Neutrophil to Lymphocyte Ratio As Predictor For Foot Ulcer in Diabetic Type II Patients at Khartoum State

Abstract

Background: Diabetes mellitus (DM), with the cost of treatment and complications causes the increasing economic burden. Macrovascular complications of diabetes, diabetic foot ulcers and amputations consequently reduce quality of life. Recently, it has been reported that neutrophil/lymphocyte ratio (NLR) is a cheap and accessible indicator of the inflammatory condition, this was case control study aimed to evaluate neutrophil to lymphocyte ratio as a marker of systemic inflammation in patients with diabetics foot ulcer. It was conducted in Khartoum State at the period from May to September 2015. Materials and Methods: One hundred patients with type 2 diabetics patients recorded in this study (50 diabetics with foot ulcer, 50 diabetics without foot ulcer) from each 2.5 ml venous blood sample was collected. Complete Blood Count (CBC) was performed using Sysmex KX-21N, and HbA1c and CRP were measured using fluorescence immunoassay. Then Statistical Package for Social Sciences (SPSS) was used to analyze the data. Results: The mean age for diabetics with foot ulcer and diabetic without food ulcer was 57.92±10.8 and 57.38±10.9 years, respectively . Statistically significant differences was observed in study groups according to TWBCs (P.value 0.000), absolute lymphocyte (P.value 0.000), absolute neutrophil (P.value 0.000), NLR (P.value 0.000), HbA1c (P.value 0.002), and CRP (P.value 0.000). In patients with diabetics foot ulcer pearson correlation analysis revealed that NLR was positively correlated with age (r =0.259, P.value = 0.045), TWBC (r = 0.650, P.value = 0.001), absolute neutrophil count (r = 0.817, P.value = 0.001) and CRP (r = 0.441, P.value = 0.002), and negatively correlated with absolute lymphocyte count (r = -0.553, P.value = 0.001). Conclusion: Neutrophil to Lymphocyte Ratio is a simple, rapid and reliable method for evaluation of the extent of systemic inflammation. NLR is significantly higher in Diabetics with foot ulcer than those without foot ulcer, NLR is positively correlated with age, total leukocyte, absolute neutrophil count and CRP, and negatively correlated with absolute lymphocyte count.