Neutrophil-Lymphocyte ratio and Platelet-Lymphocyte ratio as useful predictive markers of prediabetes and diabetes mellitus

Abstract

Aims: Chronic inflammation plays a central role in the development and progression of diabetes, and in the pathogenesis of its complications. The neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are indicators of subclinical inflammation. Mean platelet volume (MPV) is one of the platelet function indices. We investigated the association of NLR, PLR and MPV with prediabetes and type 2 diabetes mellitus and determine whether or not these are reliable markers for diagnosis.

Materials and methods: Participants were divided into four groups; 1: normal glucose tolerance, 2: impaired glucose tolerance (prediabetic), 3: newly diagnosed diabetic by OGTT. 4: group is previously diagnosed diabetic without complication. Outcomes were compared between groups.

Results: There are significant differences between all groups in NLR (p=0.004) and PLR (p=0.021) values. NLR values are significantly higher in prediabetic (1.60±0.85), firstly diagnosed diabetic (1.58±0.78) and clear diabetic (2.07±0.95) groups compared to normal group (1.37±0.69) (mean, SD). PLR values are significantly lower in prediabetic (90.35±44.34) and firstly diagnosed diabetic (86.38±45.24) groups compared to normal group (100.55±48.14) but significantly higher in clear diabetic group (122.45±37.43). There are no significant differences between all groups in MPV values.

Conclusion: Inflammation marker NLR significantly increases in prediabetic and diabetic patients. PLR significantly decreases in prediabetes and early stages of diabetes but increases in later stages. NLR and PLR values may be reliable predictive markers in prediabetes and diabetes mellitus.

Keywords: Diabetes mellitus; Neutrophil–Lymphocyte ratio; Platelet-Lymphocyte ratio; Prediabetes.