Background: There is a direct relation between C-reactive protein and leukocyte count as indicators of inflammation. The neutrophil lymphocyte ratio (NLR) is the balance between both cells and is considered a marker of low-grade inflammation and an indicator of high risk of cardiovascular events. An elevated NLR is related with type 2 diabetes (T2D), however, even when in type 1 diabetes (T1D) there is an underlying inflammatory process, an elevation of circulating neutrophils isnt observed. NLR is associated with hyperglycemia in adult patients with long-duration T2D. However, reports in pediatric populations with recent-onset type 1 (T1D) and T2D are scarce.
Objective and hypotheses: To evaluate the association between NLR and the degree of glycemic control in pediatric patients with recent-onset T1D and T2D vs healthy controls.
Method: Design: Analytical cross-sectional. Subjects 816 years of age were included, with T1D or T2D with diagnosis ≤ 3 months, who, with their guardians, signed an informed consent. A physical examination included anthropometric measurements. A blood sample was used for glucose, lipid profile and creatinine concentrations, hematic biometry and HbA1c. Subjects were classified according to metabolic control (good control HbA1c <7.5%).
Results: There were 131 subjects, 46 (35.1%) with T2D, 49 (37.5%) with T1D and 36 (27.4%) controls. Differences were observed among the three groups in leukocytes (7.6±2.0, 6.4±1.7 and 6.8±2.0 K/μL for T2D, T1D and controls, respectively). NLR was similar among the groups: 1.58±0.61 in T2D vs 1.55±1.07 in T1D and 1.53±1.04 in controls. According to metabolic control, NLR was significant in T2D (P=0.045) and T1D (P=0.035).
Conclusion: Our findings show higher NLR with poor glycemic control in T2D, and lower with poor control in T1D, from the early stages of the disease in Mexican pediatric population.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology