Monocyte–Lymphocyte Ratio and Dysglycemia: A Retrospective, Cross-Sectional Study of the Saudi Population

Abstract

Background: Abnormalities in fasting blood glucose (FBG) resulting in hypoglycemia (OG), impaired fasting glycemia (IFG), or hyperglycemia (HG) arise from disordered metabolic regulation caused in part by inflammation. To date, there is a dearth of evidence regarding the clinical utility of the monocyte–lymphocyte ratio (MLR), an emerging inflammatory index, in the management of dysglycemia. Methods: This retrospective, cross-sectional study explored MLR fluctuations as a function of glycemic control in 14,173 Saudi subjects. Data collected from 11 August 2014 to 18 July 2020 were retrieved from Al-Borg Medical Laboratories. Medians were compared by Mann–Whitney U or Kruskal–Wallis tests and the prevalence, relative risk (RR), and odds ratio (OR) were calculated. Results: MLR was significantly elevated in IFG (p < 0.0001) and HG (p < 0.05) groups compared to the normoglycemia (NG) group, and individuals with elevated MLR (>0.191) had significantly increased FBG (p < 0.001). The risk of IFG (RR = 1.12, 95% CI: 1.06–1.19, p < 0.0002) and HG (RR = 1.10, 95% CI: 1.01–1.20, p < 0.0216) was significantly increased if MLR was elevated, and individuals with elevated MLR were 1.17 times more likely to have IFG (OR = 1.17, 95% CI: 1.08–1.26, p < 0.0002) and 1.13 times more likely to have HG (OR = 1.13, 95% CI: 1.02–1.24, p < 0.0216). Conclusion: Elevated MLR is correlated with and carries a greater risk for IFG and HG. However, large prospective cohort studies are needed to establish the temporal relationship between MLR and FBG and to examine the prognostic value of this novel marker.

Association between Insulin Resistance and Pan-Immune-Inflammation Value (PIV): results from the National Health and Nutrition Examination Survey (NHANES) 2017–2020

“…Various complete blood count (CBC)-derived in ammatory indices such as neutrophil-lymphocyte ratio (NLR) (Lou et al, 2015), plateletlymphocyte ratio (PLR) (Atak et al, 2019), monocyte-lymphocyte ratio (MLR) (Alfhili et al, 2022), and systemic immune-in ammation index (SII) (Nicoară et al, 2023) have been used in estimating chronic low-grade in ammation in insulin resistance. The role of PIV has been wellelucidated in cancer as a biomarker to determine prognosis and survival outcomes (Fucà et al, 2020;Guven et al, 2022).…”

Blood indices of omega-3 and omega-6 polyunsaturated fatty acids are altered in hyperglycemia

“…Chiefly secreted from monocytes, resistin contributes to DM, atherosclerotic lesions, and cardiovascular disease. We have recently shown that the monocyte-lymphocyte ratio is disrupted in HG subjects ( Alfhili et al, 2022b ) which may be related to dysregulated resistin levels. Of note, resistin also have an inverse relation with EPA/AA ratio ( Higashioka et al, 2020 ), further highlighting the importance of a balanced PUFA intake to combat inflammation.…”

Association of Platelet-Monocyte Ratio with Dyslipidemia in Saudi Arabia: A Large, Population-Based Study

“…Furthermore, interactions between lipid species and various mediators related to monocytes and platelets, including resistin [ 40 ] and integrins [ 41 ], have been described in the literature. Of note, we have recently reported that the monocyte–lymphocyte ratio [ 42 ] and polyunsaturated fatty acids [ 43 ] are differentially regulated in hyperglycemia, which may be related to changes in PMR seen in hyperlipidemia. However, identification of the nature and role of intermediate variables mediating the correlation between PMR and deranged lipid profile remains to be determined.…”