Association between neutrophil–lymphocyte ratio on arterial stiffness in type-2 diabetes mellitus patients: a part of DiORS Study

Introduction Type-2 diabetes mellitus (T2DM) enhances the risk of atherosclerosis and cardiovascular diseases, which are the primary cause of death among T2DM patients. Neutrophil–lymphocyte ratio (NLR) is a widely available, easy-to-use, and reproducible inflammatory marker. Brachial-ankle pulse wave velocity (baPWV) serves as the indicator for early atherosclerosis changes. The exact mechanism of association between the high NLR and diabetes complications is still unclear, and the most significant mechanism may be related to inflammation. Since an inflammatory marker in clinical practice is limited, a simple, easy-to-use, and widely available marker is needed. The aim was to analyze the association between NLR and arterial stiffness in T2DM patients. Method This study is part of the Diabetic Ocular Renal Surabaya Study (DiORS Study). Participants were measured for their NLR count by dividing absolute neutrophil count with absolute lymphocyte count in peripheral blood and measuring of arterial stiffness with baPWV. The statistical analysis in use included independent t-test, Mann–Whitney test, Pearson correlation test, or Spearman correlation test. The results of the statistical analysis were significant if p < 0.05. Result The participants’ mean age was 54.33 ± 11.34 years, with the duration of diabetes for 7.34 ± 6.80 years. The mean of BMI was 25.47 ± 4.10 kg/m 2 , most patients were overweight and obese. The mean of HbA1c was 8.14 ± 1.59% and only 24% participants with good glycemic control. The mean of NLR was 2.69 ± 1.23, with a range of 0.95–6.24, while 84.7% of participants with a high count of NLR (NLR > 1.65). The mean of baPWV was 15.19 ± 2.72 m/s with a range of 10.20–23.30 m/s, and 75.0% of them saw an increased arterial stiffness (baPWV > 13.5 m/s). Association analysis between NLR count and arterial stiffness shows significant results (r = 0.235; p < 0.047). Conclusions There is a significant association between NLR with arterial stiffness and the higher NLR count, the more stiffening of the arteries experienced by the participants.