Abstract:
Background: Diabetic mellitus is a metabolic disorder characterized by chronic inflammation.
Inflammation is a predictor of type 2 diabetes complication that it shows the elevated many
inflammation markers. The interest in this study of neutrophil to lymphocyte ratio (NLR) and
platelet to lymphocyte ratio (PLR) has grown recently because they are predictive of the
complication of diseases with diverse inflammatory and these ratios are easily calculated from
hematology analyzer printout. However, in Ethiopia we have not seen published study is
available in this regard.
Objective: This study aimed to assess neutrophil to lymphocyte ratio and platelet -lymphocyte
ratio as Marker of inflammation in type two Diabetic mellitus at Ambo university referral
hospital, Ambo, Ethiopia from September 1 –November 30, 2021.
Method: Enrolling 134 participants conducted comparative cross-sectional study; 67 type 2
diabetic mellitus patients and 67sex and age matched healthy controls. A 4ml blood sample
was collected from all study participants. Systematic random sampling was used for selecting
type 2 diabetics. Fasting blood sugar was measured by glucometer for screening apparently
healthy control, Cell Blood count was measured using Sysmex XN 550 hematology analyzer
and C - reactive protein was done based on semi-quantitative method. Data analysis was
entered by Epidata 4.6 version, and exported to SPSS version 20. Simple descriptive statistics
such as; mean, standard deviation and percentages was used to present socio-demographic
characteristics, clinical parameters, neutrophil to lymphocyte ratio and platelet to lymphocyte
ratio, and other laboratory tests, and the value was compared between Diabetics and healthy
Controls. Student t-test, Receiver operating characteristic performance and Pearson
correlation was applied to analyze the statically significance of dependent variable.
Result-The mean NLR and PLR were significantly increased in type two diabetic patients
compared with healthy controls (2.20±0.82 vs 1.43 ± 0.49, p<0.001) and (120.52±37.6 vs
100.47±32.98, p<0.001) respectively. Both NLR and PLR in type two Diabetic patients were
positively correlated with ESR and C-RP. Receiver operating curve analysis showed good
predictive of NLR and PLR in type two diabetic patients those have at least one complication
with optimum cut-off point of 1.89 (AUC = 0.882, 95% CI 0.810-0.963, Se =87.2 %, and Sp =
78.6%) and 111.38.8 (AUC = 0.706, 95% CI 0.523-0.831, Se = 61.5%, and sp =60.7%),
respectively.
Conclusion: There was a statistically significant increment in the level of Neutrophil to
lymphocyte ratio and Platelet to lymphocyte ratio between type two diabetic patients compared
with healthy controls. Both NLR and PLR in type two Diabetic patients were positively
correlated with ESR and C-RP. Therefore, NLR and PLR could predict inflammation in type
two diabetics.
Recommendations: physicians can be used as alternative inflammatory markers during type
two diabetics follow-up condition.
