{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T10:48:46Z","timestamp":1793789326622,"version":"4.6.1"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T00:00:00Z","timestamp":1704326400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This investigation examined the possibility of a relationship between neutrophil-to-lymphocyte ratio (NLR) and diabetic kidney disease (DKD) in type 2 diabetes mellitus (T2DM) patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Adults with T2DM who were included in the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2020 were the subjects of the current cross-sectional investigation. Low estimated glomerular filtration rate (eGFR) (&amp;lt; 60 mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      ) or albuminuria (urinary albumin-to-creatinine ratio (ACR) \u2265 30 mg\/g) in T2DM patients were the diagnostic criteria for DKD. Weighted multivariable logistic regression models and generalized additive models were used to investigate the independent relationships between NLR levels with DKD, albuminuria, and low-eGFR. Additionally, we examined the relationships between DKD, albuminuria, and low-eGFR with other inflammatory markers, such as the aggregate index of systemic inflammation (AISI), systemic immune-inflammation index (SII), system inflammation response index (SIRI), and platelet-to-lymphocyte ratio (PLR) and monocyte-to-lymphocyte ratio (MLR). Their diagnostic capabilities were evaluated and contrasted using receiver operating characteristic (ROC) curves.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>44.65% of the 7,153 participants who were recruited for this study were males. DKD, albuminuria, and low-eGFR were prevalent in 31.76%, 23.08%, and 14.55% of cases, respectively. Positive correlations were seen between the NLR with the prevalences of DKD, albuminuria, and low-eGFR. Subgroup analysis and interaction tests revealed that the associations of NLR with DKD, albuminuria, and low-eGFR were not significantly different across populations. In addition, MLR, SII and SIRI showed positive associations with the prevalence of DKD. ROC analysis discovered that when compared to other inflammatory markers (MLR, PLR, SII, SIRI, and AISI), NLR may demonstrate more discriminatory power and accuracy in assessing the risk of DKD, albuminuria, and low-eGFR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Compared to other inflammatory markers (MLR, PLR, SII, SIRI, and AISI), NLR may serve as the more effective potential inflammatory marker for identifying the risk of DKD, albuminuria, and low-eGFR in US T2DM patients. T2DM patients with elevated levels of NLR, MLR, SII, and SIRI should be closely monitored for their potential risk to renal function.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2023.1285509","type":"journal-article","created":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T12:39:11Z","timestamp":1704371951000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":90,"title":["Association between neutrophil-to-lymphocyte ratio and diabetic kidney disease in type 2 diabetes mellitus patients: a cross-sectional study"],"prefix":"10.3389","volume":"14","author":[{"given":"Xiaowan","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lanyu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyi","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyang","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,1,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm4061207","article-title":"The concept and the epidemiology of diabetic nephropathy have changed in recent years","volume":"4","author":"Mart\u00ednez-Castelao","year":"2015","journal-title":"J Clin Med"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2014.08.001","article-title":"Diabetic kidney disease: a report from an ADA Consensus Conference","volume":"64","author":"Tuttle","year":"2014","journal-title":"Am J Kidney Dis"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.molmet.2019.10.005","article-title":"Diabetic kidney diseases revisited: A new perspective for a new era","volume":"30","author":"Fu","year":"2019","journal-title":"Mol Metab"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-1162","article-title":"A contemporary estimate of total mortality and cardiovascular disease risk in young adults with type 1 diabetes: the pittsburgh epidemiology of diabetes complications study","volume":"39","author":"Miller","year":"2016","journal-title":"Diabetes Care"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.23750\/abm.v91i4.10380","article-title":"The impact of COVID-19 in diabetic kidney disease and chronic kidney disease: A population-based study","volume":"91","author":"Leon-Abarca","year":"2020","journal-title":"Acta BioMed"},{"key":"B6","doi-asserted-by":"publisher","first-page":"996","DOI":"10.1007\/s00125-018-4567-5","article-title":"Biomarkers of diabetic kidney disease","volume":"61","author":"Colhoun","year":"2018","journal-title":"Diabetologia"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1080\/0886022X.2022.2106872","article-title":"Prognosis and risk factors of chronic kidney disease progression in patients with diabetic kidney disease and non-diabetic kidney disease: a prospective cohort CKD-ROUTE study","volume":"44","author":"Chen","year":"2022","journal-title":"Ren Fail"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-1897","article-title":"Establishment and validation of a risk prediction model for early diabetic kidney disease based on a systematic review and meta-analysis of 20 cohorts","volume":"43","author":"Jiang","year":"2020","journal-title":"Diabetes Care"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1055\/s-0043-121262","article-title":"The main determinants of serum resistin level in type 2 diabetic patients are renal function and inflammation not presence of microvascular complication, obesity and insulin resistance","volume":"127","author":"Cebeci","year":"2019","journal-title":"Exp Clin Endocrinol Diabetes"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2380","article-title":"Complement-mediated chronic inflammation is associated with diabetic microvascular complication","volume":"29","author":"Fujita","year":"2013","journal-title":"Diabetes Metab Res Rev"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-018-0064-2","article-title":"Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty","volume":"15","author":"Ferrucci","year":"2018","journal-title":"Nat Rev Cardiol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1002\/eji.1830050508","article-title":"Regulation of the immune response by subclasses of T lymphocytes. 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