Related Experiment Video
Updated: Sep 8, 2025
Quantification of Diabetes-induced Adherent Leukocytes in Retinal Vasculature
Published on: January 24, 2025
Leukocytic dysregulation in children with type 1 diabetes: relation to diabetic vascular complications
Nouran Yousef Salah1, Nesrine Radwan2, Heba Mohamed Atif3
1Pediatrics Department, Pediatric and Adolescents Diabetes Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Insights
Children with type 1 diabetes (T1D) show higher neutrophil-lymphocyte ratio (NLR) and lower platelet-lymphocyte ratio (PLR). These inflammation markers correlate with disease severity and microvascular complications in pediatric T1D.
Area of Science:
- Immunology
- Endocrinology
- Pediatrics
Background:
- Innate immune response plays a role in type 1 diabetes (T1D) vascular complications.
- Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are emerging markers of chronic inflammation.
- NLR and PLR may offer prognostic value for vascular complications in pediatric T1D.
Purpose of the Study:
- To compare NLR and PLR levels in children with T1D versus matched healthy controls.
- To assess the correlation of NLR and PLR with glycosylated hemoglobin (HbA1C) and microvascular complications.
- To evaluate the potential of NLR and PLR as indicators of diabetic microvascular complications in children.
Main Methods:
- A comparative study involving 100 children with T1D and 100 matched healthy controls.
- Data collection included medical history, diabetes duration, insulin requirements, hypoglycemic events, fundus examination, and neuropathy assessment.
- Laboratory tests comprised HbA1C, fasting lipids, urinary albumin excretion, complete blood count, and calculation of NLR and PLR.
Main Results:
- Children with T1D exhibited significantly higher NLR (p=0.008) and lower PLR (p=0.007) compared to controls.
- NLR positively correlated with HbA1C, diabetes duration, cholesterol, triglycerides, and LDL, while PLR showed negative correlations.
- Significantly higher NLR (p<0.001) and lower PLR (p=0.005) were observed in children with microvascular complications. Multivariate analysis confirmed NLR and PLR as independent predictors of these complications.
Conclusions:
- Pediatric T1D patients demonstrate altered NLR and PLR, indicative of heightened inflammation.
- Elevated NLR and reduced PLR are associated with poorer glycemic control, longer diabetes duration, and dyslipidemia.
- NLR and PLR serve as potential, cost-effective biomarkers for predicting the risk of microvascular complications in children with T1D.
Background:
Growing evidences highlight the role of the innate immune response in the pathogenesis of type 1 diabetes (T1D) vascular complications. Neutrophil lymphocytic ratio (NLR) and platelet lymphocytic ratio (PLR) are inexpensive but novel markers of chronic inflammation might have prognostic value in children with T1D.
Aim:
To study NLR and PLR levels in children with T1D in comparison to matched controls and correlate them with fraction-C of glycosylated hemoglobin (HbA1C) and micro-vascular complications.
Methodology:
Hundred children with T1D were compared to 100 matched healthy controls. History included diabetes duration, insulin dose and frequency of hypoglycemic attacks. Fundus examination and the simple rapid neuropathy disability score were done. HbA1C, fasting lipids, urinary albumin excretion and complete blood count were measured with assessment of NLR and PLR.
Results:
NLR was significantly higher (p = 0.008) and PLR was significantly lower (p = 0.007) in children with T1D than controls. NLR was positively correlated while PLR was negatively correlated with HbA1C, diabetes duration, fasting cholesterol, triglycerides and LDL. NLR was significantly higher (p < 0.001) and PLR was significantly lower (p = 0.005) in children with microvascular complications than those without. Moreover, multivariate logistic regression revealed that microvascular complications were independently associated with NLR (p = 0.013) and PLR (p = 0.004).
Conclusion:
Children with T1D had significantly higher NLR and lower PLR compared to controls. These changes were more evident in those with diabetic microvascular complications than those without. Furthermore, NLR was positively correlated and PLR was negatively correlated to HbA1C, diabetes duration and hyperlipidemia. Hence, NLR and PLR can be a potential indicator for the risk of development of diabetic microvascular complications in children with T1D.
Related Concept Videos
01:22Diabetes Mellitus: Overview and Type I Subtype
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
01:15Diabetes: Symptoms, Diagnosis, and Complications
01:20Pathophysiology of Diabetes
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
01:22Diabetes Mellitus: Type 2 and Gestational
01:27Disorders of Leukocytes
Leukopenia may result from bone marrow disorders, autoimmune diseases, and infectious diseases. For example, conditions such as multiple myeloma and aplastic anemia can impair the bone marrow's ability to produce adequate leukocytes. Similarly, autoimmune diseases like lupus and viral infections such as HIV can prompt the immune...
01:24Chronic Kidney Disease II: Clinical Manifestations