Association of New Inflammatory Markers with Diabetes Control and Albuminuria Levels in Type 2 Diabetes Mellitus Patients

Abstract

Background: Recently, new inflammatory parameters obtained from complete blood count and biochemical measurements have gained importance. They are easy and inexpensive to perform. These parameters have been shown to have relationships with glycemic control and complications in diabetic patients in various studies. We aimed to compare new inflammatory markers [neutrophil to lymphocyte ratio (NLR), red cell distribution width (RDW), monocyte to lymphocyte ratio (MLR), monocyte to high-density lipoprotein ratio (MHR), platelet to lymphocyte ratio (PLR), and mean platelet volume (MPV)] among well-controlled and poorly controlled diabetic patient groups and also between albuminuria groups in Type 2 Diabetes Mellitus (T2DM) patients. Methods: We included 415 T2DM patients and analyzed them retrospectively. We divided the patients into well-controlled diabetics (hemoglobin A1C (HbA1c) ≤7%) and poorly-controlled diabetics (HbA1c >7%) to evaluate diabetic control. We also grouped patients in order to evaluate albuminuria as follows: A1: urine albumin-creatinine ratio (UACR) <30 mg/g, A2: 30 mg/g ≤ UACR ≥ 300 mg/g, A3: UACR >300 mg/g. We compared the groups we formed based on diabetic control and albuminuria levels regarding new inflammatory markers and determined the correlation between these markers and HbA1c and UACR levels. Results: MHR showed a more remarkable and noticeable difference than other parameters when comparing A2 and A1 albuminuria group patients. Our study found that MLR was positively correlated with UACR measurements but not superior to other parameters that were positively correlated with UACR (p < 0.01). NLR and PLR differed significantly between the albuminuria groups and were positively correlated with UACR measurements (p < 0.01). RDW, on the other hand, did not show statistical differences between the albuminuria groups but was positively correlated with UACR measurements (p > 0.05, p < 0.01 respectively). MPV, neither statistically differed between the albuminuria groups nor showed correlation with UACR measurements (p > 0.05 for each). There was no difference in the results of new inflammatory markers between diabetes control groups, and there was no correlation with HbA1c measurements (p > 0.05 for each). Conclusions: These parameters are useful in assessing albuminuria in patients with T2DM, but not in assessing glycemic control.