Razões neutrófilos/linfócitos e plaquetas/linfócitos em pacientes diabéticos com ou sem disfunção renal / Neutrophil/lymphocyte and platelet/lymphocyte ratios in diabetic patients with or without renal dysfunction

RESUMO

OBJETIVOS: Comparar a razão neutrófilos/linfócitos (RNL) e a razão plaquetas/linfócitos (RPL) entre pacientes com e sem diabetes mellitus tipo 2 e entre pacientes diabéticos com e sem disfunção renal. MÉTODOS: Estudo transversal retrospectivo realizado no Laboratório de Análises Clínicas do Hospital das Clínicas da Universidade Federal de Goiás entre janeiro e dezembro de 2016. Foram incluídos no estudo os dados dos pacientes com idade maior ou igual a 40 anos. Aqueles com glicemia casual ≥200mg/dL e/ou hemoglobina glicada ≥6,5% formaram o grupo diabético, e aqueles que não apresentavam esses critérios para diabetes formaram o grupo controle, sendo pareados por idade e sexo. O grupo diabético foi classificado em um grupo com dano renal e outro sem dano renal, de acordo com a microalbuminúria de 24 horas. Os cálculos para RNL e RPL foram realizados a partir do número absoluto de neutrófilos, linfócitos e plaquetas, e foram comparadas as medianas. RESULTADOS: Um total de 122 indivíduos foi incluído no estudo, entre os quais 52,5% tinham entre 40 e 64 anos de idade e 63,9% eram do sexo masculino. A mediana da RNL foi de 2,1 (mín. 0,8 -máx. 5,3) no grupo diabético e de 1,9 (mín. 0,6 -máx. 6,2) no grupo controle (p=0,16). A mediana da RPL foi de 120,5 (mín. 63,5 -máx. 206,6) no grupo diabético e de 119,7 (mín. 40,4 -máx. 215,1) no grupo controle (p=0,19). Considerando a faixa etária, não houve diferença das medianas de RNL e RPL entre o grupo de diabéticos e o grupo controle, entretanto a da RNL foi maior para indivíduos com 65 anos ou mais, independentemente de serem diabéticos (mediana 2,2; mín. 1,0 -máx. 3,8; p=0,0144) ou não (mediana 2,4; mín. 0,9 -máx. 3,6; p=0,0019). Dentre os participantes, 38 pacientes apresentavam dano renal, sendo 24 (63,1%) do grupo diabético e 14 (36,9%) do grupo controle. As medianas da RNL e da RPL foram semelhantes entre os pacientes diabéticos com dano renal, diabéticos sem dano renal e grupo controle. CONCLUSÕES: A RNL e a RPL foram semelhantes entre o grupo diabético e o grupo controle, assim como entre diabéticos com ou sem dano renal. A RNL foi maior para indivíduos com 65 anos ou mais, independentemente de serem diabéticos ou não.

ABSTRACT

AIMS: To compare the neutrophil/lymphocyte ratio (NLR) and the platelet/lymphocyte ratio (PLR) between patients with and without type 2 diabetes mellitus and between diabetic patients with and without renal dysfunction. METHODS: A cross-sectional retrospective study was performed at the Laboratory of Clinical Analyzes of the Hospital das Clínicas of the Federal University of Goiás between January and December 2016. Data from patients aged 40 years or older were included in the study. Those with a blood glucose ≥200mg / dL and/or glycated hemoglobin ≥6.5% formed the diabetic group, and those who did not present these criteria for diabetes formed the control group, being matched by age and sex. The diabetic group was classified in one group with renal damage and another without renal damage, according to the 24-hour microalbuminuria. Calculations for NLR and PLR were performed from the absolute number of neutrophils, lymphocytes and platelets, and the medians were compared. RESULTS: A total of 122 subjects were included in the study, among which 52.5% were between 40 and 64 years of age and 63.9% were male. The median NLR was 2.1 (min 0.8-max 5.3) in the diabetic group and 1.9 (min 0.6-max 6.2) in the control group (p=0.16). The median PLR was 120.5 (min 63.5-max 206.6) in the diabetic group and 119.7 (min 40.4-max 215.1) in the control group (p=0.19). Considering the age group, there was no difference in the median NLR or PLR among the diabetic group and the control group; however, the NLR was higher for individuals 65 years of age or older, regardless of whether they were diabetic (median 2.2, min 1.0-max 3.8, p=0.01) or not (median 2.4, min 0.9-max 3.6, p=0.001). Among the participants, 38 patients presented renal damage, 24 (63.1%) of the diabetic group and 14 (36.9%) of the control group. The median NLR and PLR were similar among diabetic patients with renal damage, diabetics without renal damage and control group. CONCLUSIONS: NLR and PLR were similar between the diabetic group and the control group, as well as among diabetics with or without renal damage. RNL was higher for individuals 65 years of age or older, regardless of whether they were diabetic or not.