G-2793

Association between hematological indices and metabolic syndrome: A population-based study from southern Iran

 َAsma Ahmadi ¹ ℗, Majid Teremmahi Ardestani ², Marzieh Norouzian ³ ©   

 
Abstract

Introduction: Metabolic syndrome (MetS) comprises a constellation of metabolic abnormalities—including central obesity, hypertension, hyperglycemia, and dyslipidemia—that collectively increase the risk of cardiovascular disease and type 2 diabetes. Inflammation plays a central role in MetS pathophysiology. Emerging evidence suggests that hematological indices such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-HDL ratio (MHR), lymphocyte-to-HDL ratio (LHR), and neutrophil-to-HDL ratio (NHR) may serve as novel inflammatory biomarkers for MetS. However, evidence from Middle Eastern populations remains limited. Methods and Materials: This cross-sectional study utilized baseline data from 2,423 participants enrolled in the Bandare-Kong Non-Communicable Diseases (BKNCD) Cohort, a branch of the PERSIAN study in southern Iran. MetS was defined according to the NCEP ATP III criteria. Hematological parameters and calculated indices (NLR, PLR, MHR, LHR, NHR) were compared between MetS cases (n=439) and healthy controls (n=1984) using nonparametric statistical tests. Logistic regression models were applied to evaluate the predictive value of these indices for MetS after adjusting for confounders. Results: The MetS group exhibited higher Hb and Hct levels (P0.001) alongside lower PLR, MHR, NHR and LHR (P=0.008, P=0.03, P0.0001 and P0.0001, respectively). The correlation analysis revealed that Hb levels positively correlated with fasting blood glucose (r=0.156, P0.001) and triglycerides (r=0.070, P0.001). MHR, LHR and NHR showed significant negative correlations with HDL cholesterol and positive correlations with waist circumference, blood pressure, and triglycerides. In logistic regression indicated that Hb (OR=0.774, 95% CI: 0.631-0.949, P=0.01), LHR (OR=67.64, 95% CI: 13.13-348.3, P0.001) and NHR (OR=12.87, 95% CI:3.601-46.05, P0.001) remained important predictors of MetS. Conclusion and Discussion: Our findings suggest that Hb, LHR and NHR are strong independent predictors of MetS in this Middle Eastern population. These hematological indices reflect the underlying inflammatory and metabolic dysregulation and may be useful as cost-effective biomarkers for early identification of individuals at risk. Integrating such biomarkers into clinical screening strategies may enhance early diagnosis and prevention of cardiometabolic complications. Further longitudinal studies are needed to establish their prognostic utility across diverse populations.

Keywords: Metabolic Syndrome; Hematological Indices; Inflammation; Lymphocyte-to-HDL Ratio; Neutrophil-to-HDL Ratio; PERSIAN