Leukocyte-Derived Inflammatory Indices (DNLR AND MLR) As Markers Of Isolated Coronary Artery Disease In Type 2 Diabetes Mellitus

Abstract

Background: Type 2 diabetes mellitus (T2DM) is characterised by chronic inflammation, which is associated with increased cardiovascular risk. The derived neutrophil-to-lymphocyte ratio (dNLR) and monocyte-to-lymphocyte ratio (MLR) are inexpensive inflammatory biomarkers, but their comparative value in identifying isolated coronary artery disease (CAD) remains unclear. Objective: To compare dNLR and MLR in T2DM patients with isolated CAD and those without vascular complications, and to evaluate their diagnostic performance. Methods: This retrospective study included 414 T2DM patients with isolated CAD and 333 without macrovascular or microvascular complications. dNLR and MLR were calculated from routine complete blood counts. Group differences, ROC analysis, logistic regression, and likelihood-ratio testing were performed. Results: Both dNLR and MLR were significantly higher in patients with isolated CAD. dNLR showed good diagnostic discriminant ability for isolated CAD (AUC 0.704), compared with MLR (AUC 0.587). After adjustment for age, sex, HbA1c, hypertension, dyslipidemia, and obesity, dNLR remained independently associated with isolated CAD (adjusted OR 3.50). Incorporating MLR into the adjusted dNLR model did not significantly improve model performance. Conclusion: dNLR showed good discriminative ability and was an independent inflammatory marker for identifying isolated CAD in T2DM.dNLR outperformed MLR and provided greater diagnostic utility for identifying CAD.