Keywords
Metabolic syndrome
Inflammation
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Abstract
Objective: To investigate the possible correlation between increased insulin resistance, calculated using the HOMA-IR index, and changes in inflammatory response parameters, with a focus on total neutrophils, total lymphocytes, and the neutrophil-to-lymphocyte ratio (NLR), in patients affiliated with the Municipal Health Department of a metropolitan region in Curitiba. Methods: This was an analytical, cross-sectional, and retrospective study involving 186 individuals of both sexes. Laboratory tests (complete blood count, insulin, and glucose) were performed. Neutrophils, lymphocytes, NLR, and HOMA-IR were analyzed. Results: Patients with HOMA-IR ≥ 2.71 were classified as having increased insulin resistance. The correlation between HOMA-IR and leukocyte parameters was assessed using descriptive analysis and Spearman’s correlation. The results indicated a weak but positive correlation between HOMA-IR and total neutrophils (ρ=0.352, p<0.001) and total lymphocytes (ρ=0.300, p<0.001). However, no significant correlation was found for the neutrophil-to-lymphocyte ratio (ρ=0.123, p=0.093). Conclusion: Increased insulin resistance is associated with elevated total neutrophil and lymphocyte counts but does not significantly affect the neutrophil-to-lymphocyte ratio. Study limitations include the lack of assessment of comorbidities, anthropometric data, and additional inflammatory markers.
References
BAGYURA Z, et al. Neutrophil-to-lymphocyte ratio is an independent risk factor for coronary artery disease in central obesity. International Journal of Molecular Sciences, 2023; 24: 7397.
BALTA S, et al. The relation between atherosclerosis and the neutrophil-lymphocyte ratio. Clinical and Applied Thrombosis/Hemostasis, 2016; 22: 405-411.
BARAKAT B, ALMEIDA MEF. Biochemical and immunological changes in obesity. Archives of Biochemistry and Biophysics, 2021; 708: 108951.
CHRISTOU KA, et al. Metabolically healthy obesity is characterized by a proinflammatory phenotype of circulating. Metabolic Syndrome and Related Disorders, 2019; XX: 1-7.
ELLINGER VCM, et al. Relation between insulin resistance and hematological parameters in a Brazilian sample. Arquivos Brasileiros de Endocrinologia e Metabologia, 2006; 50: 114–117.
ENGİN A. The definition and prevalence of obesity and metabolic syndrome. Advances in Experimental Medicine and Biology, 2017; 960: 1-17.
GRANDL G, WOLFRUM C. Hemostasis, endothelial stress, inflammation, and the metabolic syndrome. Seminars in Immunopathology, 2018; 40: 215-224.
HASHEMI MP, et al. Is the neutrophil-to-lymphocyte ratio an exceptional indicator for metabolic syndrome disease and outcomes? Endocrine Practice, 2022; 28:342-348.
LEHRSKOV LL, CHRISTENSEN RH. The role of interleukin-6 in glucose homeostasis and lipid metabolism. Seminars in immunopathology. 2019; 41:491-499.
MARRA A, et al. The neutrophil to lymphocyte ratio (NLR) positively correlates with the presence and severity of metabolic syndrome in obese adults, but not in obese children/adolescents. BMC Endocrine Disorders, 2023; 23: 121.
PURDY JC, SHATZEL JJ. The hematologic consequences of obesity. European Journal of Haematology, 2021; 106: 306–319.
QIU Z, et al. Predictive role of neutrophil-to-lymphocyte ratio in metabolic syndrome: meta-analysis of 70,937 individuals. BMC Endocrine Disorders, 2024; 24: 155.
RAMKHELAWON B, et al. Netrin-1 promotes adipose tissue macrophage retention and insulin resistance in obesity. Nature medicine, 2014; 20:377-84.
ROHM TV, et al. Inflammation in obesity, diabetes, and related disorders. Immunity, 2022: 55: 31-55.
RUBINO F, et al. Definition and diagnostic criteria of clinical obesity. The Lancet Diabetes & Endocrinology, 2025; 13: 221-262.
SILVEIRA ROSSI JL, et al. Metabolic syndrome and cardiovascular diseases: going beyond traditional risk factors. Diabetes Metabolism Research and Reviews, 2022; 38: e3502.
SOCIEDADE BRASILEIRA DE DIABETES – SBD. Diretrizes da Sociedade Brasileira de Diabetes 2019-2020. São Paulo: Câmara Brasileira do Livro, 2019.
XU L, et al. Roles of Chemokines and Chemokine Receptors in Obesity-Associated Insulin Resistance and Nonalcoholic Fatty Liver Disease. Biomolecules, 2015; 5:1563-79.
ZAHOREC R. Neutrophil-to-lymphocyte ratio, past, present and future perspectives. Bratislava Medical Journal, 2021; 122: 474–488.
ZHANG SS, et al. Leukocyte related parameters in older adults with metabolically healthy and unhealthy overweight or obesity. Scientific Reports, 2021; 11: 4652.