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Neutrophil‐to‐lymphocyte ratio and red blood cell distribution width as predictors of microalbuminuria in type 2 diabetes
Author(s) -
Assulyn Tikva,
KhamisyFarah Rola,
Nseir William,
Bashkin Amir,
Farah Raymond
Publication year - 2020
Publication title -
journal of clinical laboratory analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.536
H-Index - 50
eISSN - 1098-2825
pISSN - 0887-8013
DOI - 10.1002/jcla.23259
Subject(s) - microalbuminuria , red blood cell distribution width , medicine , diabetes mellitus , gastroenterology , receiver operating characteristic , type 2 diabetes mellitus , type 2 diabetes , mean platelet volume , endocrinology , disease , platelet
Background and aim Chronic inflammation has an important role in the development and progression of type 2 diabetes through immunologic inflammatory mechanisms. Simple new inexpensive inflammatory markers may contribute to the detection of microalbuminuria. Aim of our study is to evaluate the predictive value of neutrophil‐to‐lymphocyte ratio (NLR), mean platelet volume (MPV), and red blood cell distribution width (RDW) for microalbuminuria in type 2 diabetic patients for possible application as prognostic factors for the prediction of microalbuminuria and the progression of disease in patients with diabetes. Methods A total of 168 patients with type 2 diabetes mellitus were classified into gender‐ and BMI‐matched three groups according to hemoglobin A1c and microalbuminuria: Group A: 53 patients with controlled diabetes, Group B: 57 patients with uncontrolled diabetes, both without microalbuminuria, and Group C: 58 patients with uncontrolled diabetes with microalbuminuria. Levels of NLR, MPV, and RDW between the study groups were examined and compared. Results A significant difference in NLR was found between Group C and groups A and B ( P  < .001, P  = .005, respectively). A statistically significant difference in RDW was found between groups B and C ( P  = .014). Receiver operating characteristic curve analysis of inflammatory markers and microalbuminuria prediction showed an area under curve (AUC) of 0.675 for NLR (CI 0.58‐0.76, P  < .001) and 0.614 for RDW (CI 0.52‐0.70, P  = .013). NLR value of 2.54 has 39.7% sensitivity, 78.8% specificity, and 45% positive predictive value (PPV). RDW value of 14.44 has 37.9% sensitivity, 76% specificity, and 41.5% PPV. Conclusions Neutrophil‐to‐lymphocyte ratio and RDW have PPV for microalbuminuria in diabetic patients.

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