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The direct association between the immune system and DCM with effective biomarkers has been demonstrated in previous studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Five hundred seven subjects with T2DM were recruited from April 2018 to October 2019 and divided into T2DM with cardiac dysfunction (DCM) group and T2DM without cardiac dysfunction (non-DCM) group. The relationship between the quartiles of Neutrophil: lymphocyte ratio (NLR) and subclinical DCM was evaluated by using adjusted logistic regression models.(covariates: age, sex, BMI, duration of diabetes, and hyperlipidemia).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Blood NLR was significantly upregulated in DCM group compared to non-DCM group (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.05). Then the adjusted odds ratio (95% CI) of the highest NLR quartile was 14.32 (2.92\u201370.31) compared with the lowest quartile of NLR after multiple adjusted (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). However, there was no significant relation between neutrophil and lymphocyte counts and the occurrence of DCM in T2DM patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrated that NLR was associated with the occurrence of subclinical DCM, suggesting that NLR may be a biomarker for predicting DCM with effectiveness and accuracy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      Chinese Clinical Trial Registry\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.chictr.org.cn\">(ChiCTR1900027080)<\/jats:ext-link>\n                      . Registered 30 October 2019. Retrospectively registered: www.medresman.org\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12902-020-00571-y","type":"journal-article","created":{"date-parts":[[2020,6,30]],"date-time":"2020-06-30T16:03:18Z","timestamp":1593532998000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Neutrophil: lymphocyte ratio is positively associated with subclinical diabetic cardiomyopathy"],"prefix":"10.1186","volume":"20","author":[{"given":"Xiaoli","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zihan","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feifei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohong","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Hua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6814-0948","authenticated-orcid":false,"given":"Lichan","family":"Tao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,6,30]]},"reference":[{"issue":"3","key":"571_CR1","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1016\/j.hfc.2019.02.003","volume":"15","author":"S Paolillo","year":"2019","unstructured":"Paolillo S, Marsico F, Prastaro M, Renga F, Esposito L, De Martino F, et al. 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The present study was approved by the Institutional Review Committee of the Third Affiliated Hospital of Soochow University. All subjects gave written, informed consent before enrollment in the study.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"99"}}