Evaluation of Neutrophil to High Density Lipoprotein Ratio and Glycemic Level in Type 2 Diabetics with and without Diabetic Nephropathy at Goba Referral Hospital, Bale, Southeast Ethiopia, 2023

Abstract

Background: - More than 450 million individuals globally already have diabetes. Almost 90% of cases of diabetes are type 2 diabetes mellitus, and 45% of persons with this condition fail to achieve glycemic control, which is a significant risk factor for developing diabetic complications. The most common cause of chronic kidney disease and a factor in the morbidity and mortality of diabetic patients is diabetic nephropathy, a consequence of diabetes. Type 2 diabetes mellitus is a long-term, low-grade inflammatory condition caused by an immune system imbalance; with renal damage often occurring as the inflammatory process starts before eGFR decline. Dyslipidemia also starts with poor glycemic management. Objective: - The aim of the study was to assess the neutrophil to high-density lipoprotein ratio and glycemic level in type 2 diabetics with and without nephropathy. Methods: - A cross-sectional comparative study was done on type 2 diabetes in Goba Referral Hospital, Bale Southeast Ethiopia. The sample size was determined by using G*Power 3.1.9.4 software with the assumptions of two-tailed, medium effect size (0.5), α error (0.05), power (0.8) and diabetic nephropathy to the non-nephropathy ratio (1:2). The total sample size was 144. An independent t-test was applied to determine the mean difference of the two groups. In the study, the relationship between the dependent and independent variables was evaluated using Pearson correlation. Results: - In this study, 144 type 2 diabetes mellitus patients participated with a response rate of 100%. The mean value of the neutrophil to HDL ratio (4.42 ± 1.53) was increased in the diabetic nephropathy group compared to the mean value of neutrophil to HDL ratio (3.48±1.16) of the non-nephropathy group with P value <0.001. In addition, the mean value of glycated hemoglobin was increased in the diabetic DN group (8.74 ± 1.65) compare to the non-nephropathy (7.13 ± 1.39) group with a P value <0.001. Conclusion and Recommendation: - Neutrophil to HDL ratio and glycated hemoglobin are higher in diabetic patients with nephropathy. Therefore, regular screening for glycated hemoglobin and neutrophil to HDL ratio is better for diabetic patients. It could also be a useful adjunct to standard tests to follow the prognosis of diabetic nephropathy.