The Association of Neutrophil Lymphocyte Ratio and Glycemic Markers in Hemodialysis Patients

The Association of Neutrophil Lymphocyte Ratio and Glycemic Markers in Hemodialysis Patients

Background/aims: Neutrophil lymphocyte ratio was found to be as an inflammation marker in the preceding decade and recently related with glycemic indices in patients with diabetes mellitus. The target of this research was to explore the association of neutrophil lymphocyte ratio and glycemic indices in hemodialysis population. Methods: 177 hemodialysis patients (98 diabetic and 79 non-diabetic) aged 56.08±16.06 years were enrolled in this research. Neutrophil lymphocyte ratio was calculated and its association with predialysis glucose and HbA1c was studied. Results: NLR was positively correlated with predialysis glucose (p=0.000, r=0.338), body mass index (p=0.029, r=0.220), white blood cell (p=0.000, r=0.430), platelet (p=0.034, r=0.159), neutrophil (p=0.000, r=0.656) and C-reactive protein (p=0.00, r=0.377) levels. In non-diabetic hemodialysis group, predialysis glucose was still correlated with neutrophil lymphocyte ratio (p=0.047, r=0.224). Diabetics had higher predialysis glucose (185.94±81.11 vs 111.24±25.59, p=0.000) and neutrophil lymphocyte ratio (4.99±4.17 vs 2.82±1.23, p=0.000) compared to non-diabetics. Conclusion: This study revealed that predialysis glucose levels in hemodialysis patients are correlated with neutrophil lymphocyte ratio and hemodialysis patients with diabetes have higher neutrophil lymphocyte ratio levels. Neutrophil lymphocyte ratio should be recognized as a glycemic control marker along with traditional glycemic indices in HD patients.

