Platelet–Lymphocyte Ratio, Neutrophil–Lymphocyte Ratio and Their Dynamic Changes with Type 2 Diabetes Mellitus: A Cohort Study in China

ABSTRACT

Background

This study aimed at investigating the relationships between Platelet-Lymphocyte ratio (PLR) and Neutrophil–Lymphocyte ratio (NLR) and their dynamic changes (∆PLR, ∆NLR) with type 2 diabetes mellitus (T2DM) in a Chinese cohort study.

Methods

This study recruited 41,439 individuals who were diagnosed without T2DM at first health examination and completed at least one follow-up. The relationships between NLR, PLR, ∆PLR, ∆NLR and T2DM risk were analyzed using the Cox regression model with corresponding Hazard Ratios (HRs) and 95% Confidence Intervals (CIs).

Results

PLR exhibited significant correlation with T2DM risk in a linear reverse dose–response pattern, the corresponding HRs and 95% CIs were 0.81 (0.72, 0.90), 0.71 (0.63, 0.80) and 0.56 (0.49, 0.64) respectively (P_trend < 0.001) for Q2, Q3 and Q4 vs Q1 after adjusting for age, gender, BMI, TG, TC, HDL-C, FPG, ALT, AST, heart rate, smoking, family history of diabetes, and alcohol consumption at baseline in Model 3. The significance remained in subgroups of women, <45 years, ≥45 years, BMI ≥ 24, with fatty liver disease, without fatty liver disease and normotension. Comparing with the largest decrease group of NLR (∆NLR < −0.32), the risk of T2DM increased for −0.003 ≤ ∆NLR < 0.31 (HR 1.17, 95% CI 1.01–1.36) and ∆NLR ≥ 0.31 (HR 1.23, 95% CI 1.06–1.43).

Conclusions

Higher PLR could reduce the risk of T2DM. Larger increase of NLR could increase T2DM risk.

KEYWORDS:

• Diabetes
• cohort study
• Chinese
• platelet–lymphocyte ratio
• neutrophil–lymphocyte ratio
• inflammation

Acknowledgments

The authors thank all the doctors and nurses at the physical examination center of Xiaotangshan Hospital for collecting the data. This research was funded by the Guangdong Province College Students’ Innovative Entrepreneurial Training Plan Program (grant number S202110590056).

Authorship

FH conceived and designed the study, CZ, HC, YL and SC wrote the manuscript, HC, CW, SX, XP, HC and LW participated in data analysis, DZ, CW, PZ and YL participated in data collection and manuscript revision, MZ and DH revised the manuscript and language editing. All authors have read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author, [FH], upon reasonable request.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/07435800.2022.2127757

Additional information

Funding

This research was funded by the Guangdong Province College Students’ Innovative Entrepreneurial Training Plan Program (grant number S202110590056).