Novel leukocyte and thrombocyte indexes in patients with prediabetes and type 2 diabetes mellitus

A. Klisic, A. Scepanovic, J. Kotur-Stevuljevic, A. Ninic

Primary Health Care Center, University of Montenegro, Faculty of Medicine, Podgorica, Montenegro. aleksandranklisic@gmail.com

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• Diabetes
• Internal Medicine

OBJECTIVE: To our knowledge, there are no studies that investigated the relationship between diabetes mellitus type 2 (T2D) and some novel indexes, such as monocyte/granulocyte to lymphocyte ratio (M/GLR), derived neutrophil to lymphocyte ratio (dNLR), and platelets to neutrophil ratio (PNR). The aim of this study was to examine the association between these novel indexes and glycated hemoglobin (HbA1c) in patients with prediabetes and T2D.

PATIENTS AND METHODS: A total of 827 participants were consecutively recruited. According to the American Diabetes Association (ADA) criteria, participants were divided into control, prediabetes, and T2D group.

RESULTS: White blood cell count (WBC), neutrophil count, NLR, dNLR, and M/GLR were higher in T2D patients than in the other two groups, whereas PNR was the lowest in T2D group. Lymphocyte count was higher in prediabetes and T2D patients than in control group. Multivariable ordinal regression analysis showed that WBC, neutrophil count, lymphocyte count, NLR, dNLR, and M/GLR were positively associated [OR (95% CI) 1.287 (1.191-1.390), p<0.001; 1.427 (1.275-1.594), p<0.001; 1.347 (1.130- 1.606), p=0.001; 1.350 (1.090-1.670), p=0.006; 1.662 (1.189-2.326), p=0.003; 1.275 (1.057-1.540), p=0.012, respectively] with HbA1c. However, PNR was negatively associated with HbA1c [0.987 (0.981-0.993), p<0.001].

CONCLUSIONS: Novel, modified NLR indexes, such as dNLR and M/GLR were independently correlated with HbA1c. Also, PNR showed superiority over platelets (PLT) in relation to HbA1c. These novel indexes might give a significant contribution to the timely recognition of disturbances of glucose homeostasis in patients with prediabetes and overt diabetes.

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