THE PLATELET-TO-LYMPHOCYTE RATIO (PLR) ON ACUTE COMPLICATION OF DIABETES MELLITUS

hariogie putradi

Abstract


Hariogie Putradi1, Catur Suci Sutrisnani2

1Resident of Clinical Pathology Department, Faculty of Medicine Brawijaya University Malang/ dr. Saiful Anwar General Hospital, Malang

2Clinical Pathology Department, Faculty of Medicine Brawijaya University Malang/                    dr. Saiful Anwar General Hospital, Malang


ABSTRACT

Background

Hyperglycemia crisis can occur in Diabetes Mellitus (DM). The uncontrolled complications of DM are Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar State (HHS). Inflammatory response is potentially occur in these condition. Platelet-to-Lymphocyte Ratio (PLR) is a new marker of inflammation in which platelet counts tend to increase, while lymphocyte counts tend to decrease due to severe apoptosis. AimDescribe PLR on acute complication of DM and to know the difference of PLR between DKA and non-DKA (HHS and Mixed).

Method

Retrospective study in patients with acute complication of DM in dr. Saiful Anwar General Hospital Malang in January 2017-May 2018. The platelet and lymphocyte count were obtained from the Laboratory Information System (LIS). The PLR was calculated by dividing the platelet count by the lymphocyte count.

Result

A total of 71 patients were involved in the study, consisting of 21 DKA patients and 50 non-DKA patients. There was significant difference of platelet count between DKA and non-DKA patients (p=0,001). However, there were no significant differences of lymphocyte count (p=0,087) and PLR (p=0,762) between DKA and non-DKA patients.

Discussion

In DKA, there is a chronic inflammatory process that can affect PLR. As a result, platelet counts tend to increase, while lymphocyte counts tend to decrease due to severe apoptosis.

 

 

Conclusion and Suggestion

The study showed significant difference of platelet count between DKA and non-DKA groups, and no significant difference of PLR between DKA and non-DKA groups. It is recommended to conduct further research with larger sample size.


Keywords


Diabetes Mellitus (DM), Diabetic Ketoacidosis (DKA), Hyperglycemia Crisis, Hyperglycemic Hyperosmolar State (HHS), Platelet-to-Lymphocyte Ratio (PLR)b

References


Soelistijo SA, Novida H, Rudijanto A, Soewondo P, Suastika K, Manaf A, Sanusi H, Lindarto D, Shahab A, Pramono B, Langi YA, Purnamasari D, Soetedjo NN, Saraswati MR, Dwipayana MP, Yuwono A, Sasiarini L, Sugiarto, Sucipto KW, Zufry H. 2015. Konsensus Pengelolaan Dan Pencegahan Diabetes Melitus Tipe 2 di Indonesia 2015. Jakarta: PB. PERKENI.

Maletkovic J, Drexler A. Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar State. Endocrinol Metab Clin N Am 2013; 42: 677 - 695.

Westerberg DP. Diabetic Ketoacidosis: Evaluation & Treatment. American Family Physician 2013; 87: 337 - 436.

Gotera W, Budiyasa DGA. Penatalaksanaan Ketoasidosis Diabetik (KAD). J Peny Dalam 2010; 11(2): 126 - 138.

Chou W, Chung MH, Wang HY, Chen JH, Chen WL, Guo HR, Lin HJ, Su SB, Huang CC, Hsu CC. Clinical characteristics of hyperglycemic crises in patients without a history of diabetes. J Diabetes Invest 2014; 5: 657 - 662.

Umpierrez GE, Murphy MB, Kitabchi AE. Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar Syndrome. Diabetes Spectrum 2002; 15(1): 28 - 36.

American Diabetes Association. Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 2018; 27 (suppl 1): s5 - s10.

Liu WY, Lin SG, Wang LR, Fang CC, Lin YQ, Braddock M, Zhu GQ, Zhang Z, Zheng MH, Shen FX. Platelet-to-Lymphocyte Ratio: A Novel Prognostic Factor for Prediction of 90-day Outcomes in Critically Ill Patients with Diabetic Ketoacidosis. Medicine 2016; 95(4): 1 - 7.

Toprak E, Bozkurt M, Çakmak BD, Özçimen EE, Silahlı M, Yumru AE, Çalışkan E. Platelet-to-Lymphocyte Ratio: A New Inflammatory Marker for The Diagnosis of Preterm Premature Rupture of Membranes. Journal of The Turkish German Gynecological Association 2017; 18(3): 122 - 126.

Stentz FB, Umpierrez GE, Cuervo R, Kitabchi AE. Proinflammatory Cytokines, Markers of Cardiovascular Risks, Oxidative Stress, and Lipid Peroxidation in Patients with Hyperglycemic Crises. Diabetes 2004; 53(8): 2079 - 2086.

Steenkamp DW, Alexanian SM, McDonnell ME. Adult Hyperglycemic Crisis: A Review and Perspective. Curr Diab Rep 2013; 13: 130 - 137.

Fritsch M, Rosenbauer J, Schober E, Neu A, Placzek K, Holl RW. Predictors of Diabetic Ketoacidosis in Children and Adolescents with Type 1 Diabetes. Experience from A Large Multicentre Database. Pediatr Diabetes 2011; 12(4 PT 1): 307 - 312.

Sharma M, Narang S, Nema SK. Study of Altered Platelet Morphology with Changes in Glycaemic Status. Int J Res Med Sci 2016; 4(3): 757 - 761.

Erdoğan S, Dursun F, Kırmızıbekmez H, Güven S, Yıldırım UM. Evaluation of Erythrocyte and Thrombocyte Parameters in Pediatric Patients with Diabetes Mellitus. J Clin Anal Med 2017; 8(2): 98 - 101.




DOI: http://dx.doi.org/10.24293/ijcpml.v25i3.1476

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