Neutrophil-to-Lymphocyte Ratio and Insulin Resistance Relationship in Obese Individuals with Normal and Impaired Glucose Tolerance

Yıl 2022, Cilt: 3 Sayı: 1, 265 - 272, 07.04.2022

Eyyüp Murat Efendioğlu Mustafa Araz

Öz

Neutrophil-to-lymphocyte ratio (NLR) may be a predictor of glucose intolerance in obese individuals and may be useful in the early detection of glucose intolerance. In this study, we aimed to investigate the relationship between NLR and insulin resistance (IR) in obese individuals with normal and impaired glucose tolerance. Seventy-three obese patients and 27 healthy controls were included in this study. The participants' sociodemographic characteristics, anthropometric measurements (height, body weight, and waist circumference), fasting plasma glucose, oral glucose tolerance test (OGTT), insulin, HbA1C, total cholesterol, triglyceride, HDL, TSH, complete blood count, and C-reactive protein (CRP) results were obtained from the files. Homeostasis Model Assessment Insulin Resistance (HOMA-IR) values were calculated. The mean age of the 100 patients was 36.4±10.5 years, and 59.0% were female. There was a statistically significant positive correlation between the HOMA-IR and the BMI (r = 0.457, p = 0.000), HbA1C (r = 0.359, p = 0.000), CRP (r = 0.444, p = 0.000), and waist circumference (r = 0.478, p = 0.000). There was no statistically significant difference between the obese and healthy control groups in terms of NLR. However, there was a significant difference in NLR, CRP, and neutrophil counts between the high HOMA-IR and normal HOMA-IR groups. In our study, neutrophil counts and CRP were determined to be higher among obese individuals than among healthy individuals. The NLR was increased significantly among patients with IR.

