The association between the neutrophil-to-lymphocyte ratio and type 2 diabetes mellitus: a cross-sectional study
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SUBMITTER: Chen H
PROVIDER: S-EPMC11232124 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:BackgroundDiabetes has become a global pandemic, posing a sustained threat to human health, primarily due to its associated complications. Left ventricular diastolic dysfunction (LVDD) is a prevalent cardiac complication among patients with diabetes. Since most patients are asymptomatic and lack relevant biomarkers, LVDD has not attracted significant attention from clinicians. The neutrophil-to-lymphocyte ratio (NLR) is a widely studied inflammation biomarker that has been suggested to be linked to various medical conditions, including cardiac diseases. However, its association with LVDD among patients with type 2 diabetes mellitus (T2DM) has not been explored.AimTo clarify the relationship between NLR and LVDD among patients with type 2 diabetes.MethodsWe conducted a cross-sectional study using medical records from 855 patients diagnosed with T2DM who were admitted to the Endocrinology department at Wuhan Union Hospital. According to the ASE/EACVI 2016 recommendations, these patients were categorized into two groups based on sonographic parameters: patients with normal left ventricular diastolic function (the non-LVDD group) and patients with LVDD (the LVDD group). NLR values were calculated and divided into three different levels. Statistical analysis was conducted to evaluate the correlation between NLR levels and the prevalence of LVDD.ResultsThe prevalence of LVDD among hospitalized patients with T2DM in our study was 47.8% (409/855). The mean NLR value of the LVDD group was significantly higher compared with the non-LVDD group [1.60 (1.24-2.05) vs 1.85 (1.44-2.31), P<0.001]. The prevalence of LVDD in the three different NLR levels was 35.51% (76/214), 49.27% (203/412), and 56.77% (130/229), respectively. Unjustified logistic analysis showed that NLR levels were positively associated with the prevalence of LVDD (P <0.001). Compared to the low level of NLR, the unadjusted odds ratios (OR) of LVDD at the medium and high levels were 1.764 (1.255-2.478, P=0.001) and 2.384 (1.626-3.497, P<0.001), respectively (P for trend <0.001).ConclusionOur findings suggest that the NLR is a potential indicator for assisting clinicians in identifying LVDD in patients with T2DM. Patients with elevated NLR levels may be at a greater risk of developing LVDD than those with lower NLR levels, which may require attention and interventions to prevent patients from progressing into heart failure.
| S-EPMC11757108 | biostudies-literature
Project description:ObjectiveThis study aimed to determine the neutrophil-lymphocyte ratio (NLR) as an inflammatory biomarker among type 2 diabetes mellitus (T2DM) patients with diabetic nephropathy (DN).MethodsA comparative cross-sectional study design was conducted on 199 T2DM patients attending Bole 17 Health Center, Addis Ababa, Ethiopia. The urine albumin test was done by the MICRAL-II test strip. Fasting blood sugar was measured by a glucometer. Complete blood count was analyzed using an automated hematology analyzer (HUMAN GmbH, Wiesbaden, Hesse, Germany). The student's t-test, a chi-square test, and Pearson correlation were applied to analyze the data.ResultsOut of the 199 diabetes mellitus patients, 45 (22.6%) and 154 (77.4%) were found with DN and without DN, respectively. Interestingly, the mean NLR value (2.66 ± 0.49) was found significantly higher in diabetic patients with DN compared to the mean NLR (1.65 ± 0.20) in diabetes patients without DN (p < 0.0001). The NLR showed positive significant correlation with variables such as age (r = 0.162, p = 0.023), duration of disease (r = 0.52, p < 0.0001), absolute neutrophil count (r = 0.712, p < 0.0001), total white blood cell count (r = 0.162, p = 0.022), systolic blood pressure (r = 0.338, p < 0.0001), and diastolic blood pressure (r = 0.731, p < 0.0001). On the other hand, negatively significant correlation was found between NLR and absolute lymphocyte count (r = -0.770, p < 0.000).ConclusionThe NLR was significantly increased in T2DM patients with DN, suggesting that inflammation and endothelial dysfunction could be an integral part of the pathogenesis of DN, and therefore, this ratio may be considered as a predictor and a prognostic biomarker of DN.
