Results of the summarizing process for the arXiv paper: 2205.08308v2

Chronic inflammation is increasingly recognized as a contributing factor to the pathogenesis of various diseases, and one of its markers, high neutrophil-to-lymphocyte ratio (NLR), has been associated with increased mortality and morbidity risk. Insulin resistance (IR) has been suggested as a potential associate factor in preclinical studies, but epidemiological studies investigating the association between NLR and IR are scarce and have only included diabetes mellitus patients rather than the general population. This study aimed to determine if there is a direct correlation between NLR and IR in the US general population. The sample for this study consisted of 3,307 individuals from the general population provided by the National Health and Nutrition Examination Survey (NHANES). Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) value was calculated to evaluate insulin resistance, and the relationship between NLR and HOMA-IR values was investigated through bivariate and multivariate linear regression analyses. As insulin use could result in inaccurate HOMA-IR estimation, subgroup analyses were conducted after excluding insulin users. After exclusions based on fasting glucose levels exceeding 140 mg/dL, white blood cell counts over 10,000 WBCs in collected blood samples, or NLR over 9 which could be possible outliers due to abnormal figures, 3,375 samples remained. During analysis an additional 68 insulin users were removed as they could be a confounding variable due to their unsteady insulin concentration in blood depending on when they receive treatment. The results showed that there was a relationship between NLR and IR when insulin users were included in the analysis with a beta coefficient value of 0.010 (95% confidence interval [CI] of 0.003-0.017). However, when insulin users were excluded from the analysis due to their potential confounding effect on HOMA-IR estimation, the beta value decreased to 0.004 (95% CI of -0.006-0.015). The statistical significance was not reached when age, sex, and body mass index were adjusted for in the multivariate analyses. In conclusion, there is no visible relationship between IR and NLR in the general population; IR might not explain the variation of NLR value in healthy people, and further studies are needed to reveal associated factors for high NLR values. The NHANES data source provided a representative sample of the US population; exclusions based on abnormal figures ensured accurate analysis; however limitations include potential confounding variables not accounted for in this study as well as lack of longitudinal data to establish causality between NLR and IR.

• Chronic inflammation is linked to various diseases
• High neutrophil-to-lymphocyte ratio (NLR) is a marker of chronic inflammation and associated with increased mortality and morbidity risk
• Insulin resistance (IR) has been suggested as a potential associate factor in preclinical studies
• Epidemiological studies investigating the association between NLR and IR are scarce and have only included diabetes mellitus patients rather than the general population
• This study aimed to determine if there is a direct correlation between NLR and IR in the US general population
• The sample for this study consisted of 3,307 individuals from the general population provided by the National Health and Nutrition Examination Survey (NHANES)
• Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) value was calculated to evaluate insulin resistance, and the relationship between NLR and HOMA-IR values was investigated through bivariate and multivariate linear regression analyses
• After exclusions based on fasting glucose levels exceeding 140 mg/dL, white blood cell counts over 10,000 WBCs in collected blood samples, or NLR over 9 which could be possible outliers due to abnormal figures, 3,375 samples remained.
• There is no visible relationship between IR and NLR in the general population; IR might not explain the variation of NLR value in healthy people.
• Further studies are needed to reveal associated factors for high NLR values.
• The NHANES data source provided a representative sample of the US population; exclusions based on abnormal figures ensured accurate analysis; however limitations include potential confounding variables not accounted for in this study as well as lack of longitudinal data to establish causality between NLR and IR.

Exploring the Relationship Between Neutrophil-to-Lymphocyte Ratio and Insulin Resistance in the US General Population

Chronic inflammation is increasingly being recognized as a major contributor to the pathogenesis of many diseases. One of its markers, high neutrophil-to-lymphocyte ratio (NLR), has been associated with increased mortality and morbidity risk. Preclinical studies have suggested that insulin resistance (IR) may be a potential associate factor, but epidemiological studies investigating this association have been scarce and limited to diabetes mellitus patients rather than the general population. This study aimed to determine if there is a direct correlation between NLR and IR in the US general population.

Methods

The sample for this study consisted of 3,307 individuals from the general population provided by the National Health and Nutrition Examination Survey (NHANES). Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) value was calculated to evaluate insulin resistance, and bivariate and multivariate linear regression analyses were used to investigate the relationship between NLR and HOMA-IR values. Subgroup analyses were conducted after excluding insulin users due to their unsteady insulin concentration in blood depending on when they receive treatment which could result in inaccurate HOMA-IR estimation. Exclusions based on fasting glucose levels exceeding 140 mg/dL, white blood cell counts over 10,000 WBCs in collected blood samples, or NLR over 9 which could be possible outliers due to abnormal figures were also made; 3,375 samples remained after these exclusions had been applied.

Results

The results showed that there was a relationship between NLR and IR when insulin users were included in the analysis with a beta coefficient value of 0.010 (95% confidence interval [CI] of 0.003-0.017). However, when insulin users were excluded from the analysis due to their potential confounding effect on HOMA-IR estimation, the beta value decreased to 0.004 (95% CI of -0.006-0.015). The statistical significance was not reached when age, sex, body mass index were adjusted for in multivariate analyses; thus no visible relationship between IR and NLR was found within this sample size from the general population studied here..

Conclusion

In conclusion, there is no visible relationship between IR and NLR in this sample size from US general population; IR might not explain variation of NLR value among healthy people as seen here; further research is needed into associated factors for high NLRs values observed here as well as longitudinal data collection that can establish causality between them both . The NHANES data source provided an accurate representative sample size from US population while exclusion criteria based on abnormal figures ensured accuracy during analysis; however limitations include potential confounding variables not accounted for such as dietary habits or lifestyle choices which may affect results obtained here .