Neutrophil:lymphocyte ratio is positively related to type 2 diabetes in a large-scale adult population: a Tianjin Chronic Low-Grade Systemic Inflammation and Health cohort study

Abstract

Aim: It is widely known that inflammation is related to type 2 diabetes (T2D), but few studies have shown a direct relationship between the immune system and T2D using a reliable biomarker. Neutrophil:lymphocyte ratio (NLR) is an easy-to-analyze inflammation biomarker, but few studies have assessed the relationship between NLR and T2D. In order to evaluate how NLR is related to T2D, we designed a large-scale cross-sectional and prospective cohort study in an adult population. Subjects and methods: Participants were recruited from the Tianjin Medical University General Hospital-Health Management Centre. Both a baseline cross-sectional (nZ87 686) and a prospective (nZ38 074) assessment were performed. Participants without a history of T2D were followed up for w6 years (with a median follow-up of 2.7 years). Adjusted logistic and Cox proportional hazards regression models were used to assess relationships between the quintiles of NLR and T2D (covariates: age, sex, BMI, smoking status, drinking status, hypertension, hyperlipidemia, and family history of cardiovascular disease, hypertension, hyperlipidemia, or diabetes). Results: The prevalence and incidence of T2D were 4.9% and 6.8/1000 person-years respectively. The adjusted odds ratio and hazard ratio (95% CI) of the highest NLR quintile were 1.34 (1.21, 1.49) and 1.39 (1.09, 1.78) (both P for trend !0.01) respectively as compared to the lowest quintile of NLR. Leukocyte, neutrophil, and lymphocyte counts do not significantly predict the eventual development of T2D. Conclusion: The present study demonstrates that NLR is related to the prevalence and incidence of T2D, and it suggests that NLR may be an efficient and accurate prognostic biomarker for T2D.

Adverse metabolic and mental health outcomes associated with shiftwork in a population-based study of 277,168 workers in UK biobank

“…[19][20][21] This association persisted even when participants with chronic disease were excluded, and after adjustment for multiple confounding factors, supporting that shiftwork might independently contribute to systemic inflammation. Previous studies have also reported higher systemic inflammation in shiftworkers [31,32], and this might be one mechanism through which shiftwork could contribute to the risk of cardiometabolic disease.…”

“…The ratio of neutrophils to lymphocytes (NLR) [19] was calculated from analysis of a blood sample collected from each participant at the time of attending the UK Biobank assessment centre, and used as a marker of immune activation, that could be suggestive of higher inflammation. Immune activation is thought to contribute to the pathophysiology of diabetes, and the NLR have been previously been specifically associated with metabolic disease [20,21]. Self-reported diabetes and cardiovascular disease were recorded by questionnaire, as well as family history of diabetes, hypertension or depression (Supplementary methods).…”

Systems Immunology of Diabetes-Tuberculosis Comorbidity Reveals Signatures of Disease Complications

“…1A and Supplemental Table 2). The neutrophil:lymphocyte ratio (NLR), a biomarker associated with TB severity 10 , insulin resistance and type 2 DM 11, 12 and coronary artery disease risk 13, 14 was higher in the TB and TBDM subgroups compared to DM and to healthy controls. Participants with TBDM had lower serum triglycerides and lower HDL than the DM subgroup (Fig.…”

Systemic inflammation-based scores and mortality for all causes in HIV-infected patients: a MASTER cohort study

“…In the USA general population examination survey (NAHNES), the NLR average was 2.15, ranging from 2.06 to 2.44 according to ethnicity, sex, education, age, BMI, smoking, alcohol drinking, diabetes or heart conditions [16]. Also many chronic conditions are known to increase the body inflammatory status [17]. …”