabetic nephropathy, visceral adipose tissue (VAT), and inflammation has been shown. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are simple, inexpensive, and useful markers to determine inflammation. However, to date, in the literature, there have been no studies demonstrating the relationship between epicardial adipose tissue (EAT), inflammation, and albuminuria.
  
  
  OBJECTIVE
  We aimed to investigate the association between diabetic nephropathy, NLR, and PLR as inflammatory markers and EAT thickness.
  
  
  METHODS
  This was a cross-sectional study involving 200 diabetic patients. The patients were separated into three groups according to their albuminuria levels. The NLR and PLR were calculated from a complete blood count. EAT was measured by transthoracic echocardiography. The estimated glomerular filtration rate (eGFR) was calculated by the modification of diet in renal disease (MDRD) equation.
  
  
  RESULTS
  Disease duration, EAT, creatinine, NLR, PLR, absolute neutrophil, lymphocyte, and platelet count tended to increase with increasing albuminuria while the eGFR decreased. When patients were separated into two groups according to NLR and PLR medians, albuminuria levels increased with an increase of the NLR (p = 0.003) and PLR (p = 0.009). A correlation analysis showed that albuminuria was significantly correlated with EAT, disease duration, creatinine, eGFR, PLR, and NLR levels. Additionally, in a binary logistic regression analysis, EAT, NLR, and PLR were found to be independently associated with albuminuria.
  
  
  CONCLUSIONS
  Determining various inflammatory cytokines and measuring abdominal VAT in diabetic patients is complex and expensive. Simply measuring EAT and calculating NLR and PLR can predict inflammation and albuminuria in patients with diabetes.
authors.affiliation: Department of Endocrinology, Mengücek Gazi Training and Research Hospital, School of Medicine, Erzincan University Erzincan, Turkey.
authors.forename: Emin Murat
authors.initials: EM
authors.lastname: Akbas
authors.affiliation: Department of Internal Medicine, Mengücek Gazi Training and Research Hospital, School of Medicine, Erzincan University Erzincan, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Demirtas
authors.affiliation: Department of Internal Medicine, Mengücek Gazi Training and Research Hospital, School of Medicine, Erzincan University Erzincan, Turkey.
authors.forename: Adalet
authors.initials: A
authors.lastname: Ozcicek
authors.affiliation: Department of Internal Medicine, Mengücek Gazi Training and Research Hospital, School of Medicine, Erzincan University Erzincan, Turkey.
authors.forename: Aysu
authors.initials: A
authors.lastname: Timuroglu
authors.affiliation: Department of Cardiology, Mengücek Gazi Training and Research Hospital, School of Medicine, Erzincan University Erzincan, Turkey.
authors.forename: Eftal Murat
authors.initials: EM
authors.lastname: Bakirci
authors.affiliation: Department of Cardiology, Mengücek Gazi Training and Research Hospital, School of Medicine, Erzincan University Erzincan, Turkey.
authors.forename: Hikmet
authors.initials: H
authors.lastname: Hamur
authors.affiliation: Department of Internal Medicine, Mengücek Gazi Training and Research Hospital, School of Medicine, Erzincan University Erzincan, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Ozcicek
authors.affiliation: Department of Nephrology, Mengücek Gazi Training and Research Hospital, School of Medicine, Erzincan University Erzincan, Turkey.
authors.forename: Kultigin
authors.initials: K
authors.lastname: Turkmen
keywords: Epicardial adipose tissue; diabetic nephropathy; neutrophil-to-lymphocyte ratio; platelet-to-lymphocyte ratio