The Relationship Between Neutrophil Lymphocyte Ratio With Urinary Protein and Albumin Excretion in Newly Diagnosed Patients With Type 2 Diabetes

Background: Recent evidence suggests that neutrophil/lymphocyte (N/L) ratio play a role in the development and progression of cardiovascular complications. Increased urinary albumin and protein excretion has been shown to be a risk factor for cardiovascular disease. Thus, this study aimed to investigate the relationship between circulating total and differential leukocyte counts including N/L ratio with urinary protein and albumin excretion in patients with newly diagnosed type 2 diabetes. Methods: All patients underwent history taking, physical examination, blood pressure measurement, 12-lead electrocardiographic evaluation, routine urine analysis, biochemical analysis, 24-hour urine collection to measure protein and albumin excretion and creatinine clearance. Peripheral total and differential leukocyte analyses were performed using an automated cell counter. Results: In total, 80 patients were included. Spearman correlation analysis revealed that 24-hour urinary protein excretion was correlated with neutrophil count (rho = 0.280, P = 0.012), lymphocyte count (rho = -0.365, P = 0.001) and N/L ratio (rho = 0.474, P < 0.0001). Spearman correlation analysis revealed that 24-hour urinary albumin excretion was correlated with neutrophil count (rho = 0.261, P = 0.019), lymphocyte count (rho = -0.278, P = 0.013) and N/L ratio (rho = 0.415, P < 0.0001). In stepwise linear regression analysis, 24-hour urinary protein excretion was independently associated with high-density lipoprotein cholesterol (P = 0.01), blood urea (P = 0.014) and N/L ratio (P = 0.041). On the other hand, 24-hour urinary albumin excretion was independently associated with creatinine clearance (P = 0.004), albumin (P < 0.0001) and N/L ratio (P = 0.011). Conclusions: This study demonstrated that increased N/L ratio was independently related with both 24-hour urinary protein and urinary albumin excretion in newly diagnosed patients with type 2 diabetes.