Abstract: Abstract: Objective To investigate the relationship between neutrophil/lymphocyte ratio (NLR) and fibrinogen (FIB) levels in patients with chronic obstructive pulmonary disease (COPD) and type II diabetes mellitus (T2DM). Methods The clinical information of 120 patients who went to our hospital from July 2017 to January 2019 and met the inclusion criteria was collected. According to the disease, patients were divided into three groups: group A (COPD patients without T2DM, n= 40), group B (patients with COPD and T2DM without microangiopathy, n=40) and group C (patients with COPD and T2DM and with microangiopathy, n=40). The venous blood samples were drawn from patients, and the leukocytes, neutrophil and lymphocyte counts were measured. The neutrophil/lymphocyte ratio (NLR) was calculated. The enzyme-linked immunosorbent assay was used to detect FIB, triacylglycerol (TG), total cholesterol (TC), low density lipoprotein cholesterin (LDL)-C, high density lipoprotein cholesterin (HDL)-C and high-sensitivity C-reactive protein (hs-CRP). The lung function indexes were also measured. Results The years of smoking, the times of acute exacerbation of COPD and the proportion of hypertension history were all higher in group B and group C than those in group A (P＜0.05). The levels of NLR and FIB increased in turn in group B and group C, and there were significant differences between the groups (P＜0.05). In stable COPD patients, T2DM was positively correlated with smoking years (r=0.125, P＜0.05), number of acute exacerbations of COPD in one year (rs=0.151, P＜0.05), history of hypertension (rs=0.231, P＜0.05), NLR (rs=0.342, P＜0.05) and FIB (rs= 0.312, P＜0.05). Patients with stable COPD and T2DM, microvascular complications were positively correlated with smoking years (rs=0.143, P＜0.05), prevalence of hypertension (rs=0.198, P＜0.05), NLR (rs=0.421, P＜0.05), and FIB (rs=0.350, P＜0.05). Multivariate Logistic regression analysis showed that the increased NLR (OR=1.644, 95%CI: 1.359-1.899) and FIB (OR=1.647, 95%CI: 1.386-1.931) were independent risk factors for stable COPD combined with T2DM (P＜0.05). The increased NLR (OR=1.731, 95%CI: 1.456-1.978) and FIB (OR=1.698, 95%CI: 1.543-1.928) were independent risk factors for microvascular disease in stable COPD combined with T2DM (P＜0.05). Conclusion COPD combined with T2DM and microvascular complications are closely related to NLR and FIB. NLR and FIB can be used as biomarkers for effectively assessing the severity and prognosis of stable COPD combined with T2DM.

Key words: pulmonary disease, chronic obstructive, diabetes mellitus, type 2, diabetic angiopathies, fibrinogen,
neutrophil/lymphocyte ratio