| S-EPMC9729998 | biostudies-literature
Project description:BackgroundThe neutrophil-percentage-to-albumin ratio (NPAR), as a low-cost and easily accessible inflammatory biomarker, has garnered considerable attention in various disease studies in recent years. Specifically, existing research has suggested a significant correlation between NPAR and diabetic retinopathy, indicating its potential relevance to diabetic complications. However, despite diabetic kidney disease (DKD) being a complication that severely affects the quality of life of diabetic patients, the association between the prevalence of DKD and NPAR remains to be elucidated. Therefore, this study aims to explore the potential link between NPAR and DKD in patients with type 2 diabetes mellitus.MethodsWe extracted complete data on neutrophil percentage, plasma albumin, serum creatinine, and urine albumin-to-creatinine ratio from the National Health and Nutrition Examination Survey database spanning from 2009 to 2018. Multivariable logistic regression models were employed to examine the relationship between NPAR levels and DKD, and conducted sensitivity tests, subsequently employing Generalized Additive Models combined with smooth curve fitting methods to explore the relationships among variables. Then, subgroup analyses were conducted on the association between NPAR and DKD to investigate changes in the relationship across different subgroups. Finally, Receiver operating characteristic curves were used to assess the predictive performance of the independent variable, NPAR, for the dependent variable, DKD.ResultsA total of 2,263 participants were enrolled in this cross-sectional study. After adjusting for confounding factors, the odds ratio for DKD was 1.44 (95% CI: 1.08-1.90) for the second quartile group, 1.75 (95% CI: 1.33-2.31) for the third quartile group, and 2.95 (95% CI: 2.22-3.93) for the fourth quartile group. Among patients with type 2 diabetes mellitus, a positive correlation was observed between NPAR and DKD. Results from subgroup analyses showed no significant differences among different populations. Receiver operating characteristic (ROC) analysis indicated that NPAR had good predictive performance for DKD.ConclusionThe prevalence of DKD indicated a positive association with NPAR among individuals with T2DM. Additional large-scale prospective investigations may be helpful in corroborating these findings.
| S-EPMC11922708 | biostudies-literature
Project description:ObjectiveThe neutrophil-to-lymphocyte ratio (NLR) is an inexpensive and easily measurable laboratory index indicating systemic inflammation, while the application of many other inflammatory markers has been limited in daily clinical practice. However, large population studies about investigating the associations of the NLR level with diabetic complications including cardiovascular and cerebrovascular diseases (CVD), diabetic kidney disease (DKD), and diabetic retinopathy (DR) in the same population were limited. The aim of our study is to evaluate the associations between the NLR level and the prevalence of CVD, DKD, and DR in adults with diabetes simultaneously.MethodsA cross-sectional survey of 4,813 diabetic adults was conducted in seven communities in China. Persons underwent several medical examinations, including the measurement of anthropometric factors, blood pressure, routinely analyzed leukocyte characteristics, glucose, lipid profiles, urine albumin/creatinine ratio, and fundus photographs.ResultsCompared with the first quartile of the NLR level, the odds of having CVD was significantly increased by 21% for participants in the highest quartile (OR 1.21; 95% CI 1.00, 1.47) (P for trend < 0.05). Similarly, the prevalence of DKD among participants in the highest quartile of the NLR level was significantly increased by 150% (OR 2.50; 95% CI 1.95, 3.19) (P for trend < 0.05). However, no association was found between the NLR level and the prevalence of DR (P for trend > 0.05). These associations were all fully adjusted.ConclusionsA higher NLR level was associated with an increased prevalence of CVD and DKD, other than DR, in diabetic adults.
| S-EPMC7206875 | biostudies-literature
Project description:Gut microbiota and blood neutrophil-to-lymphocyte ratio (NLR) are associated with systemic inflammation; however, data on the association between gut microbiota and NLR are lacking. We investigated the association between gut microbiota and NLR. A total of 1,309 subjects who had available data on NLR and 16 S rRNA sequencing of gut microbiota were included in this study. They were grouped according to NLR quartile (Q) as follows: lower Q (n = 328, <25% of NLR range), middle 2Q (n = 653, ≥25% to <75%) and upper Q (n = 328, ≥75%). The diversity and composition of the human gut microbiota in the groups were calculated. The phylogenetic diversity of gut microbiota in the lower group was significantly higher than in the middle 2Q group (P = 0.040). The beta-diversity was significantly different among the three groups (P = 0.043), between the lower and middle 2Q groups (P = 0.029), and between the lower and upper groups (P = 0.026). Bacteroides eggerthii showed a positive correlation with NLR (q = 0.015). The diversity and composition of the gut microbiome were different between the NLR groups. Particularly, patients with a lower NLR had a greater diversity of gut microbiota.
