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Leukocytic dysregulation in children with type 1 diabetes: relation to diabetic vascular complications

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Abstract

Background

Growing evidences highlight the role of the innate immune response in the pathogenesis of type 1 diabetes (T1D) vascular complications. Neutrophil lymphocytic ratio (NLR) and platelet lymphocytic ratio (PLR) are inexpensive but novel markers of chronic inflammation might have prognostic value in children with T1D.

Aim

To study NLR and PLR levels in children with T1D in comparison to matched controls and correlate them with fraction-C of glycosylated hemoglobin (HbA1C) and micro-vascular complications.

Methodology

Hundred children with T1D were compared to 100 matched healthy controls. History included diabetes duration, insulin dose and frequency of hypoglycemic attacks. Fundus examination and the simple rapid neuropathy disability score were done. HbA1C, fasting lipids, urinary albumin excretion and complete blood count were measured with assessment of NLR and PLR

Results

NLR was significantly higher (p = 0.008) and PLR was significantly lower (p = 0.007) in children with T1D than controls. NLR was positively correlated while PLR was negatively correlated with HbA1C, diabetes duration, fasting cholesterol, triglycerides and LDL. NLR was significantly higher (p < 0.001) and PLR was significantly lower (p = 0.005) in children with microvascular complications than those without. Moreover, multivariate logistic regression revealed that microvascular complications were independently associated with NLR (p = 0.013) and PLR (p = 0.004).

Conclusion

Children with T1D had significantly higher NLR and lower PLR compared to controls. These changes were more evident in those with diabetic microvascular complications than those without. Furthermore, NLR was positively correlated and PLR was negatively correlated to HbA1C, diabetes duration and hyperlipidemia. Hence, NLR and PLR can be a potential indicator for the risk of development of diabetic microvascular complications in children with T1D.

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Availability of data and material

Data will be available upon request.

Code availability

N/A.

Abbreviations

CRP:

C-reactive protein

HbA1C:

Fraction C of glycated hemoglobin

NDS:

Bedside neuropathy disability score

NLR:

Neutrophil–lymphocyte count ratio

PLR:

Platelet–lymphocyte count ratio

SMBG:

Self-monitoring of blood glucose

T1D:

Type 1 diabetes

T2D:

Type 2 diabetes

UAER:

Urinary albumin excretion ratio

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Authors and Affiliations

  1. Pediatrics Department, Pediatric and Adolescents Diabetes Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Nouran Yousef Salah

  2. Pediatrics Department, Allergy and Immunology Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Nesrine Radwan

  3. Clinical Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Heba Mohamed Atif

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  1. Nouran Yousef Salah
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  3. Heba Mohamed Atif
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Contributions

NS: conceptualization; data curation; formal analysis investigation; software; supervision; validation; visualization; roles/writing—original draft; NR: writing—review and editing, project administration; resources. HA: methodology; project administration; resources; writing—review and editing.

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Correspondence to Nouran Yousef Salah.

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The authors declare that they have no conflict of interest.

Ethics approval

The study was approved by the Research Ethics Committee of Ain-Shams University with an approval number R 27/2021.

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Informed consent was obtained from all patients for being included in the study.

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Salah, N.Y., Radwan, N. & Atif, H.M. Leukocytic dysregulation in children with type 1 diabetes: relation to diabetic vascular complications. Diabetol Int 13, 538–547 (2022). https://doi.org/10.1007/s13340-021-00568-5

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