Neutrophil/lymphocyte ratio and its association with cardiometabolic profile and prevalent chronic complications in type 2 diabetic patients in the Douala General Hospital

CaHReF 20116, Yaoundé Conges hall, 23 – 26 August 2016 , PL119

Diabetes mellitus (DM) is one of the most challenging health problems of the 21st century. There are numerous complications of diabetes including cardiovascular disease (CVD) and increased neutrophil to lymphocyte ratio (NLR) levels may be associated with these macro vascular complications of DM. NLR is a new, simple and cheap marker of subclinical inflammation recently reported to be associated with cardiac and non-cardiac disorders.
Our study aimed to compare the distribution of NLR in type 2 diabetes mellitus (T2DM) patients and healthy subjects; and assess the association between NLR levels and glucose control, cardiometabolic profile and prevalent chronic diabetic complications in T2DM patients

This was a hospital based retrospective file analysis study conducted at the Douala General Hospital (DGH). We reviewed files of patients with diabetes who consulted between January 2009 and February 2016 and obtained data on demographic and clinical parameters, and routine laboratory information including neutrophil and lymphocyte counts. Data were analyzed using R statistical software version 3.2.2.

We included1164 type 2 diabetic patients and 485 controls. The mean NLR of patients (1.60) was significantly higher than that of healthy (1.28) controls (p=0.009). Using Spearman’s correlation analysis (σ), there was a significant positive correlation between NLR and diabetic retinopathy (p=0.02), serum uric acid (σ=0.11, p=0.008), systolic blood pressure (σ=0.10 p=0.01) and pulse rate (σ=0.12 p=0.001) and negative correlation with estimated glomerular filtration rate (σ= -0.23, p=0.001). There was no significant association between NLR to CV risk profile-hypertension (p=0.55), total cholesterol (σ=-0.03, p=0.86), high density lipoprotein cholesterol (σ-0.01, p=0.95), low density lipoprotein cholesterol (σ-0.05, p=0.62), triglyceride (σ -0.002, p=0.66), obesity (σ0.03, p=0.58) and central obesity (σ-0.006, p=0.59).

The NLR in patients with type 2 diabetes is significantly higher than in healthy control subjects. NLR correlates positively with diabetic retinopathy, serum uric acid, systolic BP and pulse rate, and negatively with estimated glomerular filtration rate. Whether NLR estimation can assist vascular risk stratification in people with diabetes must be investigated further.

Neutrophil/lymphocyte ratio, type 2 diabetes, cardiometabolic profile, chronic diabetic complications