Neutrophil-to-lymphocyte and monocyte-to-lymphocyte ratios as inflammatory markers in the assessment of glycemic status in diabetic patients of Asir region

Abstract

Background: Diabetes mellitus (DM) is a prevalent chronic metabolic condition characterized by high blood sugar levels, resulting from insufficient insulin production or ineffective insulin use, posing substantial global health issues. Research on the relationship between glycemic status and the ratio of neutrophils to lymphocytes (NLR) and monocytes to lymphocytes (MLR) is limited. This study aimed to fill these knowledge gaps by examining the connection between DM and inflammatory markers within the Asir region.

Methods: Data from 3545 participants were retrospectively analyzed. The dataset, gathered between 2021 and 2023, comprises 38 laboratory tests obtained from the Future Lab Pioneer database. The study's inclusion criteria focused on diabetes profile tests (glycated hemoglobin [HbA1c] and fasting blood glucose [FBG]) and manually computed inflammatory markers (NLR and MLR), which were stratified by age and sex.

Results: This study demonstrated significant differences in NLR levels compared with FBG levels across all adult age groups and adult female participants (p < 0.0001), as well as among all elderly age groups (p = 0.0006) and elderly women (p = 0.01). MLR levels were significant in all adult age groups (p = 0.04) and in adult women (p = 0.02). When NLR and MLR were compared to HbA1c levels, a significant difference in the mean NLR was found in adult women (p = 0.005). Additionally, the mean MLR levels were significant in all adult age groups (p = 0.04) and adult women (p = 0.02).

Conclusion: Although a larger sample size is necessary for this research, the results indicate that NLR and MLR could serve as valuable indicators for evaluating inflammation in people with disrupted glucose metabolism, particularly in adult and female populations.

Keywords

diabetes mellitus / glucose metabolism / glycated hemoglobin (HbA1c) / inflammatory markers / insulin resistance / neutrophil-to-lymphocyte ratio

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