Vitamin D affects the neutrophil‐to‐lymphocyte ratio in patients with type 2 diabetes mellitus. Issue 2 (2nd August 2020)

• Record Type: Journal Article
• Authors: Wang, Si‐Yang; Shen, Ting‐Ting; Xi, Bei‐Li; Shen, Zhan; Zhang, Xian
• Is Part Of: Journal of diabetes investigation. Volume 12:Issue 2(2021)
• Page Start: 254
• Page End: 265
• Publication Date: 2020-08-02
• Subjects: Lymphocyte -- Neutrophil -- Vitamin D; Diabetes -- Periodicals; Diabetes -- Research -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462005
• DOI: 10.1111/jdi.13338
• Languages: English
• ISSNs: 2040-1116

Abstract

Abstract: Aims/Introduction: Chronic inflammation is an underlying feature of type 2 diabetes mellitus. Hypovitaminosis D is associated with type 2 diabetes mellitus, but whether it contributes to chronic inflammation is unclear. We examined the effects of vitamin D on various immune markers to evaluate its contribution to systemic inflammation in type 2 diabetes mellitus. Materials and Methods: We retrospectively analyzed data from type 2 diabetes mellitus patients, people with prediabetes and control patients without diabetes ( n = 9, 746). Demographic and clinical variables were evaluated using descriptive statistics and generalized linear regression. A stratified analysis based on total serum vitamin D was also carried out. Results: Neutrophil count was a significant predictor of 1, 5‐anhydroglucitol and glycated hemoglobin (HbA1c) in patients with prediabetes (1, 5‐anhydroglucitol: β = −0.719, P < 0.001 and HbA1c: β = −0.006, P = 0.002) and patients with diabetes (1, 5‐anhydroglucitol: β = 0.207, P = 0.004 and HbA1c: β = −0.067, P = 0.010). Lymphocyte count was a significant predictor of HbA1c in patients without diabetes (β = 0.056, P < 0.001) and patients with prediabetes (β = 0.038, P < 0.001). The neutrophil‐to‐lymphocyte ratio (NLR) was a significant predictor of HbA1c in patients without diabetes (β = −0.001, P = 0.032). No immune markers differed significantly based on vitamin D level among patients without diabetes ( P > 0.05 for all). Among patients with prediabetes, those who were vitamin D‐deficient had the highest NLR ( P = 0.040). Among patients with diabetes, those who were vitamin D‐deficient had the highest neutrophil count ( P = 0.001), lowest lymphocyte count ( P = 0.016) and highest NLR ( P < 0.001). Conclusions: The NLR is strongly influenced by serum vitamin D level. Given the high prevalence of hypovitaminosis D and elevated NLR among chronic disease patients and the elderly, our results suggest that clinical interpretation of NLR as a predictive marker of type 2 diabetes mellitus‐related inflammation should consider vitamin D level, age and pre‐existing morbidity. Abstract : The neutrophil‐to‐lymphocyte ratio was a predictor of glycated hemoglobin in people without diabetes. Among people with prediabetes, vitamin D deficiency led to the highest neutrophil‐to‐lymphocyte ratio. Among people with diabetes, vitamin D deficiency led to the highest neutrophil and lowest lymphocyte counts.