Neutrophil / lymphocyte (N / L) ratio and insulin resistance relationship in obese individuals with normal and impaired glucose tolerance

Obesity is chronic inflamation and oxidative stress state of the body. Oxidative stress markers are increased and anti-oxidative defense enzymes are decreased in obese individuals. Neutrophile/lymphocyte ratio (NLR), is a simple parameter which can be calculated from complete blood count test (conducted on a routine basis) and has been shown to be a marker of inflammation. NLR can be a predictor of glucose intolerance in obese individuals, or may be useful for early detection of glucose intolerance. The aim of this study was to evaluate the relationship between NLR which is an inflammatory marker and insulin resistance in obese individuals with normal and impaired glucose tolerance. In this study; 73 obese patients with a body mass index (BMI) ≥30 kg /m2 and to whom OGTT was perofrmed for screening (group 1: 43 individuals with normal glucose tolerance; group 2: 30 individuals with impaired glucose tolerance and 27 healthy individuals with normal BMI (group 3) were screened retrospectively from their health records. Biochemical parameters of all cases (complete blood count, insulin, HbA1C, lipid profile, ALT, TSH, CRP) were recorded and NLR calculated for each one. Insulin resistance (IR) was determined by using the Homeostasis Model Assessment (HOMA) index. The demographic characteristics of the patients, height, weight and waist circumference were recorded. 59 of the cases were female, 41 were male and the mean age was 36,4 ± 10,4 years. There was a significant difference between the groups in terms of age (p = 0,005). In our study, there was a significant difference between the groups in terms of HOMA-IR as well as BMI, waist circumference, insulin, TSH, CRP and neutrophil count (p<0,05). There was no significant difference between the groups in terms of lymphocyte values and NLR (p>0,05). The comparison of subgroups; in the obese patient group with NGT, compared to healthy control group; insulin, HOMA-IR, TSH, CRP and neutrophil count were significantly higher (p<0,05). In obese patient group with IGT, compared to healthy control group; insulin, HbA1C, HOMA-IR, CRP, neutrophil count and TSH was higher (p<0,05). In obese patient group with IGT; HbA1C and HOMA-IR levels were significantly higher than the obese patient gorup with NGT (p<0,05). Determination of high CRP in obese patients indicates the presence of inflammation in obesity. In obese cases, as well as increased CRP levels, increased neutrophil counts may also be a marker for progression of diabetes in future, especially in patients with impaired glucose tolerance. In the obese group with BGT a significant positive correlation between neutrophil count and BMI; and in the obese group with NGT, a significant positive correlation between CRP and BMI, CRP and waist circumference are supporting this statement. In contrast, in our study there was no significant difference between the groups in terms of NLR values and there was no correlation between the IR and NLR. According to this; impairment of glucose tolerance in obese patients thought not to affect NLR significantly. Key words: Neutrophil, diabetes mellitus, obesity, CRP, insulin resistance, neutrophil / lymphocyte ratio