Study of Neutrophil/Lymphocyte Ratio as a New Marker in Early Prediction of the Occurrence of Diabetic Ketoacidosis in Type 1 Diabetes Mellitus Patients without Infection

doi:10.21608/ejhm.2024.394122

Study of Neutrophil/Lymphocyte Ratio as a New Marker in Early Prediction of the Occurrence of Diabetic Ketoacidosis in Type 1 Diabetes Mellitus Patients without Infection

Document Type : Original Article

10.21608/ejhm.2024.394122

Abstract

Background: Diabetic ketoacidosis (DKA) is a severe, acute, life-threatening consequence of diabetes, characterized by hyperglycemia, ketoacidosis, as well as ketonuria.DKA in type 1 diabetes mellitus (T1DM) cases without infection represents an uninfected variant of systemic inflammatory response syndrome. Neutrophil-to-lymphocyte ratio (NLR) stands as a novel, simple and cost-effective marker for the systemic inflammatory response.
Objective: This study aims to investigate NLR role in predicting the DKA among T1DM cases without infection.
Patients and Methods: This observational cross-sectional study included 90 participant. They exhibited the clinical criteria of T1DM without infection in the presence or absence of DKA. Participants were grouped into: Group (I): Healthy controls, group (II) included non-DKA patients with T1DM and group (III) that consisted of DKA patients with T1DM.
Results: TLC was positively correlated with glycated hemoglobin (HbA1c), NLR, and C-reactive protein (CRP). Also, NLR was positively correlated with disease duration, HbA1c, TLC, hemoglobin, platelets and CRP.According to NLR, HbA1c and TLCfor predicting diabetic ketoacidosis in patients with T1DM without infection: At a cut-off value of ≤ 2.97, ≤ 8.35 and ≤ 6.9 respectively, the area under the curve was 0.887, 0.695 and 0.667 respectively andthe sensitivity was 86.7%, 83.3% and 83.3% respectively, the specificity was 80.0%, 60% and 73.3% respectively.
Conclusions: NLR was elevated among T1DM cases who developed DKA and an uninfected state. NLR could be a simple, easily obtainable and cheap biomarker for prediction of DKA in patients with T1DM.

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