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Objectives <p>To study the correlation of neutrophil-to-lymphocyte ratio (NLR) with glycosylated hemoglobin (HbA1c) in type 2 diabetes mellitus (T2DM) patients and investigate for hyperglycemia-induced “emergency myelopoiesis” derived immature neutrophils in peripheral blood.</p> Methods <p>The study was carried out on 304 participants (both males and females), out of which 118 served as the non-diabetic control group and 186 were T2DM patients (cases). Two milliliters of peripheral blood was withdrawn in an EDTA vial, HaA1c was measured using high-performance liquid chromatography (HPLC), and NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count. Arneth count was performed on a peripheral smear considering the number of nuclear lobes in 100 neutrophils. Statistical tests were performed using SPSS version 25.0.</p> Results <p>Total leucocyte count (TLC), absolute neutrophil count (ANC), platelet count (PC) and absolute monocyte count (AMC) were significantly higher in cases as compared to controls (<i>p</i> &lt; 0.05). The Arneth curve showed a shift towards the left with increasing HbA1c levels.</p> Conclusion <p>NLR is a simple, cheap, and reliable surrogate marker for HbA1c, and any variations over time from static baseline, with well-controlled blood sugar levels, must be documented for personalized patient care. A left shift of Arneth curve may be an indicator of myelopoiesis and should prompt therapeutic interventions.</p>

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Neutrophilia in T2 Diabetes Mellitus: Its Hyperglycemia-Induced Emergency Myelopoiesis

  • 期刊论文

  • 发表日期：

    2025年8月29日

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  • Sakib Anwer,
  • Feroz Alam,
  • Sufia Naseem,
  • Hamid Ashraf,
  • Veena Maheshwari,
  • Kiran Alam,
  • Mahboob Hasan,
  • Nishat Afroz

摘要

Objectives

To study the correlation of neutrophil-to-lymphocyte ratio (NLR) with glycosylated hemoglobin (HbA1c) in type 2 diabetes mellitus (T2DM) patients and investigate for hyperglycemia-induced “emergency myelopoiesis” derived immature neutrophils in peripheral blood.

Methods

The study was carried out on 304 participants (both males and females), out of which 118 served as the non-diabetic control group and 186 were T2DM patients (cases). Two milliliters of peripheral blood was withdrawn in an EDTA vial, HaA1c was measured using high-performance liquid chromatography (HPLC), and NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count. Arneth count was performed on a peripheral smear considering the number of nuclear lobes in 100 neutrophils. Statistical tests were performed using SPSS version 25.0.

Results

Total leucocyte count (TLC), absolute neutrophil count (ANC), platelet count (PC) and absolute monocyte count (AMC) were significantly higher in cases as compared to controls (p < 0.05). The Arneth curve showed a shift towards the left with increasing HbA1c levels.

Conclusion

NLR is a simple, cheap, and reliable surrogate marker for HbA1c, and any variations over time from static baseline, with well-controlled blood sugar levels, must be documented for personalized patient care. A left shift of Arneth curve may be an indicator of myelopoiesis and should prompt therapeutic interventions.