Ghasempour Dabaghi Ghazal, Rabiee Rad Mehrdad, Mortaheb Mohammadreza, Darouei Bahar, Amani-Beni Reza, Mazaheri-Tehrani Sadegh, Izadan Mahshad, Touhidi Ali
From the Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Science, Isfahan, Iran.
Cardiol Rev. 2025;33(3):202-211. doi: 10.1097/CRD.0000000000000820. Epub 2024 Nov 12.
The neutrophil-to-lymphocyte ratio (NLR) has been found as a potential biomarker for acute inflammation and the prognosis of different diseases. Here, we provided a meta-analysis of studies evaluating the association of NLR with cardiovascular outcomes among patients with diabetes. We searched PubMed, Scopus, and Web of Science databases from inception to April 06, 2024, to include papers based on eligible criteria. The outcomes of interest were all-cause mortality, cardiovascular mortality, major adverse cardiovascular events, myocardial infarction, and stroke. The pooled risk ratio (RR) and corresponding 95% confidence intervals (CI) were reported. Meta-analysis was performed using StataMP 14.0. A total of 15 studies involving 407,512 participants were included. Meta-analysis revealed that both categorical and continuous NLRs are linked to increased risk of all-cause mortality (RR = 1.68; 95% CI, 1.49-1.88; P < 0.001 and RR = 1.03; 95% CI, 1.03-1.03; P < 0.001, respectively) and cardiovascular mortality (RR = 2.04; 95% CI, 1.58-2.63; P < 0.001 and RR = 1.25; 95% CI, 1.19-1.32; P < 0.001, respectively) in patients with diabetes. However, NLR was not associated with the risk of major adverse cardiovascular events, myocardial infarction, and stroke in patients with diabetes. Subgroup analysis revealed sample size as the main source of the heterogeneity found between studies. The findings suggest NLR as a prognostic marker for mortality outcomes in patients with diabetes, providing clinicians with a noninvasive and readily available indicator for risk assessment and patient management.
中性粒细胞与淋巴细胞比值（NLR）已被发现是急性炎症和不同疾病预后的潜在生物标志物。在此，我们对评估NLR与糖尿病患者心血管结局之间关联的研究进行了荟萃分析。我们检索了从数据库建立到2024年4月6日的PubMed、Scopus和Web of Science数据库，以纳入符合入选标准的论文。感兴趣的结局包括全因死亡率、心血管死亡率、主要不良心血管事件、心肌梗死和中风。报告了合并风险比（RR）及相应的95%置信区间（CI）。使用StataMP 14.0进行荟萃分析。共纳入15项研究，涉及407,512名参与者。荟萃分析显示，分类和连续的NLR均与糖尿病患者全因死亡率（RR = 1.68；95% CI，1.49 - 1.88；P < 0.001和RR = 1.03；95% CI，1.03 - 1.03；P < 0.001）和心血管死亡率（RR = 2.04；95% CI，1.58 - 2.63；P < 0.001和RR = 1.25；95% CI，1.19 - 1.32；P < 0.001）风险增加相关。然而，NLR与糖尿病患者主要不良心血管事件、心肌梗死和中风的风险无关。亚组分析显示样本量是研究间发现的异质性的主要来源。研究结果表明NLR是糖尿病患者死亡结局的预后标志物，为临床医生提供了一种用于风险评估和患者管理的非侵入性且易于获得的指标。
