title: High neutrophil-to-lymphocyte ratio is associated with increased carotid artery intima-media thickness in type 2 diabetes.
abstract: OBJECTIVE
  Emerging evidence suggests that the neutrophil-to-lymphocyte ratio (NLR) is a novel potential marker of inflammatory responses. The objective was to evaluate the association between NLR and carotid artery intima-media thickness (cIMT) in type 2 diabetes.
  
  
  METHODS
  We carried out a case-control study involving 320 patients with type 2 diabetes, and 250 age-, sex- and body mass index-matched healthy controls who all underwent carotid ultrasonography and took a blood examination. We divided the diabetes patients into two groups according to cIMT: 188 diabetes patients with high cIMT and 132 diabetes patients with low cIMT, and compared baseline characteristics and NLR between the two groups and healthy controls.
  
  
  RESULTS
  The mean NLR was significantly higher in the group of diabetes patients with high cIMT than the group of diabetes patients with low cIMT, who in turn showed a significantly higher NLR compared with control participants. Logistic regression analysis showed that the NLR was an independent risk factor for diabetes patients with high cIMT (odds ratio 140.89, 95% CI 1.71-11615.30, P = 0.028). Based on the receiver operating characteristic curve, use of the NLR as an indicator for diabetes patients with high cIMT diagnosis was projected to be 3.16, and yielded a sensitivity and specificity of 36.2% and 93.2%, respectively, with an area under the curve of 0.606 (95% CI 0.544-0.667).
  
  
  CONCLUSIONS
  High NLR might be a potential biomarker for the increased cIMT in type 2 diabetes patients. Future studies are required to validate our findings.
authors.affiliation: Department of Gerontology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China.
authors.forename: Xueqin
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Neurology, Huai'an Hospital Affiliated of Xuzhou Medical College and Huai'an Second People's Hospital, Huai'an, Jiangsu, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Shen
authors.affiliation: Department of Gerontology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China.
authors.forename: Zhenghong
authors.initials: Z
authors.lastname: Lu
authors.affiliation: Department of Gerontology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China.
authors.forename: Min
authors.initials: M
authors.lastname: Chen
authors.affiliation: Department of Gerontology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China.
authors.forename: Xiaozheng
authors.initials: X
authors.lastname: Fang
authors.affiliation: Department of Urology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China.
authors.forename: Gongcheng
authors.initials: G
authors.lastname: Wang
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology*; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism*; D012372:ROC Curve
chemical_list: D015415:Biomarkers
keywords: Carotid artery intima-media thickness; Neutrophil-to-lymphocyte ratio; Type 2 diabetes