{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T20:55:24Z","timestamp":1790283324807,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Type\u202f2 diabetes mellitus (T2DM) is increasingly seen as a chronic inflammatory state, with the neutrophil\u2010to\u2010lymphocyte ratio (NLR) studied as a new biomarker of systemic inflammation. Evidence links NLR to glycemic control, but its consistency and strength vary. This review summarizes data on NLR's relationship with glycemic indicators, such as hemoglobin\u202fA1c (HbA1c), across different T2DM glycemic states.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic literature search was carried out in PubMed\/MEDLINE, Scopus, Web of Science, and Embase through November 2025 to find studies that reported both NLR and glycemic control indicators in adults with T2DM. Data were systematically extracted based on predefined criteria. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were combined using random\u2010effects models. Heterogeneity was measured using the I\u00b2 statistic, and robustness was assessed using sensitivity analyses. Publication bias was investigated using Begg's and Egger's tests, trim\u2010and\u2010fill analysis, and funnel plot examination. All statistical analyses were conducted using STATA\u202f18 (StataCorp, College Station, TX, USA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The meta\u2010analysis consisted of 27 studies (37 comparisons) with a total of 48,714 individuals from 11 nations. NLR demonstrated a stepwise gradient with deteriorating glycemic control: poorly controlled T2DM (HbA1c\u2009&gt;\u2009\u202f7%) had higher NLR than well\u2010controlled T2DM (HbA1c\u2009\u2264\u2009\u202f7%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009\u202f0.001), prediabetes (HbA1c\u202f5.7\u20136.4%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009\u202f0.001), and normoglycemia (HbA1c\u2009\u2264\u2009\u202f5.7%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009\u202f0.037).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>NLR rises progressively with deteriorating glycemic control and is markedly raised in poorly controlled T2DM. These observations endorse NLR as an inexpensive, widely available inflammatory biomarker that can augment conventional glycemic measures in the clinical setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.71784","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T05:02:20Z","timestamp":1770008540000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Association Between Neutrophil\u2010to\u2010Lymphocyte Ratio and Glycemic Control in Type 2 Diabetes Mellitus: An Updated Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"9","author":[{"given":"Maryam","family":"Mohammadi","sequence":"first","affiliation":[{"name":"Islamic Azad University of Najafabad Najafabad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0983-2117","authenticated-orcid":false,"given":"Parsa","family":"Panahiyan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Gaziantep University Gaziantep Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9634-613X","authenticated-orcid":false,"given":"Faizan","family":"Bashir","sequence":"additional","affiliation":[{"name":"School of Medicine Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shayesteh","family":"Haghighi","sequence":"additional","affiliation":[{"name":"Department of Nursing, School of Nursing and Midwifery Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Ahmadi","sequence":"additional","affiliation":[{"name":"School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ensiyeh","family":"Olama","sequence":"additional","affiliation":[{"name":"Student Research Committee, School of Medicine Georgian National University SEU Tbilisi Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2278-4849","authenticated-orcid":false,"given":"Yasaman Ghodsi","family":"Boushehri","sequence":"additional","affiliation":[{"name":"Shiraz University of Medical Sciences Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elnaz","family":"Olama","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Georgian National University SEU Tbilisi Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5421-1722","authenticated-orcid":false,"given":"Alaleh","family":"Alizadeh","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Mashhad Branch, Islamic Azad University Mashhad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra Sadat Hoseini","family":"Nasab","sequence":"additional","affiliation":[{"name":"School of Medicine Mashhad University of Medical Sciences Mashhad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahdyieh","family":"Naziri","sequence":"additional","affiliation":[{"name":"Student Research Committee, Department of Biostatistics, School of Public Health Iran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6965-6927","authenticated-orcid":false,"given":"Niloofar","family":"Deravi","sequence":"additional","affiliation":[{"name":"Student Research Committee, School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neda","family":"Fakhrghasemi","sequence":"additional","affiliation":[{"name":"Allergy Research Center Mashhad University of Medical Sciences Mashhad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4509-2447","authenticated-orcid":false,"given":"Danyal","family":"Yarahmadi","sequence":"additional","affiliation":[{"name":"Student Research Committee, School of Medicine Iran University of Medical Sciences Tehran Iran"},{"name":"Razi Herbal Medicines Research Center Lorestan University of Medical Sciences Khorramabad Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,1]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-0442"},{"issue":"1","key":"e_1_2_15_3_1","first-page":"S61","article-title":"6. 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