The relationship between neutrophil-to-lymphocyte ratio and albuminuria in type 2 diabetic patients: a pilot study.
BACKGROUND
Diabetes mellitus (DM) has become a global economic burden due to treatment costs and attendant complications. Albuminuria is the precursor of end stage renal failure and is an inflammatory process. In the recent past, it has been reported that the neutrophil/lymphocyte ratio (NLR), which is a cost-effective and accessible marker, may be a favorable indicator of the inflammatory status. The aim of this study was to investigate the relationship between the neutrophil/lymphocyte ratio and the presence and level of diabetic nephropathy (DN).


METHODS
A total of 112 patients with type-2 DM who were followed by our internal medicine and nephrology clinics between February 2013 and June 2014 were included in this pilot study and were retrospectively evaluated. All participants had a 24-hour urinary albumin excretion (UAE) record. Demographic parameters, biochemical parameters and albuminuria levels were recorded. Patients were divided into three groups according to their level of albuminuria.


RESULTS
Significant differences were detected between the groups in terms of NLR (p < 0.001). There was a linear increase in NLR in parallel to the increase in 24-hour UAE mean values (p < 0.001). A positive correlation was detected between NLR and C-reactive protein, urea, creatinine, and red cell distribution width. However, 24-hour UAE was negatively correlated with lymphocyte count (p < 0.001).


CONCLUSIONS
A high degree of correlation was determined among albuminuria, glomerular filtration rate and NLR levels. These results may suggest the notion that diabetic nephropathy involves an inflammatory process.
Department of Internal Medicine, Dumlupinar University, School of Medicine, Kutahya, Turkey.
Cüneyt
C
Kahraman
Department of Internal Medicine, DPU Evliya Çelebi Research and Education Hospital, Kutahya, Turkey.
Nilüfer Kuzeyli
NK
Kahraman
Department of Urology, Dumlupinar University, School of Medicine, Kutahya, Turkey.
Bekir
B
Aras
Department of Internal Medicine, Dumlupinar University, School of Medicine, Kutahya, Turkey.
Süleyman
S
Coşgun
Department of Internal Medicine, Dumlupinar University, School of Medicine, Kutahya, Turkey.
Erim
E
Gülcan
albuminuria; diabetic nephropathy; inflammation; neutrophil/lymphocyte ratio