Neutrophil-To-Lymphocyte Ratio and Glycemic Control in Adults With Type 2 Diabetes Mellitus: A Cross-Sectional Study
DOI:
https://doi.org/10.54536/ajmsi.v5i2.8550Keywords:
Glycated Hemoglobin, Glycemic Control, HbA1c, Neutrophil-To-Lymphocyte Ratio, Systemic Inflammation, Type 2 Diabetes MellitusAbstract
The neutrophil-to-lymphocyte ratio (NLR) is a simple and readily available marker of inflammation, and its relationship with type 2 diabetes mellitus (T2DM) and insulin resistance has been investigated by many researchers; however, its association with long-term glycemic control remains unclear and findings are inconsistent. This cross-sectional laboratory-based study was conducted among 100 adults with T2DM attending Al-Zahawi Private Laboratory for Medical Laboratory Investigations from April to August 2026. Absolute neutrophil and lymphocyte counts were obtained from blood count tests, and NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count, while HbA1c was measured using an automated high-performance liquid chromatography technique. Participants were divided into two groups according to HbA1c levels (<7% and ≥7%), and associations were assessed using Pearson and Spearman correlation, Mann–Whitney U test, partial correlation, and multivariable linear and logistic regression models adjusted for age and sex. The mean NLR was 2.20 ± 1.26, while the mean HbA1c was 7.72 ± 1.87%. Spearman correlation showed no significant association between NLR and HbA1c (p = −0.050, p = 0.619), which was also supported by Pearson correlation (r = 0.106, p = 0.296), the Mann–Whitney U test (p = 0.151), and partial correlation adjusted for age and sex (r = 0.137, p = 0.175). Linear regression also showed that NLR was not independently associated with HbA1c (β = 0.200, p = 0.180), whereas age showed a positive association with HbA1c (β = 0.055, p = 0.041). Logistic regression similarly found no significant association between NLR and poor glycemic control (OR = 1.035, 95% CI: 0.744–1.439, p = 0.839). Overall, NLR was not significantly associated with HbA1c or glycemic control in adults with T2DM, suggesting that it may reflect general systemic inflammation rather than long-term glycemic variations; future longitudinal, multicenter studies are required to further elucidate the metabolic factors influencing this relationship.
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Copyright (c) 2026 Baraa J. Kadhim, Dhulfiqar A. Khaleel, Mohammed H. Abdul Zahra
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