Dabla PK, Shrivastav D, Mehra P, Mehta V. Role of lymphocyte-to-monocyte ratio as a predictive marker for diabetic coronary artery disease: A cross-sectional study. World J Methodol 2024; 14(3): 92807 [PMID: 39310235 DOI: 10.5662/wjm.v14.i3.92807]
Corresponding Author of This Article
Pradeep Kumar Dabla, MD, Professor, Department of Biochemistry, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, Department of Biochemistry, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research Delhi, J.L.N Marg, Delhi 110002, India. pradeep_dabla@yahoo.com
Research Domain of This Article
Biochemistry & Molecular Biology
Article-Type of This Article
Case Control Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Pradeep Kumar Dabla, Department of Biochemistry, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, Delhi 110002, India
Dharmsheel Shrivastav, Department of Biochemistry, Govind Ballabh Pant Institute of Post Graduate and Medical Research, Delhi 110002, India
Pratishtha Mehra, Vimal Mehta, Department of Cardiology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, Delhi 110002, India
Author contributions: Dabla PK designed the study; Shrivastav D, Dabla PK, Mehta V analysed the manuscript; Dabla PK provided facilities for biochemical testing and Mehta V and Mehra P provided the facility for the enrolment of patients; all authors reviewed and approved the manuscript.
Institutional review board statement: The study was reviewed and approved by Maulana Azad Medical College and Associated Hospitals Delhi, India the institutional review board and ethical committee (Approval No. F1/IEC/MAMC/85/03/21/no.422; Dt-30.08.2021).
Informed consent statement: All study participants, or their legal guardians, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors have no conflicts of interest to disclose.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at pradeep_dabla@yahoo.com.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Pradeep Kumar Dabla, MD, Professor, Department of Biochemistry, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, Department of Biochemistry, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research Delhi, J.L.N Marg, Delhi 110002, India. pradeep_dabla@yahoo.com
Received: February 6, 2024 Revised: April 19, 2024 Accepted: May 11, 2024 Published online: September 20, 2024 Processing time: 140 Days and 1.4 Hours
Abstract
BACKGROUND
The lymphocyte to monocyte ratio (LMR) is considered a marker of systemic inflammation in cardiovascular disease and acts as predictor of mortality in coronary artery disease.
AIM
To investigate the predictive role of LMR in diabetic coronary artery disease patients.
METHODS
This cross-sectional study was conducted at tertiary care super-specialty hospital at New Delhi, India. A total of 200 angiography-proven coronary artery disease (CAD) patients were enrolled and grouped into two categories: Group I [CAD patients with type 2 diabetes mellitus (T2DM) and glycated hemoglobin (HbA1c) levels ≥ 6.5%], and Group II (CAD patients without T2DM and HbA1c levels < 6.5%). Serum lipoproteins, HbA1c, and complete blood count of enrolled patients were analyzed using fully automatic analyzers.
RESULTS
The logistic regression analysis showed an odds ratio of 1.48 (95%CI: 1.28-1.72, P < 0.05) for diabetic coronary artery disease patients (Group I) in unadjusted model. After adjusting for age, gender, diet, smoking, and hypertension history, the odds ratio increased to 1.49 (95%CI: 1.29-1.74, P < 0.01) in close association with LMR. Further adjustment for high cholesterol and triglycerides yielded the same odds ratio of 1.49 (95%CI: 1.27-1.75, P < 0.01). Receiver operating characteristic curve analysis revealed 74% sensitivity, 64% specificity, and 0.74 area under the curve (95%CI: 0.67-0.80, P < 0.001), suggesting moderate predictive accuracy for diabetic CAD patients.
CONCLUSION
LMR showed positive association with diabetic coronary artery disease, with moderate predictive accuracy. These findings have implications for improving CAD management in diabetics, necessitating further research and targeted interventions.
Core Tip: The lymphocyte to monocyte ratio (LMR) proves to be a potential marker of systemic inflammation in cardiovascular disease, demonstrating a predictive role in mortality among diabetic coronary artery disease (CAD) patients. This cross-sectional study investigates the predictive capacity of LMR specifically in individuals with diabetic coronary artery disease. The results reveal LMR as a contributing factor in diabetic CAD, with its moderate predictive accuracy. The study underscores the potential clinical relevance of LMR in improving CAD management in diabetic patients, urging further research and targeted interventions for enhanced patient outcomes.
