LAUSR

ABSTRACT Background This study aimed at investigating the relationships between Platelet-Lymphocyte ratio (PLR) and Neutrophil–Lymphocyte ratio (NLR) and their dynamic changes (∆PLR, ∆NLR) with type 2 diabetes mellitus (T2DM) in a Chinese cohort study. Methods This study recruited 41,439 individuals who were diagnosed without T2DM at first health examination and completed at least one follow-up. The relationships between NLR, PLR, ∆PLR, ∆NLR and T2DM risk were analyzed using the Cox regression model with corresponding Hazard Ratios (HRs) and 95% Confidence Intervals (CIs). Results PLR exhibited significant correlation with T2DM risk in a linear reverse dose–response pattern, the corresponding HRs and 95% CIs were 0.81 (0.72, 0.90), 0.71 (0.63, 0.80) and 0.56 (0.49, 0.64) respectively (P trend < 0.001) for Q2, Q3 and Q4 vs Q1 after adjusting for age, gender, BMI, TG, TC, HDL-C, FPG, ALT, AST, heart rate, smoking, family history of diabetes, and alcohol consumption at baseline in Model 3. The significance remained in subgroups of women, <45 years, ≥45 years, BMI ≥ 24, with fatty liver disease, without fatty liver disease and normotension. Comparing with the largest decrease group of NLR (∆NLR < −0.32), the risk of T2DM increased for −0.003 ≤ ∆NLR < 0.31 (HR 1.17, 95% CI 1.01–1.36) and ∆NLR ≥ 0.31 (HR 1.23, 95% CI 1.06–1.43). Conclusions Higher PLR could reduce the risk of T2DM. Larger increase of NLR could increase T2DM risk.