Relationship between inflammatory markers and their interactions and insulin resistance: a cross-sectional study based on NHANES database from 2011-2016

Abstract

Abstract Objective: To explore the relationship between inflammatory markers and their interactions and insulin resistance (IR). Background: Patients with chronic inflammatory disorders, which are defined by an imbalanced secretion of pro-inflammatory and anti-inflammatory cytokines, frequently have insulin resistance; however, the association between IR and inflammatory markers remains unclear. Methods: We analyzed 6,742 participants (from 2011 to 2016) from the National Health and Nutrition Examination Survey database who had diabetes, no diabetes, or a borderline status. The receiver operating characteristic curve method was used to analyze the optimal cutoff value of inflammation indicators to predict IR, with adjustments for gender, age, race, body mass index, hypertension, hyperlipidemia, smoking history , and exercise status. The interaction between inflammatory markers and IR was then assessed. Results: When the confounding factors were not adjusted, compared to those with NLR ≤3.237 (odds ratio [OR]=1.266, 95% confidence interval [CI]=1.150–1.393), individuals with a neutrophil/lymphocyte ratio (NLR) of >3.237 had a greater risk of IR. The participants with a monocyte/lymphocyte ratio (MLR) of >0.262 had a decreased chance of developing IR than those with MLR ≤0.262 (OR=0.851, 95%CI=0.771–0.939). Individuals with an eosinophil/lymphocyte ratio (ELR) of >0.078 were more likely to have IR than those with ELR < 0.078 (OR=1.209, 95%CI=1.095–1.334). Individuals with a platelet/lymphocyte ratio (PLR) of >122.649 had a lower risk of IR than those with PLR ≤122.649 (OR=0.726, 95%CI=0.658–0.802). Participants with a systemic inflammation index (SII) of >0.262 had a higher risk of developing IR than those with SII ≤0.262 (OR=1.334, 95%CI=1.209–1.472). After controlling for the confounding variables, no significant association between NLR, MLR, ELR and IR was observed. Individuals with PLR ≥122.649 had a lower risk of IR than those with PLR ≤122.649 (OR=0.758, 95%CI =0.673–0.854). In addition, participants with SII ≥0.262 were more likely to have IR compared to those with an adjusted SII of ≤0.262 (OR=1.155, 95%CI =1.026–1.300). Furthermore, our study indicated that the combination of PLR ≥122.649 and ELR ≥0.078 had an effect on IR (OR=0.876, 95%CI=0.767–1.000) and that the combination of PLR ≥122.649 and SII >724.560 had a synergistic effect on IR (OR=0.872, 95%CI=0.773–0.985). The interaction effect of MLR ≥0.262 and PLR ≥122.649 on IR was revealed (OR=0.766, 95%CI=0.674–0.872). Conclusion: Insulin resistance is associated with decreased PLR and increased SII.