['Diabetic nephropathy (DN) is a common complication in diabetics. Recent evidence suggests that neutrophil-lymphocyte ratio (NLR) affects the development and acceleration of some diabetic complications. Scholars have rarely investigated the relationship between DN and NLR. This study aims to evaluate the relationship between DN and NLR and estimate whether or not NLR is a reliable marker for early-stage DN.', 'The study included 253 patients with type 2 diabetes mellitus, 115 of whom have early-stage DN. The control group was composed of 210 healthy age- and sex-matched subjects.', 'The NLR values of the patients with diabetes were significantly higher than those of the healthy controls (P < 0·001), and the NLR values of the patients with early-stage DN were higher than those of the patients without DN (P < 0·001). Logistic regression analysis showed that the risk predictors of DN include NLR, creatinine, total cholesterol, systolic blood pressure, HbA1c and insulin resistance. NLR (P = 0·004, EXP(B) = 2·088, 95% CI = 1·271-3·429) levels positively correlated with DN. The DN odds ratio increased by a factor of 2·088 (95% CI, 1·271-3·429) for every one unit increase in NLR.'] Is neutrophil-lymphocyte ratio a reliable predictive marker for early-stage diabetic nephropathy?