Abstract: Objective To explore the predictive value of red blood cell distribution width (RDW) and neutrophil/lymphocyte ratio (NLR) on the poor prognosis of elderly patients with type 2 diabetes mellitus (T2DM). Methods A total of 316 elderly patients with T2DM in our hospital from January 2015 to January 2018 were enrolled. All patients were followed up by telephone to record whether all-cause deaths occurred. According to the follow-up results, the patients were divided into death group and survival group, and the general data of the two groups were compared. Pearson correlation coefficient was used to describe the correlation of RDW and NLR with other laboratory indicators. Receiver operating characteristic (ROC) curve was drawn to analyze the value of RDW and NLR in predicting the all-cause mortality risk of the elderly T2DM patients. According to the cut-off value of the ROC curve, the preditive value of RDW and NLR for the complications of elderly patients with T2DM was analyzed. Results The follow-up time of this study was 46.22±11.48 months, and 303 patients were enrolled in this study. There were 71 cases occurring all-cause deaths. There were no significant differences in age, gender, body mass index, and duration of diabetes between the two groups (P>0.05). There were statistically significant differences in the levels of fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), albumin (ALB), creatinine (Cr), RDW and NLR between the two groups (P<0.05). Pearson correlation analysis showed that RDW and NLR were positively correlated with FPG, HbA1c and Cr, but negatively correlated with ALB (P<0.05). ROC curve analysis showed the area under the curve of RDW, NLR alone and combination of the two indicators for predicting the risk of all-cause mortality in the elderly T2DM patients was 0.795 (sensitivity: 78.87%; specificity: 68.10%; cut-off value: 13.2%), 0.838 (sensitivity: 88.73%; specificity: 64.66%; cut-off value: 6.13%) and 0.903 (sensitivity: 81.69%; specificity: 85.78%). Compared with the patients with RDW≤13.2% and NLR≤6.13%, the patients with RDW>13.2% and NLR>6.13% were prone to presenting with diabetic nephropathy, diabetic retinopathy, diabetic foot and diabetic neuropathy (P<0.01). Conclusions RDW and NLR can be used as independent predictors of all-cause mortality in the elderly patients with T2DM, and the combination of the two indicators has higher predictive value. Elderly T2DM patients with elevated levels of RDW and NLR are more prone to presenting with the complications of diabetes.

Key words: red blood cell distribution width, neutrophils/lymphocytes ratio, diabetes, aged