Abstract
ABSTRACT:
BACKGROUND:
Diabetes in pregnancy has a major health risk to the mother and the fetus. Neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) were shown to be as important markers of inflammation in neoplasms, cardiac diseases and diabetes-associated complications.
OBJECTIVE:
To estimate the mean Lymphocyte, Neutrophil, Platelet, PLR, NLR in diabeticand non-diabetic pregnant women and to identify the correlation between NLR and PLR with each type of diabetes in pregnancy.
PATIENTS AND METHODS:
A case control study was conducted to determine the relationshipbetween (PLR) and (NLR) in 2 groups of pregnant women; in Diabetic Centre and outpatient clinics, Maternity Teaching Hospital, Kurdistan region, Iraq from 21st February 2019 to 15th September 2019. Study included 100 pregnant women 24-36 weeks gestation after exclusion of cardiovascular risk factors and underlying chronic inflammatory conditions. Group 1 included 50 diabetic women having positive 75g-OGTT(gestational DM) or known cases of type 1 or 2 diabetes mellitus. Group 2 were control group having negative 75g-OGTT .
RESULTS:
The neutrophil count was significantly higher in the diabetic group .No significantdifferences were detected between the two study groups regarding the platelets (p = 0.225), lymphocytes (p = 0.251), NLR (p = 0.121), PLR (p = 0.784) except for the difference between type II diabetes and the control group where the mean NLR among type II diabetics was 3.86 and that of the control was 3.16 (p = 0.029).
CONCLUSION:
We could only find significant difference in terms of NLR in type 2diabetes mellitus when compared to the comparison group and in terms of PLR in type 2 diabetes mellitus when compared to the gestational diabetes group.
Keywords
10. Yasar Z, Buyuksirin M, Ucsular FD, Kargi A, Erdem F, Talay F, Kurt OK. Is an elevated neutrophil-to-lymphocyte ratio a predictor of metabolic syndrome in patients with chronic obstructive pulmonary disease. Eur Rev Med Pharmacol Sci. 2015 Jan 1;19(6):956-62.
11. Aygün F, Efe D. Association of neutrophil/lymphocyte ratio with obstructive coronary artery disease and coronary artery calcium score detected by multislice computed tomography in type 2 diabetes mellitus patients. Patient preference and adherence. 2015;9:1023.
12. O Olumuyiwa-Akeredolu OO, Pretorius E. Rheumatoid arthritis: notable biomarkers linking to chronic systemic conditions and cancer. Current pharmaceutical design. 2016 Feb 1;22(7):918-24.
13. Abdel Galil SM, Edrees AM, Ajeeb AK, Aldoobi GS, El-Boshy M, Hussain W. Prognostic significance of platelet count in SLE patients. Platelets. 2017 Feb 17;28(2):203-7.
14. Mertoglu C, Gunay M. Neutrophil-Lymphocyte ratio and Platelet-Lymphocyte ratio as useful predictive markers of prediabetes and diabetes mellitus. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2017 Nov 1;11:S127-31.
15. Akbas EM, Demirtas L, Ozcicek A, Timuroglu A, Bakirci EM, Hamur H, Ozcicek F, Turkmen K. Association of epicardial adipose tissue, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with diabetic nephropathy. International journal of clinical and experimental medicine. 2014;7(7):1794.
16. Celikbilek M, Dogan S, Ozbakır O, Zararsız G, Kücük H, Gürsoy S, Yurci A, Güven K, Yücesoy M. Neutrophil–lymphocyte ratio as a predictor of disease severity in ulcerative colitis. Journal of clinical laboratory analysis. 2013 Jan;27(1):72-6.
17. Diabetes in pregnancy: management from preconception to the postnatal period. NICE guidline (NG3). Published on 25th February 2015.
18. Wolf M, Sauk J, Shah A, Smirnakis KV, Jimenez-Kimble R, Ecker JL, Thadhani R. Inflammation and glucose intolerance: a prospective study of gestational diabetes mellitus. Diabetes care. 2004 Jan 1;27 (1):21-7.
19. Yilmaz H, Celik HT, Namuslu M, Inan O, Onaran Y, Karakurt F, Ayyildiz A, Bilgic MA, Bavbek N, Akcay A. Benefits of the neutrophil-to-lymphocyte ratio for the prediction of gestational diabetes mellitus in pregnant women. Experimental and Clinical Endocrinology & Diabetes. 2014 Jan;122(01):39-43.
20. Abbassi-Ghanavati M, Greer LG, Cunningham FG. Pregnancy and laboratory studies: a reference table for clinicians. Obstetrics & Gynecology. 2009 Dec 1;114(6):1326-31.
21. Yılmaz ZV, Yılmaz E, İçer B, Küçüközkan T. Association of complete blood count parameters with gestational diabetes mellitus. Gynecology Obstetrics & Reproductive Medicine. 2017 Aug 22;23(2):65-9.
22. Sargın MA, Yassa M, Taymur BD, Celik A, Ergun E, Tug N. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios: are they useful for predicting gestational diabetes mellitus during pregnancy?. Therapeutics and clinical risk management. 2016;12:657.
23. Hussain M, Babar MZ, Akhtar L, Hussain MS. Neutrophil lymphocyte ratio (NLR): A well assessment tool of glycemic control in type 2 diabetic patients. Pakistan journal of medical sciences. 2017 Nov;33(6):1366.
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