J Diabetes Metab Disord. 2026 Apr 11;25(1):123. doi: 10.1007/s40200-026-01933-4. eCollection 2026 Jun.
ABSTRACT
BACKGROUND: Cardiovascular Disease (CVD) is the leading cause of morbidity and mortality among individuals with Type 2 diabetes mellitus (T2DM). This study evaluated the association of neutrophil-to-HDL ratio (NHR) and lymphocyte-to-HDL ratio (LHR) for metabolic syndrome (MetS), comorbidities, and cardiovascular risk among adults with T2DM in the Cape Coast Metropolis, Ghana.
METHODS: A cross-sectional study was conducted among 150 adults with T2DM attending the Cape Coast Teaching Hospital between January and June 2025. Sociodemographic, clinical, and biochemical data-including full blood count and lipid profile-were obtained using standard protocols. NHR and LHR were computed from neutrophil, lymphocyte, and HDL values. MetS was defined by the World Health Organization (WHO) clinical criteria. Associations were explored using chi-square and logistic regression analyses, and discriminative ability assessed with receiver operating characteristic (ROC) curves.
RESULTS: MetS and cardiovascular symptoms were present in 51% and 47% of participants respectively. Mean HDL was significantly lower, while triglycerides, non-HDL cholesterol, NHR, and LHR were significantly higher among participants with MetS (all p < 0.05). On univariate analysis, both NHR (OR = 1.01, p = 0.035) and LHR (OR = 1.02, p = 0.023) were associated with MetS, though only LHR remained significant after adjustment (aOR = 1.03, 95% CI: 1.01-1.05, p = 0.022). Age and NHR was independently associated with comorbidity burden, while stress increased the odds of cardiovascular symptoms (aOR = 2.19, p = 0.048). ROC analysis demonstrated fair discriminative ability for NHR (AUC = 0.71) and improved performance when combined with LHR (AUC = 0.74).
CONCLUSION: Among Ghanaian adults with T2DM, elevated NHR and LHR are associated with metabolic syndrome, with LHR emerging as an independent predictor. Combined assessment of NHR and LHR may enhance early risk stratification for metabolic and cardiovascular complications in diabetic populations.
PMID:41978634 | PMC:PMC13070094 | DOI:10.1007/s40200-026-01933-4