Lavanya, P K (2023) Neutrophil-To-Lymphocyte Ratio as a Surrogate Marker of Albuminuria in Type 2 Diabetes Mellitus. Masters thesis, Stanley Medical College, Chennai.
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Abstract
BACKGROUND: Diabetes mellitus is a systemic disease resulting in serious microvascular and macrovascular complications. Diabetic Nephropathy is one of the microvascular complication of diabetes. Diabetic Nephropathy is clinically manifested as an increase in urine albumin excretion starting from microalbuminuria to macroalbuminuria and eventually end stage renal disease (ESRD). Neutrophil-to-lymphocyte ratio is a crude but sensitive indicator of inflammation and studied in many cardiac and noncardiac diseases as an inflammatory marker such as acute myocardial infarction, stroke, and heart failure. In this study, the association of Neutrophil-to-lymphocyte ratio (NLR) with albuminuria is studied. AIM OF THE STUDY: The aim of our study is to prove that there is a positive correlation between Neutrophil-to-lymphocyte ratio and albuminuria in type 2 diabetes. OBJECTIVES: 1. To calculate neutrophil-to-lymphocyte ratio and spot urine albumin-to-creatinine ratio in patients with type 2 diabetes. 2. To assess whether neutrophil-to-lymphocyte ratio correlates with microalbuminuria in patients with type 2 diabetes. METHODS: We did an hospital based cross sectional study in patients attending general medicine outpatient department with type 2 diabetes mellitus during period of July 2021 to July 2022. Patients aged ≥ 40 years and on oral hypoglycaemic agents ≥ 4 years were included in the study. Patients with type 1 diabetes mellitus, patients with recent diagnosis of acute infection, uncontrolled hypertension, chronic kidney disease, hepatic failure, cardiac failure, acute coronary syndrome, arrythmia, patients whose total wbc count > 9000, leucopenia, severe anemia, chronic infection, chronic systemic inflammatory disease, patients on anti-inflammatory drugs, steroids, ACEI or ARB, alcohol and patients with nephritic syndrome, UTI, renal artery stenosis and dehydration states are excluded from the study. FBS, PPBS, HbA1C, urine ACR were calculated. The aim of our study is to prove that there is a positive correlation between neutrophil-to-lymphocyte ratio and albuminuria in type 2 diabetes patients. RESULTS: Out of 120 participants, 79 were male and 41 were female. In the present study about 43.5% were above 60 years of age. About 37.5% were in the range of 51 to 60 years. Only 19% were in the age of 41 to 50 years. In the present study about 72.5% were overweight, 18.5% were obese and 9% were normal. Number of study population with NLR≥2 & microalbuminuria is more in number (N=70) compared to those who have low NLR. The association is statistically significant (P<0.05).The results of our study have shown that there is a significant correlation between NLR and albuminuria in type 2 diabetes mellitus patients. CONCLUSION: In many cardiac and noncardiac disorders, the neutrophil-lymphocyte ratio in a complete blood count is investigated as an inflammatory marker. This ratio is used to predict the prognosis of diseases such as acute myocardial infarction, stroke, and heart failure. Against this background, our study has been conducted to find that whether NLR can be used as an alternate marker instead of albumin-to- creatinine ratio in diabetic nephropathy. The results of our study has shown positive correlation between NLR and albuminuria. In a setting with limited resources, NLR is an simple, cost effective investigation which can be an alternative for urine albumin-to-creatinine ratio.
| Item Type: | Thesis (Masters) |
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| Additional Information: | Reg.No.200120101016 |
| Uncontrolled Keywords: | NLR, SPOT Urine ACR, Type 2 Diabetes mellitus, Albuminuria. |
| Subjects: | MEDICAL > General Medicine > MEDICAL > General Medicine |
| Depositing User: | Thavamani K |
| Date Deposited: | 17 May 2022 10:39 |
| Last Modified: | 20 Mar 2024 05:12 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/19524 |
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