Diabetes: It’s Complications and Inflammation Markers

Zavaleta-Muñiz Soraya Amali; Maravilla-Domínguez María Aurora

doi:10.37871/jbres1631

ISSN: 2766-2276

Medicine Group . 2022 December 30;3(12):1538-1540. doi: 10.37871/jbres1631.

Subject area(s)

Diabetes

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Short Communication

Diabetes: It’s Complications and Inflammation Markers

Zavaleta-Muñiz Soraya Amali* and Maravilla-Domínguez María Aurora

Faculty of Health Sciences, University of the State of Durango, Mexico

*Corresponding author: Zavaleta-Muñiz Soraya Amali, Faculty of Health Sciences, University of the State of Durango, Mexico E-mail:

Received: 26 December 2022 | Accepted: 29 December 2022 | Published: 30 December 2022

How to cite this article: Zavaleta-Muñiz SA, Maravilla-Domínguez MA. Diabetes: It’s Complications and Inflammation Markers. 2022 Dec 28; 3(12): 1538-1540. doi: 10.37871/jbres1631, Article ID: jbres1631

Keywords

Diabetes complications
Inflammation markers
Aging
Neutrophil lymphocyte ratio
Platelet lymphocyte ratio

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Abstract

Type 2 Diabetes (T2DM) is a chronic inflammatory metabolic disease of high prevalence around the world. The elevated inflammation markers such as Neutrophil Lymphocyte Ratio (NLR), and Platelet Lymphocyte Ratio (PLR) are associated with macrovascular and microvascular complications and have been described as a predictors of mortality in patients with renal damage, atherosclerosis and cardiovascular diseases. The chronic inflammation state and the oxidative stress associated with aging could accelerate the microvascular complications in diabetic patients.

Summary

Type 2 Diabetes (T2DM) is a chronic inflammatory metabolic disease characterized by elevated levels of blood glucose. Their prevalence has raised dramatically around the world [1]. In the United States, the Centers for Disease Control and Prevention (CDC), recently reported more than 130 million adults living with diabetes or prediabetes. The prevalence was 14.5% in American Indian and Alaska Native people, 12.1% in non-Hispanic Black people, 11.8% in people of Hispanic origin, 9.5% in non-Hispanic Asian people and 7.4% in non-Hispanic White people in 2018-2019 [2].

The macrovascular and microvascular are the most frequent complications of T2DM with severe damage to target organs such as heart, blood vessels, eyes, kidneys and nerves [3]. The diabetic microvascular complications may have devastating consequences, including blindness and End-Stage Renal Disease (ESRD) [4-7]. There is a strong correlation between development and severity of Diabetic Nephropathy (DN) and Diabetic Retinopathy (DR); both result from damage to small vessels in these organs [8]. A meta-analysis reports an association between DR and an increased risk of DN in patients with DM [9], and Kotlarsky P, et al. [10] described a chronological correlation with the renal injury preceding retinal damage.

The chronic inflammation plays a central role in the development and progression of the T2DM and in the pathogenesis of their complications [3]. Markers such as Neutrophil Lymphocyte Ratio (NLR), and Platelet Lymphocyte Ratio (PLR) are indicators of subclinical inflammation in T2DM [3,10-12]. High NLR and PLR values have been shown in patients with DR and are associated to high rate of mortality of all causes, their levels have been found higher in proliferative diabetic retinopathy, and PLR has been described as an independent predictor of all-causes mortality in Hemodialysis (HD) patients [8,13,14].

In diabetes, the chronic inflammation is an important factor in the pathogenesis and progression of atherosclerosis, the destabilization of atherosclerotic plaques and formation of clots on the plaque surface [15] and plays a key role in the pathophysiology of acute coronary syndrome. NLR is related to the progression of coronary atherosclerosis, and has been described as a strong and independent predictor of future coronary events [16], and predictor of all-cause mortality and cardiovascular events in patients undergoing angiography or cardiac revascularization [17]. High NLR and PLR has high value in predicting the prognosis of different cardiovascular diseases including heart failure, atherosclerosis and myocardial infarction [18].

Chronic diseases increase in incidence with age. Different reports demonstrated a higher NLR in older age healthy population, ≥ 70 age groups had highest NLR [19], and both NLR and PLR are increased in old adult’s ≥ 65 year old [20]. A longitudinal study suggests a relation between chronic low-grade inflammation and oxidative stress in patients with diabetes [21]. The oxidative stress associated with aging and the inflammatory state in these patients could accelerate the microvascular complications, retinopathy, nephropathy, myocardial infarction and stroke and increase the mortality risk. Therefore, the use of noninvasive, accessible, cheap and reliable parameters as prognostic markers in diabetic patients would help to identify high risk mortality groups which would allow to adapt the therapy to the individual needs of patients.