NÖTROFİL/LENFOSİT ORANI PREDİYABETİK HASTALARDA İNSÜLİN DİRENCİ TAHMİNİNDE HOMA-IR İNDEKSİNE ALTERNATİF BİR BELİRTEÇ OLABİLİR Mİ?: BİR RETROSPEKTİF ÇALIŞMA
Abstract
Amaç: Çalışmamızda prediyabet ve diyabet olmayan hastalarda HOMA-IR indeksi ile Trigliserid/Glukoz (TyG) indeksi, LDL-K/HDL-K oranını, Trigliserid/ HDL-K oranını ve Nötrofil/ Lenfosit Oranını (NLO) bir biri ile karşılaştırmayı amaçladık. Gereç ve Yöntem: Çalışmamıza Niğde Ömer Halisdemir Üniversitesi Eğitim ve Araştırma Hastanesine 2019-2021 yılları arasında başvuran 18-75 yaş arasında 673’ü kadın 890’ü erkeklerden oluşan toplam 1433 hasta dahil edilmiştir. HOMA-IR indeksi, TyG indeksi, LDL-K/HDL-K oranı, Trigliserid/ HDL-K oranı, NLO hesaplamaları analizi yapılan testler vasıtasıyla yapılmıştır. Bulgular: Bulgularımıza göre diyabetik olmayan grupta Trigliserid/HDL-K oranının ve pre-diyabetik grupta NLO’nun rutinde kullanılan yöntem olan HOMA-IR indeksine göre hem de IR tahmininde kullanılan diğer indekslere göre duyarlılığı ve özgüllüğünün daha yüksek olduğu tespit edildi. Ayrıca diyabetik olmayan grupta Trigliserid/HDL-K oranı ile HOMA-IR indeksi arasında pozitif anlamlı bir korelasyon sonucuna ulaşılırken (r=0,219; p<0,001), pre-diyabetik grupta NLO ile HOMA-IR indeksi arasında anlamlı bir korelasyon sonucu bulunamadı (r=0,034; p=0,290). Sonuç: Sonuç olarak, NLO pre-diyabetik hastalarda IR tahmininde HOMAIR yerine alternatif bir parametre olabilir. Ancak bunun referans yöntem ile verifikasyonu yapılan prospektif çalışmalar ile doğrulanması gerektiği düşüncesindeyiz.
Keywords
Trigliserid/HDL-K oranı TyG indeksi HOMA-IR oranı LDL-K/HDL-K oranı NLO insülin resistansı metabolik sendrom
References
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COULD THE NEUTROPHIL/LYMPHOCYTE RATIO BE AN ALTERNATIVE MARKER FOR THE PREDICTION OF INSULIN RESISTANCE IN PREDIABETIC PATIENTS?: A RETROSPECTIVE STUDY
Abstract
Objective: In our study, we aimed to compare Triglyceride/Glucose (TyG) index, LDL-C/HDL-C ratio, Triglyceride/HDL-C ratio, and Neutrophil/ Lymphocyte Ratio (NLR) with the HOMA-IR index in non-diabetes and prediabetes. Material and methods: A total of 1433 patients were included 673 women, and 890 men, aged between 18-75 years, applied to Niğde Ömer Halisdemir University Training and Research Hospital between 2019-2021 in our study. HOMA-IR index, TyG index, LDL-C/HDL-C ratio, Triglyceride/ HDL-C ratio, and NLO values were calculated by means of the analyzed tests. Results: According to our findings, the sensitivity and specificity of the Triglyceride/HDL-C ratio in the non-diabetic group and the NLR in the prediabetic group were higher than the routinely used method, the HOMA-IR index, as well as other indexes used in IR estimation. In addition, while a positive significant correlation was found between the Triglyceride/HDL-C ratio and the HOMA-IR index in the non-diabetic group (r=0.219; p<0.001), there was no significant correlation between NLR and HOMA-IR index in the pre-diabetic group (r=0.219; p<0.001), r=0.034; p=0.290). Conclusion: NLR may be an alternative parameter to predict IR in prediabetic patients. However, we think that there is a need for prospective studies that are verified by the reference method.
