Evaluation of Inflammatory Markers as Predictors of Cardiovascular Risk in Patients with Type 2 Diabetes Mellitus

Abstract

Background: Type 2 diabetes mellitus (T2DM) is associated with an increased risk of cardiovascular disease, with chronic low-grade inflammation playing an important role in the development and progression of atherosclerosis. Inflammatory markers such as high-sensitivity C-reactive protein (hs-CRP), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) may provide additional information for cardiovascular risk stratification.

Methods: This cross-sectional observational study included 110 patients with T2DM. Demographic, clinical, glycemic, lipid, and inflammatory parameters were assessed. Cardiovascular risk was estimated using conventional risk parameters, and patients were categorized according to risk. The associations of hs-CRP, NLR, and PLR with cardiovascular risk were evaluated using correlation and multivariate logistic regression analyses.

Results: The mean age was 57.6 ± 9.8 years, and 56.4% of patients were male. Hypertension and dyslipidemia were present in 58.2% and 51.8%, respectively. Overall, 36.4% of patients were classified as having high cardiovascular risk. High-risk patients had significantly higher hs-CRP (5.2 vs 2.6 mg/L), NLR (3.54 vs 2.39), and PLR (158.6 vs 119.8) compared with the low-to-moderate risk group (all p<0.001). hs-CRP showed the strongest correlation with cardiovascular risk (r=0.52), followed by NLR (r=0.46) and PLR (r=0.38; all p<0.001). On multivariate analysis, hs-CRP ≥3 mg/L (AOR 2.74; 95% CI: 1.21–6.20) and NLR ≥3.0 (AOR 2.48; 95% CI: 1.10–5.60) independently predicted high cardiovascular risk.

Conclusion: Increased systemic inflammation was significantly associated with cardiovascular risk in patients with T2DM. hs-CRP and NLR may serve as simple and clinically useful adjunctive markers for identifying patients at increased cardiovascular risk.