| S-EPMC6207698 | biostudies-literature
Project description:Inflammation plays a crucial role in cancer development. The neutrophil-to-lymphocyte ratio (NLR), a measure of inflammation, is obtained from a complete blood count. However, little is known about the association between NLR and cancer in the general adult population in the United States. This study aimed to evaluate whether NLR is associated with cancer in American adults. This retrospective cross-sectional study included 28,016 adult participants from the National Health and Nutrition Examination Survey (NHANES) dataset spanning 2005 to 2018. Data on demographics (age, sex, race, marital status, Poverty-Income Ratio, education level), lifestyle factors (smoking, alcohol consumption, body mass index), medical conditions (hypertension, diabetes, cardiovascular disease), and laboratory parameters (hemoglobin, platelet count, alanine aminotransferase, creatinine, albumin, and lactate dehydrogenase), were collected. Logistic regression analysis was used to investigate the research objectives. Of the total 28,016 participants, 2639 had cancer. The mean age was 49.6 ± 17.6 years, and 50% were male. A positive association between NLR and cancer risk was observed after multivariate adjustment (OR = 1.20, 95% confidence interval (CI) = 1.05-1.36, p = 0.006). Similar patterns were observed in subgroup analyses (all p-values for interaction > 0.05). A higher NLR was directly correlated with an increased risk of developing cancer in adults.
| S-EPMC11467198 | biostudies-literature
Project description:BackgroundDiabetes mellitus among patients with exocrine pancreatic disorders is commonly known to be associated with chronic inflammation, including chronic pancreatitis and pancreatic ductal adenocarcinoma (PDAC). The neutrophil-to-lymphocyte ratio (NLR) is a novel marker that indicates the presence of various chronic inflammatory diseases, including type 2 diabetes (T2DM). However, no studies have examined the relationship between the NLR value and diabetes secondary to exocrine pancreatic disorders.AimTo determine whether the NLR value is associated with diabetes secondary to exocrine pancreatic disorders.MethodsThe medical data of subjects with confirmed pancreatic disease who were admitted to the Department of Pancreatic Surgery of our institution from August 2017 to October 2021 were obtained from the database and retrospectively analyzed. Anthropometric measures, laboratory data, including HbA1c, fasting insulin, and fasting C-peptide levels and the inflammatory index (white blood cell count, NLR, platelet-to-lymphocyte ration, monocyte-to-lymphocyte ratio) were recorded. The NLR is the ratio of neutrophils to lymphocytes. A homeostasis model (HOMA-B and HOMA-IR) was used to measure beta-cell dysfunction and insulin resistance.ResultsThe NLR values of the diabetes secondary to exocrine pancreatic disorders group were significantly higher than those of the nondiabetic group (P=0.001). In multivariate logistic regression, after adjusting for covariates, high NLR values were found to be an independent risk factor for diabetes secondary to exocrine pancreatic disorders (OR: 1.37, 95% CI: 1.138-1.649, P=0.001). According to Spearman correlation analysis, the NLR was significantly correlated with fasting plasma glucose levels (P<0.0001) and HOMA2-IR values (P=0.02).ConclusionThe NLR inflammation marker was significantly higher in subjects with diabetes secondary to exocrine pancreatic disorders and was associated with insulin resistance. NLR values may be reliable predictive markers for diabetes among patients with exocrine pancreatic disorders.
| S-EPMC9352859 | biostudies-literature
Project description:AimThe available evidence for predicting length of stay in acute psychiatric hospitals includes demographics, diagnosis, and treatment variables. This study aimed to evaluate the association between neutrophil-to-lymphocyte ratio (NLR) and length of hospital stay in an acute psychiatric hospital.MethodsA total of 116 patients who were admitted to an acute psychiatric ward at Urawa Neuropsychiatric Sanatorium (Saitama, Japan) from August 2022 to December 2022 were eligible for this study. Laboratory data of lymphocytes and neutrophils were assessed on the first day of admission and NLR was calculated based on the data. Participants were categorized into two groups, high NLR and low NLR, which were set as predictor variables, as well as using NLR as a continuous variable. Multiple linear regression was performed to determine the association between NLR and length of hospital stay, adjusting for confounding factors.ResultsA total of 90 participants were included in this study. The association of NLR as a continuous variable and length of hospital stay was not significant. When we categorized participants into high- and low-NLR groups, the association was significant even after adjusting by covariates (p < 0.05).ConclusionCategorized NLR was positively associated with the length of hospital stay in patients admitted to an acute psychiatric hospital. Categorized NLR may predict the length of hospital stay for patients who are admitted to an acute psychiatric hospital.
