Systemic Immune Inflammation Index and Neutrophil-to-Lymphocyte Ratio Correlate with Fasting Glucose Levels Among Type 2 Diabetic Patients


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DOI:

https://doi.org/10.58600/eurjther2029

Keywords:

type 2 diabetes mellitus, glucose, glycated hemoglobin, neutrophil, lymphocyte

Abstract

Objective: Type 2 diabetes mellitus (T2DM) pathogenesis involves low-grade chronic inflammation, which can be measured via surrogate markers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune inflammation index (SII), and pan-immune inflammation value (PIIV). They were demonstrated to be correlated with T2DM-related outcomes, including mortality, akin to glycemic indices of fasting blood glucose and glycated hemoglobin. However, it is not clear whether a correlation exists between inflammatory markers and glycemic indices.

Methods: A retrospective study was designed. Clinical and medication variables, glycemic control variables, and complete blood count differential variables were acquired via electronic medical records. NLR, PLR, SIIV, and PIIV values were calculated. Correlation analyses between fasting blood glucose, glycated hemoglobin values, and inflammatory indices were conducted.

Results: Sixty-three patients were included in the study. The median fasting blood glucose and glycated hemoglobin levels were 115 mg/dL and 6.2%, respectively. SII and NLR significantly correlated with fasting blood glucose levels (r = .271, p = .032, and r = .364 p = .003, respectively). Although PIIV and NLR showed a correlation trend with glycated hemoglobin (r = .238 and r = .236, respectively), this correlation did not reach statistical significance (p = .061 and p = .062, respectively).

Conclusion: This study demonstrated that SII and NLR are not only associated with long-term diabetic complications but are also correlated with the cross-sectional glycemic index of fasting blood glucose. Further studies with larger patient groups have the potential to demonstrate significant correlations between inflammatory indices and glycated hemoglobin levels.

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Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, Stein C, Basit A, Chan JCN, Mbanya JC, Pavkov ME, Ramachandaran A, Wild SH, James S, Herman WH, Zhang P, Bommer C, Kuo S, Boyko EJ, Magliano DJ (2022) IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 183:109119. https://doi.org/10.1016/j.diabres.2021.109119

American Diabetes Association Professional Practice Committee (2024) 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes-2024. Diabetes Care. 47(Suppl 1):S179-S218. https://doi.org/10.2337/dc24-S010

American Diabetes Association Professional Practice Committee (2024) 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes-2024. Diabetes Care. 47(Suppl 1):S219-S230. https://doi.org/10.2337/dc24-S011

American Diabetes Association Professional Practice Committee (2024) 12. Retinopathy, Neuropathy, and Foot Care: Standards of Care in Diabetes-2024. Diabetes Care. 47(Suppl 1):S231-S243. https://doi.org/10.2337/dc24-S012

American Diabetes Association Professional Practice Committee (2024) 6. Glycemic Goals and Hypoglycemia: Standards of Care in Diabetes-2024. Diabetes Care. 47(Suppl 1):S111-S125. https://doi.org/10.2337/dc24-S006

Dimas AS, Lagou V, Barker A, Knowles JW, Mägi R, Hivert MF, Benazzo A, Rybin D, Jackson AU, Stringham HM, Song C, Fischer-Rosinsky A, Boesgaard TW, Grarup N, Abbasi FA, Assimes TL, Hao K, Yang X, Lecoeur C, Barroso I, Bonnycastle LL, Böttcher Y, Bumpstead S, Chines PS, Erdos MR, Graessler J, Kovacs P, Morken MA, Narisu N, Payne F, Stancakova A, Swift AJ, Tönjes A, Bornstein SR, Cauchi S, Froguel P, Meyre D, Schwarz PE, Häring HU, Smith U, Boehnke M, Bergman RN, Collins FS, Mohlke KL, Tuomilehto J, Quertemous T, Lind L, Hansen T, Pedersen O, Walker M, Pfeiffer AF, Spranger J, Stumvoll M, Meigs JB, Wareham NJ, Kuusisto J, Laakso M, Langenberg C, Dupuis J, Watanabe RM, Florez JC, Ingelsson E, McCarthy MI, Prokopenko I, and MAGIC Investigators (2014) Impact of type 2 diabetes susceptibility variants on quantitative glycemic traits reveals mechanistic heterogeneity. Diabetes. 63(6):2158-2171. https://doi.org/10.2337/db13-0949