Keywords
Triglyceride/HDL-C ratio TyG index HOMA-IR ratio LDL-C/HDL-C ratio NLO insulin resistance metabolic syndrome
References
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- 2. Buchanan T A, Watanabe R M, Xiang A H. Limitations in surrogate measures of insulin resistance. J Clin Endocrinol Metab 2010;95(11):4874-6. google scholar
- 3. Thompson DS, Boyne MS, Osmond C, Ferguson TS, Tulloch-Reid MK, Wilks RJ, et al. Limitations of fasting indices in the measurement of insulin sensitivity in Afro-Caribbean adults. BMC Res Notes 2014;7(1):98. google scholar
- 4. Unger G, Benozzi F S, Perruza F, Pennacchiotti L G. Triglycerides and glucose index: A useful indicator of insulin resistance. Endocrinol Nutr 2014;61(10):533-40. google scholar
- 5. Kang B, Yang Y, Lee EY, Yang HK, Kim HS, Lim SY, et al.Triglycerides/ glucose index is a useful surrogate marker of insulin resistance among adolescents. Int J Obes 2017;41(5):789-92. google scholar
- 6. Roa Barrios M, Arata-Bellabarba G, Valeri L, Velazquez-Maldonado E. Relationship between the triglyceride/high-density lipoproteincholesterol ratio, insulin resistance index and cardiometabolic risk factors in women with polycystic ovary syndrome. Endocrinol Nutr 2009;56(2):59-65. google scholar
- 7. Aslan Çin NN, Yardımcı H, Koç N, Uçaktürk SA, Akçil Ok M. Triglycerides/high-density lipoprotein cholesterol is a predictor similar to the triglyceride-glucose index for the diagnosis of metabolic syndrome using International Diabetes Federation criteria of insulin resistance in obese adolescents: a cross-sectional study. J Pediatr Endocrinol Metab 2020;33(6):777-84. google scholar
- 8. Hong S, Han K, Park C-Y. The triglyceride glucose index is a simple and low-cost marker associated with atherosclerotic cardiovascular disease: a population-based study. BMC Med 2020;18(1):361. google scholar
- 9. Guerrero-Romero F, Simental-Mendía LE, González-Ortiz M, Martínez-Abundis E, Ramos-Zavala MaG, Hernández-González SO, et al. The product of triglycerides and glucose, a simple measure of insulin sensitivity. comparison with the euglycemic-hyperinsulinemic clamp. J Clin Endocrinol Metab 2010;95(7):3347-51. google scholar
- 10. Lou M, Luo P, Tang R, Peng Y, Yu S, Huang W, et al. Relationship between neutrophil-lymphocyte ratio and insulin resistance in newly diagnosed type 2 diabetes mellitus patients. BMC Endocr Disord 2015;15:9. google scholar
- 11. Rodríguez-Rodríguez E, Salas-González MD, Ortega RM, López-Sobaler AM. Leukocytes and neutrophil-lymphocyte ratio as indicators of insulin resistance in overweight/obese schoolchildren. Front Nutr 2021;8:811081. google scholar
- 12. American Diabetes Association; 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes 2021. Diabetes Care 2021;44 (Supplement_1):15-33. google scholar
- 13. Chen Y, Zhang X, Pan B, Jin X, Yao H, Chen B, et al.A modified formula for calculating low-density lipoprotein cholesterol values. Lipids Health Dis 2010;9(1):52. google scholar
- 14. Kamon T, Kaneko H, Itoh H, Kiriyama H, Koyama K, Fujiu K, et al. Association between insulin resistance and left ventricular diastolic dysfunction in non-diabetic general population. Eur Heart J 2020;41(Supplement_2):3057. google scholar
- 15. Hirschler V, Maccallini G, Sanchez M, Gonzalez C, Molinari C. Association between triglyceride to HDL-C ratio and insulin resistance in indigenous Argentinean children. Pediatr Diabetes 2015;16(8):606-12. google scholar
- 16. Giannini C, Santoro N, Caprio S, Kim G, Lartaud D, Shaw M, et al. The triglyceride-to-HDL cholesterol ratio: association with insulin resistance in obese youths of different ethnic backgrounds. Diabetes Care 2011;34(8):1869-74. google scholar
- 17. Kang HT, Yoon JH, Kim JY, Ahn SK, Linton JA, Koh SB, et al. The association between the ratio of triglyceride to HDL-C and insulin resistance according to waist circumference in a rural Korean population. Nutr Metab Cardiovasc Dis 2012;22(12):1054-60. google scholar
- 18. Yeh WC, Tsao YC, Li WC, Tzeng IS, Chen LS, Chen JY. Elevated triglyceride-to-HDL cholesterol ratio is an indicator for insulin resistance in middle-aged and elderly Taiwanese population: a cross-sectional study. Lipids Health Dis 2019;18(1):176. google scholar
