Study of Platelet to Lymphocyte Ratio as a Predictor Inflammatory Markerfor Diabetic Nephropathy in Patients with Type 2 Diabetes Mellitus

Diabetes Mellitus, whose incidence rates are rising, 1 poses a severe danger to global health.Elevated blood sugar levels are the hallmark of this chronic metabolic disorder, caused by either increased cellular resistance to 2 insulin or decreased insulin secretion, or both.Because diabetes raises blood glucose levels over time, it can cause a variety of problems that fall under the categories of microvascular and macrovascular illnesses.Neuropathy, nephropathy, and retinopathy are examples of 3 microvascular consequences.Accelerated cardiovascular diseases, myocardial infarction and cerebrovascular disease resulting in strokes are the main macrovascular consequences.A steady decrease in renal function and chronic albumin-4 uria are the hallmarks of diabetic nephropathy (DN).DN is estimated to affect 20% to 50% of diabetics, and in many populations, it becomes a leading cause of end stage kidney disease.While renal involvement can be caused by both type of diabetes, type 2 diabetes is far more common in ESRD patients than type 1 diabetes.The clinical symptom of DN is an increase in urine albumin excretion, which progresses from micro albumin-5 uria to macro albuminuria and ultimately ESRD.Due to a number of its inherent shortcomings, albuminuria, the biomarker used for the current diagnosis of DN, 6 is not a very reliable indicator of the disease.One possible pathophysiology thought to be in charge of the emergence of diabetic complications is chronic inflamma- AbstractObjective: To compare ratio of platelet to lymphocyte (PLR) in diabetic patients with nephropathy to those diabetics without nephropathy. Methods:It was an observational study carried out in the medical department from June 2022 to May 2023.A total of 246 patients of type 2 diabetes mellitus hospitalized in all medical wards were included.Based on urinary albumin excretion, two groups of patients were formed: diabetics without nephropathy (Group A) and diabetics with nephropathy (Group B).Ratio of Platelet to lymphocyte was calculated by dividing platelet count with lymphocyte count and ratio of neutrophil to lymphocyte (NLR) was calculated by dividing neutrophil to lymphocyte count.PLR and NLR were compared amongst both groups.Results: There were 246 subjects (111 females, 134 males).131 subjects did not have nephropathy, 115 patients had nephropathy.Comparison of hematological parameters showed that NLR of patients with type 2 DM with nephropathy was 2.59 0.51 and without nephropathy group was 1.70 0.44.The PLR of diabetic nephropathy group was 251 62.4 and that without nephropathy was 213 59.6.Statistical significance (p < 0.05) was seen in the NLR and PLR values of the two groups when compared using the student t-test. Conclusion:Increased ratio of platelet-to-lymphocyte significantly correlates with diabetic nephropathy, and may serve as a predictor inflammatory marker for diabetic nephropathy.