| S-EPMC11325829 | biostudies-literature
Project description:IntroductionNeutrophil-to-lymphocyte ratio (NLR) is a routinely available biomarker that reflects systemic inflammation. The study evaluated the predictive value of NLR for ischemic stroke and atrial fibrillation (AF) in patients with type 2 diabetes mellitus.MethodsThis was a population-based cohort study of patients with type 2 diabetes mellitus and complete blood count tests at baseline between 1 January 1st, 2009, and 31 December, 2009, at government-funded hospitals/clinics in Hong Kong. Follow-up was until 31 December, 2019, or death.ResultsA total of 85,351 patients (age = 67.6 ± 13.2 years old, male = 48.8%, follow-up = 3101 ± 1441 days) were included. Univariable Cox regression found that increased NLR at quartiles 2, 3 and 4 was significantly associated with higher risks of new-onset ischemic stroke (hazard ratio [HR]: 1.28 [1.20-1.37], p < .001, HR: 1.41 [1.32-1.51], p < .001 and HR: 1.38 [1.29-1.47], p < .001) and AF (HR: 1.09 [1.02-1.17], p < .015; HR: 1.28 [1.20-1.37], p < .001; HR: 1.39 [1.31-1.49], p < .001) compared to quartile 1. On multivariable analysis, NLR remained a significant predictor of ischemic stroke risk for quartiles 2 and 3 (quartile 2: HR: 1.14 [1.05, 1.22], p = .001; quartile 3: HR: 1.14 [1.06, 1.23], p < .001) but not quartile 4 (HR: 1.08 [0.994, 1.17], p = .070). NLR was not predictive of AF after adjusting for confounders (quartile 2: HR: 0.966 [0.874, 1.07], p = .499; quartile 3: HR: 0.978 [0.884, 1.08], p = .661; quartile 4: HR: 1.05 [0.935, 1.16], p = .462).ConclusionNLR is a significant predictor of new-onset ischaemic stroke after adjusting for significant confounders in Chinese type 2 diabetes patients.
| S-EPMC9836252 | biostudies-literature
Project description:BackgroundDelirium is a severe neuropsychiatric symptom following acute ischemic stroke (IS) and is associated with poor outcomes. Systemic inflammation and immune dysregulation are believed to contribute to the pathophysiology of delirium. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) are widely recognized as convenient and reliable biomarkers of systemic inflammation. However, their association with delirium after IS remains unclear.MethodsIn this study, we identified IS patients requiring ICU admission from the Medical Information Mart for Intensive Care (MIMIC)-IV database. We employed multivariable logistic regression and restricted cubic splines (RCS) to assess the association between the NLR, PLR, and LMR and delirium. Two-sample Mendelian randomization (MR) analysis was performed to further explore their causal relationship at the genetic level.ResultsA total of 1,436 patients with IS were included in this study, of whom 214 (14.9%) had delirium. In the multivariate logistic regression analysis, after adjustment for confounders, the patients in the highest quartile of the NLR (odds ratio [OR] 2.080, 95% confidence interval [CI], 1.282-3.375) and LMR (OR 0.503, 95% CI 0.317-0.798) and the patients in the second quartile of the PLR (OR 1.574, 95% CI 1.019-2.431) were significantly associated with delirium. The RCS function showed a progressive increase in the risk of delirium with higher NLR and PLR and lower LMR. In the MR analysis, only the PLR was negatively associated with the risk of delirium.ConclusionThe observational studies found significant associations between the NLR, PLR, and LMR and delirium. However, the MR analysis only demonstrated a potential protective causal relationship between the PLR and delirium. Further prospective studies are needed to validate their association and to elucidate the underlying mechanisms.
| S-EPMC11743177 | biostudies-literature