title: Usefulness of the neutrophil-to-lymphocyte ratio to prediction of type 2 diabetes mellitus in morbid obesity.
abstract: BACKGROUND
  There is growing consensus in the literature that inflammation plays a central role in the pathophysiology of obesity and type 2 diabetes mellitus (T2DM) and cardiovascular complications. Neutrophil-to-lymphocyte ratio (NLR) provides a simple method for assessment of inflammatory status and it is a new, inexpensive marker. The aim of the present study was to investigate the predictive value of preprocedural (before the OGTT) NLR on development of type 2 diabetes (T2DM) in morbid obesity patients (MOP).
  
  
  METHODS
  306 MOP (body mass index ≥ 40 kg/m(2)) and 95 normal weight patients with normal OGTT [fasting plasma glucose (FPG)<100mg/dL. Two-hour glucose during OGTT<140 mg/dL] were evaluated in this study.
  
  
  RESULTS
  The mean ± SD NLR of MOP was significantly higher than that of patients with normal weight healthy patients (3.67 ± 0.95 vs. 1.82 ± 1.02, P<0.001, respectively). In receiver operating characteristics curve analysis, NLR>3.12 had 79.2% sensitivity and 64.9% specificity in predicting T2DM. Logistic regression analysis showed that elevated NLR (OR: 2.577, 95% CI: 1.363-4.872, P=0.004) was an independent variable for predicting T2DM in MOP.
  
  
  CONCLUSIONS
  MOP have higher NLR than healthy controls. High NLR is a powerful and independent predictor of T2DM in MOP. Elevated NLR levels are usually considered as an inflammatory marker. The results of this study suggested that inflammation plays a role in the pathogenesis of T2DM with MOP.
authors.affiliation: Turgut Ozal University School of Medicine, Department of Internal Medicine, Turkey. Electronic address: drhakkiyilmaz@yahoo.com.
authors.forename: H
authors.initials: H
authors.lastname: Yilmaz
authors.affiliation: Dışkapı Yıldırım Beyazıt Education and Researching Hospital, Department of Endocrinology and Metabolism, Turkey.
authors.forename: B
authors.initials: B
authors.lastname: Ucan
authors.affiliation: Dışkapı Yıldırım Beyazıt Education and Researching Hospital, Department of Endocrinology and Metabolism, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Sayki
authors.affiliation: Dışkapı Yıldırım Beyazıt Education and Researching Hospital, Department of Endocrinology and Metabolism, Turkey.
authors.forename: I
authors.initials: I
authors.lastname: Unsal
authors.affiliation: Dışkapı Yıldırım Beyazıt Education and Researching Hospital, Department of Endocrinology and Metabolism, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Sahin
authors.affiliation: Dışkapı Yıldırım Beyazıt Education and Researching Hospital, Department of Endocrinology and Metabolism, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Ozbek
authors.affiliation: Dışkapı Yıldırım Beyazıt Education and Researching Hospital, Department of Endocrinology and Metabolism, Turkey.
authors.forename: T
authors.initials: T
authors.lastname: Delibasi
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology*; D009767:Obesity, Morbid / Q000150:complications*; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D015415:Biomarkers
keywords: Inflammation marker; Morbid obesity; Neutrophil-to-lymphocyte ratio; Type 2 diabetes mellitus