Donath MY, Shoelson SE (2011) Type 2 diabetes as an inflammatory disease. Nat Rev Immunol. 11(2):98-107. https://doi.org/10.1038/nri2925

Pérez-Morales RE, Del Pino MD, Valdivielso JM, Ortiz A, Mora-Fernández C, Navarro-González JF (2019) Inflammation in Diabetic Kidney Disease. Nephron. 143(1):12-16. https://doi.org/10.1159/000493278

Fucà G, Guarini V, Antoniotti C, Morano F, Moretto R, Corallo S, Marmorino F, Lonardi S, Rimassa L, Sartore-Bianchi A, Borelli B, Tampellini M, Bustreo S, Claravezza M, Boccaccino A, Murialdo R, Zaniboni A, Tomasello G, Loupakis F, Adamo V, Tonini G, Cortesi E, de Braud F, Cremolini C, Pietrantonio F (2020) The Pan-Immune-Inflammation Value is a new prognostic biomarker in metastatic colorectal cancer: results from a pooled-analysis of the Valentino and TRIBE first-line trials. Br J Cancer. 123(3):403-409. https://doi.org/10.1038/s41416-020-0894-7

Hu B, Yang XR, Xu Y, Sun YF, Sun C, Guo W, Zhang X, Wang WM, Qiu SJ, Zhou J, Fan J (2014) Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res. 20(23):6212-6222. https://doi.org/10.1158/1078-0432.CCR-14-0442

Balta S, Ozturk C (2015) The platelet-lymphocyte ratio: A simple, inexpensive and rapid prognostic marker for cardiovascular events. Platelets. 26(7):680-681. https://doi.org/10.3109/09537104.2014.979340

Zahorec R (2021) Neutrophil-to-lymphocyte ratio, past, present and future perspectives. Bratisl Lek Listy. 122(7):474-488. https://doi.org/10.4149/BLL_2021_078

Guo W, Song Y, Sun Y, Du H, Cai Y, You Q, Fu H, Shao L (2022) Systemic immune-inflammation index is associated with diabetic kidney disease in Type 2 diabetes mellitus patients: Evidence from NHANES 2011-2018. Front Endocrinol (Lausanne). 13:1071465. https://doi.org/10.3389/fendo.2022.1071465

Dong G, Gan M, Xu S, Xie Y, Zhou M, Wu L (2023) The neutrophil-lymphocyte ratio as a risk factor for all-cause and cardiovascular mortality among individuals with diabetes: evidence from the NHANES 2003-2016. Cardiovasc Diabetol. 22(1):267. https://doi.org/10.1186/s12933-023-01998-y

Yamamoto Y, Yamamoto H (2013) RAGE-Mediated Inflammation, Type 2 Diabetes, and Diabetic Vascular Complication. Front Endocrinol (Lausanne). 4:105. https://doi.org/10.3389/fendo.2013.00105

Lin K, Lan Y, Wang A, Yan Y, Ge J (2023) The association between a novel inflammatory biomarker, systemic inflammatory response index and the risk of diabetic cardiovascular complications. Nutr Metab Cardiovasc Dis. 33(7):1389-1397. https://doi.org/10.1016/j.numecd.2023.03.013

Lowe G, Woodward M, Hillis G, Rumley A, Li Q, Harrap S, Marre M, Hamet P, Patel A, Poulter N, Chalmers J (2014) Circulating inflammatory markers and the risk of vascular complications and mortality in people with type 2 diabetes and cardiovascular disease or risk factors: the ADVANCE study. Diabetes. 63(3):1115-1123. https://doi.org/10.2337/db12-1625

American Diabetes Association Professional Practice Committee (2024) 7. Diabetes Technology: Standards of Care in Diabetes-2024. Diabetes Care. 47(Suppl 1):S126-S144. https://doi.org/10.2337/dc24-S007

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Published

2024-04-03

How to Cite

Güven, A. T. (2024). Systemic Immune Inflammation Index and Neutrophil-to-Lymphocyte Ratio Correlate with Fasting Glucose Levels Among Type 2 Diabetic Patients. European Journal of Therapeutics, 30(5), 733–738. https://doi.org/10.58600/eurjther2029

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