Relationship between hematologic inflammatory markers and glycemic control in patients with Type 2 Diabetes Mellitus in a tertiary hospital in Lagos, Nigeria: a cross-sectional study

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Abstract Background: Hematologic inflammatory biomarkers derived from a complete blood count (CBC) are elevated in Type 2 diabetes mellitus (Type 2 DM). In low- and middle-income countries like Nigeria, a CBC is an affordable and easily available test, even in hard-to-reach rural areas. Glycated hemoglobin (Hb A1c), a measure of glycemic control, has been found to correlate with hematologic inflammatory markers. In Nigeria, where the cost of health care is expensive, and patients largely pay out-of-pocket, a more affordable and accessible alternative to HbA1c in determining glycemic control would be a welcome development. Therefore, this study aimed to the relationship between Hb A1c and hematologic inflammatory biomarkers - neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and mean platelet volume (MPV) in predicting glycemic control. Methods: This was a six-month cross-sectional study of 109 patients with Type 2 DM in a diabetic outpatient clinic in a large tertiary hospital in Lagos. The Hb A1c and CBC of the patients were measured. Neutrophil-lymphocyte ratio, PLR, and MPV were derived from the CBC values. We categorized the patients based on their glycemic control. Spearman correlation analysis was used to determine the relationship between Hb A1c and the inflammatory biomarkers. Results: There was no significant difference in NLR, PLR, and MPV between optimal and sub-optimal controlled diabetic patients. Spearman’s correlation analysis showed no significant association between NLR, PLR MPV, and Hb A1c in the patients: [(NLR: r= 0.027, p= 0.680; PLR: r= - 0.091, p=0.356; MPV: r= - 0.032, p=0.744)] respectively. Conclusion: The inflammatory markers studied had no significant relationship with HbA1c and might not be helpful in monitoring glycemic control in Type2 DM patients.

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