The association between neutrophil and lymphocyte to high-density lipoprotein cholesterol ratio and metabolic syndrome among Iranian population, finding from Bandare Kong cohort study

Abstract

Background: Metabolic Syndrome (MetS) is characterized by the co-occurrence of various metabolic risk factors, significantly increasing the risk of cardiovascular diseases (CVD) and type 2 diabetes (T2DM). This study investigates the potential of hematological indices, specifically the neutrophil to high-density lipoprotein cholesterol ratio (NHR) and lymphocyte to high-density lipoprotein cholesterol ratio (LHR), as predictors of MetS in a population from southern Iran. Methods: Utilizing baseline data from the Bandare-Kong Non-Communicable Diseases (BKNCD) Cohort, part of the Prospective Epidemiological Research Studies in IrAN (PERSIAN), A total of 2,684 participants aged 35–70 years were analyzed. Participants were evaluated using the Iranian National Cholesterol Education Program (NCEP) criteria to diagnose MetS. Receiver operating characteristic (ROC) analysis was conducted to assess the predictive validity of NHR and LHR across different demographic categories. Results: The mean LHR and NHR values were significantly higher in individuals diagnosed with MetS (P < 0.001). Specifically, the LHR was 0.85 ± 0.26 in MetS patients compared to 0.76 ± 0.23 in those without MetS, while the NHR was 1.33 ± 0.35 in MetS patients compared to 1.20 ± 0.32 in those without MetS. After adjusting for confounding factors, both LHR and NHR remained significantly associated with MetS, with odds ratios (OR) of 6.61 (95% CI: 4.43–9.83) for LHR and 4.76 (95% CI: 3.51–6.45) for NHR. Among MetS components, LHR was associated with low HDL cholesterol and elevated triglycerides, while NHR showed significant associations with central obesity, low HDL cholesterol, and elevated triglycerides. ROC analysis revealed moderate predictive capabilities for both indices, with areas under the curve of 0.60 for LHR and 0.61 for NHR. Conclusion: The findings suggest that NHR and LHR are promising, easily obtainable hematological markers for predicting MetS. These indices could serve as valuable tools for early detection and ongoing monitoring in clinical settings, aiding in the prevention and management of MetS.