Anahtar Kelimeler

Obesity, insulin resistance, neutrophil-to-lymphocyte ratio

Kaynakça

• Lumeng CN, Saltiel AR. Inflammatory links between obesity and metabolic disease. J Clin Invest. 2011 Jun;121(6):2111–7.
• Heilbronn LK, Campbell L V. Adipose tissue macrophages, low grade inflammation and insulin resistance in human obesity. Curr Pharm Des. 2008;14(12):1225–30.
• Eriksson J, Franssila-Kallunki A, Ekstrand A, Saloranta C, Widén E, Schalin C, et al. Early metabolic defects in persons at increased risk for non-insulin-dependent diabetes mellitus. N Engl J Med. 1989 Aug;321(6):337–43.
• Zimmet PZ, McCarty DJ, de Courten MP. The global epidemiology of non-insulin-dependent diabetes mellitus and the metabolic syndrome. J Diabetes Complications. 1997;11(2):60–8.
• Shoelson SE, Lee J, Goldfine AB. Inflammation and insulin resistance. J Clin Invest. 2006 Jul;116(7):1793–801.
• Zulfic Z, Weickert CS, Weickert TW, Liu D, Myles N, Galletly C. Neutrophil-lymphocyte ratio - a simple, accessible measure of inflammation, morbidity and prognosis in psychiatric disorders? Australas psychiatry Bull R Aust New Zeal Coll Psychiatr. 2020 Aug;28(4):454–8.
• Faria SS, Fernandes PCJ, Silva MJB, Lima VC, Fontes W, Freitas-Junior R, et al. The neutrophil-to-lymphocyte ratio: a narrative review. Ecancermedicalscience. 2016;10:702.
• Tamhane UU, Aneja S, Montgomery D, Rogers E-K, Eagle KA, Gurm HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol. 2008 Sep;102(6):653–7.
• Benites-Zapata VA, Hernandez A V, Nagarajan V, Cauthen CA, Starling RC, Tang WHW. Usefulness of neutrophil-to-lymphocyte ratio in risk stratification of patients with advanced heart failure. Am J Cardiol. 2015 Jan;115(1):57–61.
• Shao Q, Chen K, Rha S-W, Lim H-E, Li G, Liu T. Usefulness of Neutrophil/Lymphocyte Ratio as a Predictor of Atrial Fibrillation: A Meta-analysis. Arch Med Res. 2015 Apr;46(3):199–206.
• Tsai P-L, Su W-J, Leung W-H, Lai C-T, Liu C-K. Neutrophil-lymphocyte ratio and CEA level as prognostic and predictive factors in colorectal cancer: A systematic review and meta-analysis. J Cancer Res Ther. 2016;12(2):582–9.
• Dimitriou N, Felekouras E, Karavokyros I, Alexandrou A, Pikoulis E, Griniatsos J. Neutrophils to lymphocytes ratio as a useful prognosticator for stage II colorectal cancer patients. BMC Cancer. 2018 Dec;18(1):1202.
• Imtiaz F, Shafique K, Mirza SS, Ayoob Z, Vart P, Rao S. Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population. Int Arch Med. 2012 Jan;5(1):2.
• Karakaya S, Altay M, Kaplan Efe F, Karadağ İ, Ünsal O, Bulur O, et al. The neutrophil-lymphocyte ratio and its relationship with insulin resistance in obesity. Turkish J Med Sci. 2019 Feb;49(1):245–8.
• Xu H, Barnes GT, Yang Q, Tan G, Yang D, Chou CJ, et al. Chronic inflammation in fat plays a crucial role in the development of obesity-related insulin resistance. J Clin Invest. 2003 Dec;112(12):1821–30.
• Rajwani A, Cubbon RM, Wheatcroft SB. Cell-specific insulin resistance: implications for atherosclerosis. Diabetes Metab Res Rev. 2012 Nov;28(8):627–34.
• Ellulu MS, Patimah I, Khaza’ai H, Rahmat A, Abed Y. Obesity and inflammation: the linking mechanism and the complications. Arch Med Sci. 2017 Jun;13(4):851–63.
• Durmaz Z. The ratio of neutrophil lymphocytes and CRP comparison in young obese. 2017;(August).
• Furuncuoğlu Y, Tulgar S, Dogan AN, Cakar S, Tulgar YK, Cakiroglu B. How obesity affects the neutrophil/lymphocyte and platelet/lymphocyte ratio, systemic immune-inflammatory index and platelet indices: a retrospective study. Eur Rev Med Pharmacol Sci. 2016 Apr;20(7):1300–6.
• Aydin M, Yilmaz A, Donma MM, Tulubas F, Demirkol M, Erdogan M, et al. Neutrophil/lymphocyte ratio in obese adolescents. North Clin Istanbul. 2015;2(2):87–91.
• Angkananard T, Anothaisintawee T, McEvoy M, Attia J, Thakkinstian A. Neutrophil Lymphocyte Ratio and Cardiovascular Disease Risk: A Systematic Review and Meta-Analysis. Biomed Res Int. 2018;2018:2703518.
• Oh BS, Jang JW, Kwon JH, You CR, Chung KW, Kay CS, et al. Prognostic value of C-reactive protein and neutrophil-to-lymphocyte ratio in patients with hepatocellular carcinoma. BMC Cancer. 2013 Feb;13:78.
• Bahadır A, Baltacı D, Türker Y, Türker Y, Iliev D, Öztürk S, et al. Is the neutrophil-to-lymphocyte ratio indicative of inflammatory state in patients with obesity and metabolic syndrome? Anatol J Cardiol. 2015 Oct;15(10):816–22.
• Mertoglu C, Gunay M. Neutrophil-Lymphocyte ratio and Platelet-Lymphocyte ratio as useful predictive markers of prediabetes and diabetes mellitus. Diabetes Metab Syndr. 2017 Nov;11 Suppl 1:S127–31.
• Lou M, Luo P, Tang R, Peng Y, Yu S, Huang W, et al. Relationship between neutrophil-lymphocyte ratio and insulin resistance in newly diagnosed type 2 diabetes mellitus patients. BMC Endocr Disord. 2015 Mar;15:9.
• Shiny A, Bibin YS, Shanthirani CS, Regin BS, Anjana RM, Balasubramanyam M, et al. Association of neutrophil-lymphocyte ratio with glucose intolerance: an indicator of systemic inflammation in patients with type 2 diabetes. Diabetes Technol Ther. 2014 Aug;16(8):524–30.