Saurabh Pandey, Poonam Gupta, Ajeet Kumar Chaurasia, Arvind Gupta, Manoj Kumar Mathur

A NOVEL DIAGNOSTIC APPROACH: NEUTROPHIL LYMPHOCYTE RATIO AND SERUM FERRITIN IN TYPE 2 DIABETES PATIENTS WITH DIABETIC NEPHROPATHY

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Introduction- DM is a chronic metabolic disease characterized by elevated blood sugar levels (hyperglycemia) caused by impaired insulin production, cellular insulin resistance, or both. DM is a systemic disease having severe microvascular and macrovascular complications. Diabetic nephropathy (DN), diabetic retinopathy, and diabetic neuropathy are examples of microvascular complications whereas stroke, cardiovascular diseases (CVDs), and peripheral vascular diseases are examples of macrovascular complications. DN is a common micro-angiopathic complication in patients with diabetes. Inammation plays a crucial role in the development and progression of DN, as many inammatory cytokines such as interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-8 (IL-18), and tumor necrosis factor α (TNF- ) contribute in the pathogenesis of DN. An increase in neutrophil count is seen in thrombus forming and ischemic diseases. The Neutrophil-Lymphocyte ratio (NLR) in complete blood count is studied in many cardiac and non-cardiac diseases as inammatory marker and is used to predict the prognosis. Serum ferritin concentration is usually increased in poorly controlled type 2 diabetic patients reecting increased oxidative stress. Objectives- To study the Neutrophil Lymphocyte ratio (NLR) and serum ferritin in patients of type 2 diabetes. Methods- A cross-sectional study was conducted on 150 patients with T2DM in SRN hospital, afliated to MLNMC, prayagraj. Blood samples were taken to estimate CBC, LFT, KFT, S. Electrolyte, HbA1C, FBS/PPBS, S. ferritin and urine for microalbumin. Data was collected, entered in MS Excel Spreadsheet & appropriate statistical package applied. Results- The median NLR of the type 2 DM patients was 2.10. Of total 150 diabetic patients 26 patients (17.3%) were having nephropathy based on urine microalbumin. Based on nephropathy in patients of T2DM, two groups (A and B) were made. Group A includes patients with nephropathy, while Group B includes patient without Nephropathy. The mean Hb, MCV, and ALC were lower in Group A (T2DM patients with nephropathy) patients. In contrast, TLC, Mean ANC and NLR were higher in Group A (T2DM patients with nephropathy) patients. NLR and haemoglobin show a signicant difference between both groups A and B. The mean S. ferritin levels were higher in Group A (T2DM patients with nephropathy) patients, difference was signicant between both groups. In the present study, NLR was negatively correlated with S. ferritin with r= - 0.092, and the correlation was insignicant. Conclusion- the results of our study showed that there was a signicant relation between NLR, S. ferritin and DN. Therefore, NLR and S. Ferritin may be considered as a novel surrogate marker of DN in early stages

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