A study of platelet to lymphocyte ratio in patients with metabolic syndrome


  • Thyagaraj . Department of Medicine, Basaveshwara Medical College and Research Institute, Chitradurga, Karnataka, India
  • Manjushree Mohan Department of Medicine, Basaveshwara Medical College and Research Institute, Chitradurga, Karnataka, India
  • Sreedevi . Department of Medicine, Basaveshwara Medical College and Research Institute, Chitradurga, Karnataka, India




Insulin resistance, Metabolic syndrome


Background: The prevalence of the metabolic syndrome varies around the world, in part reflecting the age and ethnicity of the populations studied and the diagnostic criteria applied. Numerous studies have shown an association of Metabolic Syndrome (MS) and insulin resistance (IR) with inflammation. Platelet-lymphocyte ratio (PLR) has recently emerged as a novel inflammatory index that may serve as an important predictor of inflammatory state and overall mortality. Aim of this study is to evaluate the PLR in patients with MS and to correlate the same with the severity of MS based on its categories.

Methods: A cross sectional study was conducted on 210 subjects (105 subjects with Metabolic Syndrome and 105 age and gender matched control participants without Metabolic Syndrome) seen on outpatient basis at hospitals attached to Basaveshwara medical college and research institute, Chitradurga. Detailed history including history of risk factors if any, physical examinations and baseline investigations like complete blood counts, HbA1c levels, serum glucose levels, fasting lipid profile, electrocardiography and the data was analyzed using appropriate statistical methods.

Results: PLR was 6% higher in males (PLR-144.77±34.6) when compared to females (PLR-136.57±30.4) in subjects with metabolic syndrome. There was 95.9% higher PLR in subjects with metabolic syndrome when compared to subjects without metabolic syndrome (p<0.05). Furthermore, PLR increased more as severity of metabolic syndrome increased (5/5 PLR-180.55±25.3,4/5 PLR-132.33±23.6, 3/5 PLR- 109.63±22.6 and non-metabolic syndrome (PLR- 77.45±19.5).

Conclusions: In this study, PLR above 90 predicted significant inflammation. PLR is calculated from complete blood count with differential, is an inexpensive, easy to obtain, widely available marker of inflammation, which can aid in the risk stratification of patients with various cardiovascular diseases in addition to the traditionally used markers.


Misra A. Metabolic Syndrome. In: Sharma SK, Agarwal AK, Singal RK, Gupta P, Sundar S, et al editors. API Textbook of Medicine. 9th ed. Jaypee Brothers Medical Publishers Ltd.; 2012:1279.

Fernandez-Real JM, Ricart W. Insulin resistance and chronic cardiovascular inflammatory syndrome. Endocr Rev.2003 Jun;24(3):278-301.

Shoelson SE, Lee J, Goldfine AB. Inflammation and insulin resistance. J Clin Invest. 2006 Jul;116(7):1793-801.

Prakash K, Mamatha TR, Nirgude D, Prakash B. High sensitivity C-reactive protein in metabolic syndrome. Int J Adv Med. 2016 Aug;3(3):607-10.

Brownlee M, Aiello L, Cooper M, Vinik A, Nesto R. Complications of Diabetes Mellitus. In: Melmed S, Polonsky K, Larsen R, Kronenberg H editors. Williams Textbook of Endocrinology. 12th ed. Philadelphia: Saunders, Elsevier; 2011:1523.

Uçar FM, Açar B, Gul M, Özeke Ö, Aydogdu S. The association between platelet/lymphocyte ratio and coronary artery disease severity in asymptomatic low ejection fraction patients. Korean Circulation J. 2016 Nov 1;46(6):821-6.

Grundy SM, Brewer Jr HB, Cleeman JI, Smith Jr SC, Lenfant C. Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation. 2004 Jan 27;109(3):433-8.

Bhat T, Teli S, Rijal J, Bhat H, Raza M, Khoueiry G, et al. Neutrophil to lymphocyte ratio and cardiovascular diseases . Expert Rev Cardiovasc Ther. 2013 Jan;11(1):55-9.

Buyukkaya E, Karakas MF, Karakas E, Akçay AB, Tanboga IH, Kurt M. Correlation of neutrophil to lymphocyte ratio with the presence and severity of metabolic syndrome. Clin Appl Thromb Hemost. 2014 Mar;20(2):159-63.

Valga F, Monzón T, Henriquez F, Antón-Pérez G. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as biological markers of interest in kidney disease. Nefrologia. June 2019;39(3):223-338.

Wu L, Zou S, Wang C, Tan X, Yu M. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio in Chinese Han population from Chaoshan region in South China. BMC cardiovascular disorders. 2019 Dec 1;19(1):125.






Original Research Articles