Neutrophil/lymphocyte ratio and its association with cardiometabolic profile and prevalent chronic complications in type 2 diabetic patients in Douala General Hospital
Eugene Adze Nkwetateba1, André Pascal Kengne2, François Folefack Kaze3, Siméon Pierre Choukem1,&
1Department of Internal Medicine, Faculty of Health Sciences, University of Buea, Buea, Cameroon, 2Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa, 3Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
Siméon Pierre Choukem, Department of Internal Medicine, Faculty of Health Sciences, University of Buea, Buea, Cameroon
Neutrophil/lymphocyte ratio (NLR) is a simple and affordable marker of subclinical inflammation, reported to be associated with cardiac and non-cardiac disorders. We compared the distribution of NLR in type 2 diabetes mellitus (T2DM) patients and healthy subjects and assessed the association of NLR with glucose control, cardiometabolic parameters and prevalent chronic diabetic complications in T2DM patients receiving care at a tertiary health facility in Cameroon.
absolute neutrophil and lymphocyte counts were obtained from a consecutive sample of T2DM patients who attended the outpatient section of the Douala General Hospital between January 2009 to February 2016, and from healthy blood donors. Other data included cardiometabolic parameters, glycated haemoglobin and estimated glomerular filtration rate (eGFR)-calculated using the Modification of Diet in Renal Disease formula.
we included 822 T2DM patients and 485 controls. The mean NLR patients vs.
control was 1.60 vs. 1.28 (p = 0.009). Using Spearman’s correlation analysis
(s), there was an association 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), pulse rate (σ = 0.12, p = 0.001) and chronic kidney disease
(σ = -0.23, p = 0.001). There was no association between NLR and hypertension,
total cholesterol, high density lipoprotein cholesterol, low density lipoprotein
cholesterol, triglyceride, obesity and central obesity (all p ≥ 0.55).
NLR in T2DM patients is significantly higher than in healthy subjects, and correlates positively with diabetic retinopathy, serum uric acid, blood pressure, and negatively with eGFR. Whether NLR estimation can assist vascular risk stratification in people with diabetes must be investigated further.