review · Journal of Diabetes Research
Glycated haemoglobin is standardly used to evaluate glycemic control in patients with type 2 diabetes mellitus, yet it does not capture underlying inflammatory processes. The neutrophil-to-lymphocyte ratio offers a practical method to track these inflammatory changes. Through a systematic review and meta-analysis of thirteen eligible studies published up to July 2021, the relationship between this inflammatory ratio and blood sugar regulation was evaluated using a random effects model. The analysis revealed a standardized mean difference of 0.79 in neutrophil-to-lymphocyte ratio levels when comparing individuals with poor versus good glycemic control. Furthermore, elevated ratios showed a statistically significant link to poor glycemic control, with an odds ratio of 1.50. These pooled findings indicate that higher neutrophil-to-lymphocyte ratios correspond to elevated glycated haemoglobin, supporting its potential role as a supplementary clinical marker.
Managing type 2 diabetes traditionally relies on monitoring blood glucose levels via glycated haemoglobin, which overlooks internal inflammation. By establishing that a high neutrophil-to-lymphocyte ratio correlates with poorer glycemic control, this work supports using an accessible immune marker to gain a more complete picture of patient health and disease progression.
The findings point towards the potential clinical use of the neutrophil-to-lymphocyte ratio as an adjunct diagnostic marker for healthcare providers monitoring type 2 diabetes. Because the research is a meta-analysis of existing observational studies, translation into formal clinical practice guidelines or standardised diagnostic tools remains at an early to intermediate stage, requiring validated clinical protocols before routine adoption.
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Background: Glycated hemoglobin (HbA1c) is a commonly used clinical marker to monitor the control of type 2 diabetes mellitus patients (T2DM). However, it is unable to identify the ongoing inflammatory changes in the body. These factors could be easily identified and monitored by the neutrophil-to-lymphocyte ratio (NLR). Therefore, this study is aimed at investigating the relationship between NLR and glycemic control in T2DM. Method: A comprehensive search of eligible studies was performed in various databases published until July 2021. A random effect model was used to estimate the standardized mean difference (SMD). A metaregression, subgroup, and sensitivity analysis were conducted to search for potential sources of heterogeneity. Result: A total of 13 studies were included in this study. Accordingly, the SMD of the NLR values between the poor and good glycemic control groups was 0.79 (95% CI, 0.46-1.12). Our study also showed that high NLR was significantly associated with poor glycemic control in T2DM patients (OR = 1.50, 95% CI: 1.30-1.93). Conclusion: The results of this study suggest an association between high NLR values and an elevated HbA1C in T2DM patients. Therefore, NLR should be considered a marker of glycemic control in addition to HbA1c in T2DM patients.
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DOI: 10.1155/2023/3117396
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