Association Between Systemic Inflammatory Markers NLR and PLR in Patients with Type 2 Diabetes Mellitus

Abstract

Type 2 diabetes is a metabolic inflammatory disease. However, Neutrophil-to-Lymphocyte ratio (NLR) and Platelet-to-Lymphocyte ratio (PLR) have emerged as potential inflammatory markers in patients with type 2 diabetes mellitus (T2DM). Therefore, its relationship with glycemic parameters remains controversial. This study aims to investigate the association between NLR, PLR, glycemic parameters, and hematological indices in patients with T2DM. A cross-sectional study was conducted on 65 patients with T2DM. Fasting blood sugar (FBS), glycated hemoglobin (HbA1c), and hematological indices were obtained from the medical record, including a complete blood count. NLR was calculated as the absolute neutrophil count divided by the absolute lymphocyte count, and PLR was calculated as the absolute platelet count divided by the absolute lymphocyte count. Data normality was assessed using the Shapiro-Wilk test. The data were non-normally distributed; Spearman's rank correlation was performed to investigate the associations between inflammatory markers and glycemic parameters. Statistical significance was set at p < 0.05. A total of 65 patients with T2DM were included (36 males, 55.4%; 29 females, 44.6%) with a mean age of 50±6.65 years. The mean level of FBS was 210±84 mg/dL, and the mean level of HbA1c was 9.34±2.16%. The study patient's cohort exhibited elevated systemic inflammatory markers. The mean NLR value was 3.0±2.89, and the mean PLR value was 153.08±130.89, both of which are higher than the standard reference ranges for healthy individuals. However, no statistically significant correlations were found between the inflammatory markers (NLR and PLR) and glycemic parameters. A strong and statistically significant positive correlation was observed between NLR and PLR (rho = 0.516, p < 0.001). NLR did not significantly correlate with FBS (rho = 0.025, p = 0.846) or HbA1c (rho = -0.044, p = 0.726). Similarly, no significant association was observed between PLR and FBS (rho = 0.100, p = 0.428) or HbA1c (rho = -0.048, p = 0.703).