The association between neutrophil lymphocyte ratio, vitamin (D) deficiency and development of peripheral neuropathy in type 2 diabetic patients

Abdel Wahab, Amr M.; Abdel Tawab, Rawhia R.; Abdel Aziz, Mohamed O.; Aly, Hend M. Moness; Ali, Reem M. Abdel Salam

doi:10.21608/mjmr.2022.221502

The association between neutrophil lymphocyte ratio, vitamin (D) deficiency and development of peripheral neuropathy in type 2 diabetic patients

Document Type : Original Article

Authors

¹ Department of Internal Medicine, Faculty of Medicine, Minia University.

² Department of Rheumatology and Rehabilitation, Faculty of Medicine, Minia University.

³ Department of Clinical Pathology, Faculty of Medicine, Minia University.

10.21608/mjmr.2022.221502

Abstract

Background/Aims: Some studies had suggested that neutrophil lymphocyte ratio (NLR) levels grow
with the increase of nerve conduction velocity (NCV). Recently, several studies found that vitamin (D)
deficiency can cause the risk of diabetes mellitus (DM) and its complication including neuropathy.
The aim of our study is to evaluate the association between NLR, vitamin (D) deficiency and
development of peripheral neuropathy in type 2 diabetic (T2DM) patients. Methods: In cross sectional
study we selected a total of 60 T2DM patients. All patients underwent nerve conduction study (NCS).
Then we divided them according to the results into two groups, 45 patients with DPN and 15 patients
without DPN as a control group. DPN group was subdivided according to NCS results into three
groups, 11 patients with mononeuropathy, 4 patients with mononeuropathy multiplex and 30 patients
with polyneuropathy. We evaluated the effect of DPN in these patients as regarded NCS results on
HbA1c levels, NLR and vitamin (D) levels. Results: There were very highly statistically significant
differences between DPN group and non-DPN group as regard HbA1c and [25(OH) D] levels, (P <
0.001*** for all). There was no statistically significant difference between them as regarded NLR, (P
= 0.501). Multivariate logistic regression analysis showed that, [25(OH) D] levels and duration of DM
were independent risk factors for DPN, (P = 0.041*, OR = 0.88, 95% CI = 0.78-0.10), (P = 0.016*,
OR = 1.54, 95% CI = 1.09-2.18) respectively. Conclusions: Vitamin (D) deficiency and HbA1c levels
may be independent risk factors for development of DPN in T2DM in Minia. It is important to supply
vitamin (D) appropriately and control of diabetes for preventing the generation of DPN in T2DM.
NLR can't be a predictor for DPN.
Abbreviations: NLR = Neutrophil lymphocyte ratio, NCS = nerve conduction study, NCV = nerve
conduction velocity, DPN = diabetic peripheral neuropathy, DM = diabetes mellitus and T2DM =
type 2 diabetes mellitus.

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