Monocyte lymphocyte ratio As a predictor of Diabetic Kidney Injury in type 2 Diabetes mellitus; The MADKID Study

J Diabetes Metab Disord. 2020 Jul 29;19(2):997-1002. doi: 10.1007/s40200-020-00595-0. eCollection 2020 Dec.

Abstract

Aims: Inflammation is a cardinal pathogenetic mechanism in diabetic kidney injury (DKI). The detection of microalbuminuria (MA) is very important in preventing end-stage renal failure in diabetic subjects. A combination of high monocyte and low lymphocyte counts are used as a marker of inflammation. Monocyte to lymphocyte ratio (MLR) is considered as a marker in inflammatory diseases. We aimed to evaluate the MLR levels in diabetic subjects as a predictive marker in detecting MA.

Methods: A total of 212 patients with type 2 diabetes mellitus (T2DM) were included in the study. Patients with T2DM were divided into two groups as MA and normoalbuminuria (NA). MLR of the groups were compared.

Results: There were 72 patients in MA and 140 patients in NA group. MLR of the MA and NA groups were 0.247 (0.131-0.540) and 0.211 (0.052-0.390), respectively (p < 0.001). There was a statistically significant correlation between MLR and MA (r = 0.228, p = 0.001). In multivariate backward logistic regression analysis, MLR, fasting blood glucose, HbA1c and presence of comorbid clinical diseases were determined as independent predictors of DKI.

Conclusions: We suggest that MLR could serve as a predictive and effective marker for DKI in diabetic subjects due to its strong correlation with MA and inexpensive and readily available nature.

Keywords: Diabetic kidney injury; Inflammation; Microalbuminuria; Monocyte lymphocyte ratio; Type 2 diabetes mellitus, HbA1c.