Association Between HbA1c with Platelet to Lymphocyte Ratio and Neutrophil to Lymphocyte Ratio in Type 2 Diabetes Mellitus

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease in which inflammation plays a significant role in both microvascular and macrovascular complications. The Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) are simple hematological biomarkers that can reflect systemic inflammatory status and potentially correlate with HbA1c levels as an indicator of glycemic control.

Objective: To determine the association between HbA1c levels and NLR and PLR in T2DM patients at Haji Adam Malik General Hospital, Medan.

Methods: This was a retrospective cross-sectional study using secondary data from the medical records of T2DM patients between May and July 2024. A total of 96 patients met the inclusion criteria. Data were analyzed using the Kruskal-Wallis test with a significance level of p<0.05.

Results: The median HbA1c of the patients was 9% (range 4.2–15.4%). Median NLR increased according to HbA1c categories: 3.91 (HbA1c <7%), 5.77 (HbA1c 7–9%), and 7.19 (HbA1c >9%) with p=0.012. Median PLR also increased across categories: 134.75, 189.00, and 233.33 with p=0.009.

Conclusion: A significant association was observed between HbA1c and both NLR (p = 0.012) and PLR (p = 0.009). NLR and PLR can be used as additional hematological parameters to assess inflammation and glycemic control in patients with type 2 diabetes.