___

  • Mehdi U, Toto RD. Anemia, diabetes, and chronic kidney disease. Diabetes Care 2009 Jul;32,7:1320-6. doi: 10.2337/dc08-0779.
  • Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group. KDIGO 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease. Kidney Int 2020 Oct;98,4S:S1-S115. doi: 10.1016/j.kint.2020.06.019.
  • American Diabetes Association Professional Practice Committee; American Diabetes Association Professional Practice Committee:, Draznin B, Aroda VR, Bakris G, Benson G, Brown FM, Freeman R, et al. 6. Glycemic Targets: Standards of Medical Care in Diabetes-2022. Diabetes Care 2022 Jan 1;45,Supplement_1:S83-S96. doi: 10.2337/dc22-S006.
  • Copur S, Onal EM, Afsar B, Ortiz A, van Raalte DH, Cherney DZ, et al. Diabetes mellitus in chronic kidney disease: Biomarkers beyond HbA1c to estimate glycemic control and diabetes-dependent morbidity and mortality. J Diabetes Complications 2020 Nov;34,11:107707. doi: 10.1016/j.jdiacomp.2020.107707.
  • Huang Z, Fu Z, Huang W, Huang K. Prognostic value of neutrophil-to-lymphocyte ratio in sepsis: A meta-analysis. Am J Emerg Med 2020 Mar;38,3:641-7. doi: 10.1016/j.ajem.2019.10.023.
  • Yilmaz H, Bozkurt A, Cakmak M, Celik HT, Bilgic MA, Bavbek N, et al. Relationship between late arteriovenous fistula (AVF) stenosis and neutrophil-lymphocyte ratio (NLR) in chronic hemodialysis patients. Ren Fail 2014 Oct;36,9:1390-4. doi: 10.3109/0886022X.2014.945183.
  • Zhu X, Li G, Li S, Gong Z, Liu J, Song S. Neutrophil-to-lymphocyte ratio and red blood cell distribution width-to-platelet ratio predict cardiovascular events in hemodialysis patients. Exp Ther Med 2020 Aug;20,2:1105-1114. doi: 10.3892/etm.2020.8756.
  • Diaz-Martinez J, Campa A, Delgado-Enciso I, Hain D, George F, Huffman F, et al. The relationship of blood neutrophil-to-lymphocyte ratio with nutrition markers and health outcomes in hemodialysis patients. Int Urol Nephrol 2019 Jul;51,7:1239-1247. doi: 10.1007/s11255-019-02166-6.
  • Catabay C, Obi Y, Streja E, Soohoo M, Park C, Rhee CM, et al. Lymphocyte Cell Ratios and Mortality among Incident Hemodialysis Patients. Am J Nephrol 2017;46,5:408-416. doi: 10.1159/000484177.
  • Mertoglu C, Gunay M. Neutrophil-Lymphocyte ratio and Platelet-Lymphocyte ratio as useful predictive markers of prediabetes and diabetes mellitus. Diabetes Metab Syndr 2017 Nov;11 Suppl 1:S127-S131. doi: 10.1016/j.dsx.2016.12.021.
  • Fawwad A, Butt AM, Siddiqui IA, Khalid M, Sabir R, Basit A. Neutrophil-to-lymphocyte ratio and microvascular complications in subjects with type 2 diabetes: Pakistan’s perspective. Turk J Med Sci 2018 Feb 23;48,1:157-161. doi: 10.3906/sag-1706-141.
  • Huang W, Huang J, Liu Q, Lin F, He Z, Zeng Z, et al. Neutrophil-lymphocyte ratio is a reliable predictive marker for early-stage diabetic nephropathy. Clin Endocrinol (Oxf) 2015 Feb;82,2:229-33. doi: 10.1111/cen.12576.
  • Kawamoto R, Ninomiya D, Kikuchi A, Akase T, Kasai Y, Kusunoki T, et al. Association of neutrophil-to-lymphocyte ratio with early renal dysfunction and albuminuria among diabetic patients. Int Urol Nephrol 2019 Mar;51,3:483-490. doi: 10.1007/s11255-018-02065-2.
  • Duman TT, Aktas G, Atak BM, Kocak MZ, Erkus E, Savli H. Neutrophil to lymphocyte ratio as an indicative of diabetic control level in type 2 diabetes mellitus. Afr Health Sci 2019 Mar;19,1:1602-6. doi: 10.4314/ahs.v19i1.35.
  • Shiny A, Bibin YS, Shanthirani CS, Regin BS, Aniana RM, Balasubramanyam M, et al. Association of neutrophil-lymphocyte ratio with glucose intolerance: an indicator of systemic inflammation in patients with type 2 diabetes. Diabetes Technol Ther 2014 Aug;16,8:524-30. doi: 10.1089/dia.2013.0264.
  • Sefil F, Ulutas KT, Dokuyucu R, Sumbul AT, Yengil A, Yagiz AE, et al. Investigation of neutrophil lymphocyte ratio and blood glucose regulation in patients with type 2 diabetes mellitus. J Int Med Res 2014 Apr;42,2:581-8. doi: 10.1177/0300060513516944.
  • Hussain M, Babar MZM, Akhtar L, Hussain MS. Neutrophil lymphocyte ratio (NLR): A well assessment tool of glycemic control in type 2 diabetic patients. Pak J Med Sci 2017 Nov-Dec;33,6:1366-1370. doi: 10.12669/pjms.336.12900.
  • Mendes BB, Oliveira ACR, Alcântara KC. Comparison of the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in normoglycemic and hyperglycemic subjects. Einstein (Sao Paulo) 2019 Jan 14;17,1:eAO4403. doi: 10.31744/einstein_journal/2019AO4403.
  • Bilgin S, Aktas G, Zahid Kocak M, Atak BM, Kurtkulagi O, Duman TT, et al. Association between novel inflammatory markers derived from hemogram indices and metabolic parameters in type 2 diabetic men. Aging Male 2020 Dec;23,5:923-7. doi: 10.1080/13685538.2019.1632283. Epub 2019 Jun 28.
  • Demirtas L, Degirmenci H, Akbas EM, Ozcicek A, Timuoglu A, Gurel A, et al. Association of hematological indicies with diabetes, impaired glucose regulation and microvascular complications of diabetes. Int J Clin Exp Med 2015 Jul 15;8,7:11420-7.
  • Lou M, Luo P, Tang R, Peng Y, Yu S, Huang W, et al. Relationship between neutrophil-lymphocyte ratio and insulin resistance in newly diagnosed type 2 diabetes mellitus patients. BMC Endocr Disord 2015 Mar 2;15:9. doi: 10.1186/s12902-015-0002-9.
  • Zhang F, Ren Y, Fu W, Wang Y, Qian J, Tao C, et al. Association between neutrophil to lymphocyte ratio and blood glucose level at admission in patients with spontaneous intracerebral hemorrhage. Sci Rep 2019 Oct 30;9,1:15623. doi: 10.1038/s41598-019-52214-5.
Genel Tıp Dergisi-Cover
  • ISSN: 2602-3741
  • Yayın Aralığı: Yılda 6 Sayı
  • Başlangıç: 1997
  • Yayıncı: SELÇUK ÜNİVERSİTESİ > TIP FAKÜLTESİ
Sayıdaki Diğer Makaleler

