Neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR) as biomarkers in diabetic ketoacidosis

Abstract Background This study aimed to assess neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR) as inflammatory markers in diabetic pediatrics with and without diabetic ketoacidosis (DKA) and to evaluate their DKA diagnostic ability in the absence of infection. Methods This cross-sectional observational study encompassed a total of 70 diabetic children who were either admitted or sought outpatient consultations at Assiut University Pediatric Hospital (Assiut, Egypt) between August 2022 and May 2023. The pediatric patients were grouped into two equal groups according to the presence of DKA: DKA and non-DKA (NDKA). CBC, ABG, HbA1c, CRP, and C-peptide were evaluated in the participants. Results The DKA patients had higher WBCs, neutrophil, and monocyte levels than NDKA patients. On the contrary, DKA patients had lower lymphocytes than NDKA. The NLR and MLR were higher DKA patients than NDKA patients. NLR and MLR had high odds ratios. MLR and NLR were positively correlated. Conclusion NLR and MLR are convenient, inexpensive markers that can serve as useful tools in DKA diagnosis.