Haematological Inflammatory Indices and Erythrocyte Sedimentation Rate among Patients with Type 2 Diabetes Mellitus Attending Rivers State University Teaching Hospital, Port Harcourt, Nigeria

Abstract

Introduction: Chronic inflammation plays a key role in the development and progression of diabetic complications. Haematological inflammatory indices have emerged as reliable markers of systemic inflammation in diabetes. Aim/Objectives: This study aimed to evaluate the neutrophil-to-lymphocyte ratio (NLR), platelet-to-neutrophil ratio (PNR), platelet-to-lymphocyte ratio (PLR), and erythrocyte   sedimentation rate (ESR) derived from routine complete blood count (CBC) among individuals with type 2 diabetes mellitus (T2DM) attending the Rivers State University Teaching Hospital in Port Harcourt, Nigeria. The study compared the levels of NLR, PNR, PLR, and ESR between individuals with T2DM and non-diabetic controls, and examined the association between these haematological indices and glycaemic control, as indicated by glycated haemoglobin (HbA1c) levels. Methodology: This case-control study was conducted among 70 diabetic and 70 non-diabetic subjects, each group consisting of 41 female and 29 male subjects, aged between 28 and 74 years. The NLR, PNR, and PLR were calculated from CBC results obtained using the Mindray BC-5150 haematology analyzer. ESR was measured using the Westergren method. Data obtained was analyzed using Graphpad Software version 8.0.2. Results: The NLR and ESR were significantly elevated in diabetic subjects compared to controls (NLR: P=0.0004; ESR: P<0.0001). In contrast, the PNR and PLR were significantly lower in the diabetic group (P<0.0001). Gender-based analysis revealed that male diabetic subjects had significantly higher NLR (P=0.0036) and ESR (P=0.0040), and lower PNR (P=0.0001) compared to male controls, with no significant difference in PLR. Among female subjects, diabetic subjects also had significantly higher NLR (P=0.0375) and ESR (P <0.0001), alongside lower PNR (P=0.0003) and PLR (P=0.0002). Although variations in these markers were observed with increasing duration of diabetes, the differences were not statistically significant. HbA1c was negatively correlated with PNR (P=0.0117) and PLR (P=0.0123), while NLR and ESR showed non-significant positive correlations. Conclusion: The findings highlight the relevance of haematological inflammatory indices as accessible tools for evaluating systemic inflammation in diabetes management.