Bipolar bozuklukta önceki yanlış tanıların sıklığı

Şuheda KAYA, Gülay TAŞCI, Sevda KORKMAZ, Murad ATMACA

Acil serviste ince bağırsak ileusu tanısı alan hastalardaki immatür granülosit ve immatür granülosit/ total granülosit oranının cerrahi tedavi ihtiyacını öngörmedeki değerliliği

Hakan YAŞAR, Emine EMEKTAR, Meral YILDIRIM, Şeref Kerem ÇORBACIOĞLU, Yunsur ÇEVİK

ATRİOVENTRİKÜLER SEPTAL DEFEKT ONARIMI: KLASİK TEK YAMA VE ÇİFT YAMA TEKNİKLERİNİN KARŞILAŞTIRILMASI

Başak SORAN TÜRKCAN, Atakan ATALAY, Ata Niyazi ECEVİT, Mustafa YILMAZ, Ahmet Vedat KAVURT, Yasemin ÖZDEMİR ŞAHAN, Gökçe SELÇUK SERT, Kanat ÖZIŞIK

Aşırı Aktif Mesaneli Erkek Bireylerdeki Otonomik Sinir Sistemi Fonksiyon Bozukluğu

Betül Banu KARASU, Ahmedi Uğur ORUÇ

Sjögren Sendromlu ve Diabetik Hastalarda Serum Büyüme Faktörleri ve İnflamatuar Sitokin Düzeyleri

Şule Nur ACAR DUYAN, Banu BOZKURT, Ali UNLU, Sema YİLMAZ, Yalçın KARAKÜÇÜK

The Efficacy of Surgical Treatment for Kienböck’s Disease with 4-5 ECA Pedicled Osseous Flap: A Retrospective Study

Ali ÖZDEMİR, Musa ERGİN, Erkan Sabri ERTAŞ, Mehmet Ali ACAR

The Association of Neutrophil Lymphocyte Ratio and Glycemic Markers in Hemodialysis Patients

Mustafa TOPAL

Opinions of Turkish physicians about the participation of patients and/or patient caregivers in multidisciplinary tumor boards; A survey study from tertiary Center in Konya.

Orhan Önder EREN, Melek ÇAĞLAYAN, Muslu Kazım KÖREZ

Eğitimin Doğum Korkusu ve Doğum Sonrası Sonuçlara Etkisi: Sistematik İnceleme ve Meta Analiz

Aysu YILDIZ KARAAHMET, Ayşenur TURAN, Zulfıyya NURALIYEVA

Juglon, PANC-1 ve BxPC-3 Pankreas Kanser Hücre Hatlarında Hücre Büyümesi, Hayatta Kalma ve Metabolizmada Merkezi Rol Oynayan mTOR Gen İfadesine İki Yönlü Etki Eder

Emine Merve DEMİRBAŞ BÜYÜKTÜT, Dudu ERKOÇ KAYA, Fatma GÖKTÜRK, Hilal ARIKOĞLU