Platelet-to-Lymphocyte Ratio Predicts the Presence of Diabetic Neurogenic Bladder

Abstract

Purpose

Diabetic neurogenic bladder (DNB) has been widely recognized in recent years. It is common in patients with long-term diabetes and may also lead to many severe complications. Although there has been widespread evidence that inflammation is involved in the development of some diabetic complications, there is little evidence that this can also occur in the bladder. In recent years, platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) have been viewed as potential novel markers of inflammatory responses. This study was designed to evaluate the relationship between the presence of DNB and the PLR and NLR.

Patients and Methods

A total of 371 cases of T2DM patients were included in this retrospective study. Patients were divided into two groups, with 115 diabetic subjects diagnosed with diabetic neurogenic bladder and 256 control subjects without DNB. The independent predictors of DNB were analyzed using logistic regression.

Results

Compared with patients without DNB, the mean PLR and NLR were significantly higher in those with DNB (p < 0.001). Based on the logistic regression, PLR was found to be an independent risk factor for DNB (odds ratio [OR]: 1.408, 95% confidence interval [CI]: 1.248–1.617). From the receiver operating characteristic (ROC) curve, using PLR as indicative of DNB was expected to be 101.1949, and it generated a sensitivity and specificity value of 89.6% and 23.4%, respectively. The area under the curve (AUC) was also found to be 0.899 (95% CI: 0.865–0.932).

Conclusion

In our study, PLR and NLR were significantly higher for patients with DNB. The PLR was found to be a risk factor in the presence of DNB after correcting for possible confounding factors. Considering the severe complications associated with DNB, patients with elevated PLR should be seriously cared for in clinics.

Keywords:

• diabetic autonomic neuropathy
• neurogenic bladder
• oxidative stress
• inflammatory response

Ethics Statement

This study was conducted in accordance with the Declaration of Helsinki, and it was approved by the ethics committee in Clinical Research of the First Affiliated Hospital of Wenzhou Medical University; Acceptance Number: KY2021-R089.

Acknowledgments

The authors thank the staff at the Department of Endocrinology and Metabolism, the First Affiliated Hospital of Wenzhou Medical University, and all the patients who participated in the study. Yiying Liu and Xin Wang are co-first authors of this study.

Disclosure

The authors report no conflicts of interest in this work.