Relationship between Neutrophil-Lymphocyte Ratio and Cardiac Autonomic Neuropathy in Diabetes Mellitus Type 2 Patients

Cahyandari Nurlaelatiningsih, Sunaryo Sastradimaja Barki Sastradimaja, Irma Ruslina Defi

Abstract


Objective: To analyze the correlation between cardiac autonomic neuropathy (CAN) and neutrophil-lymphocyte ratio (NLR) in DM type 2 patients.

Methods: This was a cross-sectional study which was conducted at the Internal Medicine Clinic of Dr. Hasan Sadikin General Hospital, Bandung and Chronic Disease Management (CDM) Club in Garut District, West Java, Indonesia from October to December 2015. Subjects were 57 DM type 2 patients who met the inclusion criteria. Cardiac autonomic neuropathy examination and complete blood count (CBC) were performed to discover the subjects’ neutrophil-lymphocyte ratio.

Results: A strong correlation was found between CAN in DM type 2 patients and NLR (r=0.679; p=0.000) based on Rank Spearman correlation test. The NLR to CAN cut off point was 1.34.

Conclusions: NLR examination can be used as an indicator of CAN in DM type 2 patients with NLR cut off point. There was a correlation between CAN and DM type 2 diagnosis duration.

Keywords: Cardiac autonomic neuropathy, diabetes mellitus type 2, Ewing test, neutrophil-lymphocyte ratio

 

DOI: 10.15850/ijihs.v5n1.961


Keywords


Cardiac autonomic neuropathy, diabetes mellitus type 2, Ewing test, neutrophil-lymphocyte ratio

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References


Perkumpulan Endokrinologi Indonesia. Konsensus pengendalian dan pencegahan diabetes mellitus tipe 2 di Indonesia 2012. 1st ed. Jakarta: PB Perkeni; 2012.

Sacks DB, Arnold M, Bakris GL, Bruns DE, Horvath AR, Kirkman MS, et al. Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Diabetes Care. 2011;34(6):61–99.

Oakley I, Emond L. Diabetic cardiac autonomic neuropathy and anesthetic management: review of the literature. AANA J. 2011;79(6):473–9.

Dimitropoulos G, Tahrani AA, Stevens MJ. Cardiac autonomic neuropathy in patient with diabetes mellitus. World J Diabetes. 2014;5(1):17–39.

Tangvarasittichai S. Oxidative stress, insulin resistance, dyslipidemia and type 2 diabetes mellitus. World J Diabetes. 2015;6(3):456–80.

Vinik AI, Maser RE, Mitchell BD, Freeman R. Diabetic autonomic neuropathy. Diabetes Care. 2003;26(5):1553–79.

Balcıoğlu AS, Müderrisoğlu H. Diabetes and cardiac autonomic neuropathy: clinical manifestations, cardiovascular consequences, diagnosis and treatment. World J Diabetes. 2015;6(1):80–91.

Bratawidjaya KG, Rengganis I. Imunologi dasar. 11th ed. Jakarta: Badan Penerbit Fakultas Kedokteran Universitas Indonesia; 2014.

Sefil F, Ulutas KT, Dokuyucu R, Sumbul AT, Yengil E, Yagiz AE, et al. Investigation of neutrophil lymphocyte ratio and blood glucose regulation in patients with type 2 diabetes mellitus. J Int Med Res. 2014;42(2):581–8.

Taşoğlu İ, Sert D, Colak N, Uzun A, Songur M, Ecevit A. Neutrophil–lymphocyte ratio and the platelet–lymphocyte ratio predict the limb survival in critical limb ischemia. Clin Appl Thromb Hemost. 2014;20(6):645–50.

Turkmen S, Dogdu O, Tekin K, Kucukdurmaz Z, Cagliyan CE, Sarikaya S, et al. The correlation between neutrophil/lymphocyte ratio and the timi flow grade in patients with STEMI undergoing primary PCI. Eur Rev Med Pharmacol Sci. 2013;17(16):2185–9.

Lou M, Luo P, Tang R, Peng Y, Yu S, Huang W, et al. Correlation between neutrophil-lymphocyte ratio and insulin resistance in newly diagnosed type 2 diabetes mellitus patients. BMC Endocr Disord [serial on the internet]. 2015 Mar 2 [cited 2016 April 30];15(9):[about 6 p.] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4357061/#.

Ekpenyong CE, Akpan UP, Ibu JO, Nyebuk DE. Gender and age specific prevalence and associated risk factors of type 2 diabetes mellitus in Uyo Metropolis, South Eastern Nigeria. Diabetologia Croatica. 2012;41(1):17–28.

Infodatin Pusat Data dan Informasi Kementrian Kesehatan 2014. Situasi dan analisis diabetes. [cited 2016 June 2]. Available from: http://www.depkes.go.id/folder/view/01/structure-publikasi-pusdatin-info-datin.html.

Gulichsen E, Fleischer J, Ejskjaer N, Eldrup E, Tarnow L. Screening for diabetic cardiac autonomic neuropathy using a new handle device. J Diabetes Sci Technol. 2012;6(4):965–72.

Leon BM, Maddox TM. Diabetes and cardiovascular disease: epidemiology, biological mechanisms, treatment recommendations and future research. World J Diabetes. 2015;6(13):1246–58.

Huang W, Huang J, Liu Q, Lin F, He Z, Zeng Z, et al. Neutrophil-lymphocyte ratio is a reliable predictive marker for early-stage diabetic nephropathy. Clin Endocrinol (Oxf). 2015;82(2):229–33.

Luo H, Yuan D, Yang H, Yukui M, Huang B, Yang Y, et al. Post-treatment neutrophil-lymphocyte ratio independently predicts amputation in critical limb ischemia without operation. Clinics (Sao Paulo). 2015;70(4):273–7.

Raha O, Chowdhury S, Dasgupta S, Raychaudhuri P, Sarkar BN, Raju PV, et al. Approaches in type 1 diabetes research: a status report. Int J Diabetes Dev Ctries. 2009;29(2):85–101.

Spallone V, Ziegler D, Freeman R, Bernardi L, Frontoni S, Pop-Busui R, et al. Cardiovascular autonomic neuroathy in diabetes: clinical impact, assessment, diagnosis and management. Diabetes Metab Res Rev. 2011;27(7):639–53.


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