- 19. Sumner AE, Finley KB, Genovese DJ, Criqui MH, Boston RC. Fasting triglyceride and the triglyceride-HDL cholesterol ratio are not markers of insulin resistance in African Americans. Arch Intern Med 2005;165(12):1395-400. google scholar
- 20. Kimm H, Lee SW, Lee HS, Shim KW, Cho CY, Yun JE, et al. Associations between lipid measures and metabolic syndrome, insulin resistance and adiponectin: usefulness of lipid ratios in Korean men and women. Circ J 2010;74(5):931-7 google scholar
- 21. Kuang M, Peng N, Qiu J, Zhong Y, Zou Y, Sheng G. Association of LDL:HDL ratio with prediabetes risk: a longitudinal observational study based on Chinese adults. Lipids Health Dis 2022;21(1):44. google scholar
- 22. Novida H, Murtiwi S, Tjokroprawiro A, Pranoto A, Sutjahjo A, Soelistijo SA, et al. Are there any correlations between ratio LDL-C/HDL-C and lipoprotein (A) with insulin resistance in type 2 diabetes patients with abdominal obesity? Diabetes Res Clin Pract 2014;106(Supp1):S208. google scholar
- 23. Rahmayani R, Aman AK, Safril S. The association of insulin resistance and lipid profile ratio in metabolic syndrome. Indones J Clin Path Med Labor 2019;25(1):21-5. google scholar
- 24. Efendioğlu EM, Mustafa A. Neutrophil-to-lymphocyte ratio and insulin resistance relationship in obese individuals with normal and impaired glucose tolerance. Exper Appl Med Sci 2022;3(1):265-72. google scholar
- 25. Karakaya S, Altay M, Efe FK, Karadağ İ, Ünsal O, Bulur O, et al. The neutrophil-lymphocyte ratio and its relationship with insulin resistance in obesity. Turk J Med. Sci 2019;49(1):245-8. google scholar
- 26. Zafar U, Ali Z, Khaliq S, Lone KP. Correlation of insulin resistance with neutrophil to lymphocyte ratio and serum ferritin in male patients of metabolic syndrome. J Pak Med Assoc 2022;72(4):696-701. google scholar
- 27. Rodríguez-Rodríguez E, Salas-González MD, Ortega RM, López-Sobaler AM. Leukocytes and neutrophil-lymphocyte ratio as indicators of insulin resistance in overweight/obese schoolchildren. Frontiers Nut 2022;8:811081. google scholar
- 28. Wang J, Zhu Q-W, Cheng X-Y, Sha C-X, Cui Y-B. Clinical significance of neutrophil-lymphocyte ratio and monocyte-lymphocyte ratio in women with hyperglycemia. Postgraduate Med 2020;132(8):702-8. google scholar
- 29. Sefil F, Ulutas KT, Dokuyucu R, Sumbul AT, Yengil E, Yagiz AE, et al. Investigation of neutrophil lymphocyte ratio and blood glucose regulation in patients with type 2 diabetes mellitus. J Int Med Res 2014;42(2):581-8. google scholar
- 30. Hussain M, Babar MZM, Akhtar L, Hussain MS. Neutrophil lymphocyte ratio (NLR): A well assessment tool of glycemic control in type 2 diabetic patients. Pak J Med Sci 2017;33(6):1366-70. google scholar
- 31. Akin S, Aydin Z, Yilmaz G, Aliustaoglu M, Keskin O. Evaluation of the relationship between glycaemic regulation parameters and neutrophil-to-lymphocyte ratio in type 2 diabetic patients. EMJ Diabet 2019;7(1):91-6. google scholar
- 32. Mendes BB, Oliveira ACR, Alcântara KC. Comparison of the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in normoglycemic and hyperglycemic subjects. Einstein (Sao Paulo) 2019;17(1):eAO4403. google scholar
- 33. Liu CC, Ko HJ, Liu WS, Hung CL, Hu KC, Yu LY, et al. Neutrophil-to-lymphocyte ratio as a predictive marker of metabolic syndrome. Med (Baltimore) 2019;98(43):e17537. doi: 10.1097/ MD.0000000000017537. google scholar
- 34. Hashemi Moghanjoughi P, Neshat S, Rezaei A, Heshmat-Ghahdarijani K. Is the neutrophil-to-lymphocyte ratio an exceptional indicator for metabolic syndrome disease and outcomes? Endocr Pract 2022;28(3):342-8. google scholar
- 35. Li J, Chen Q, Luo X, Hong J, Pan K, Lin X, et al. Neutrophil-to-lymphocyte ratio positively correlates to age in healthy population. J Clin Lab Anal 2015;29(6):437-43. google scholar
- 36. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013;28(2):169-80. google scholar
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | February 28, 2023 |
| Submission Date | October 1, 2022 |
| Published in Issue | Year 2023 Volume: 6 Issue: 1 |
