Evaluation of blood neutrophil to lymphocyte and platelet to lymphocyte ratios according to plasma glucose status and serum insulin-like growth factor 1 levels in patients with acromegaly

Hum Exp Toxicol. 2016 Jun;35(6):608-12. doi: 10.1177/0960327115597313. Epub 2015 Jul 29.


Introduction: Cardiovascular, respiratory, and cerebrovascular diseases and malignancies are responsible for morbidity and mortality in acromegaly. Also these diseases are associated with chronic inflammation. The neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are currently gaining interest as new markers of inflammation. Moreover, increased morbidity and mortality are positively correlated with the presence of diabetes and levels of insulin-like growth factor 1 (IGF-1) in acromegaly. The objective of the present study was to investigate the relationship between these markers and acromegaly according to plasma glucose status and serum IGF-1 levels.

Materials and methods: We retrospectively analyzed data from 61 acromegaly patients who were in a newly diagnosed period (35 male, 26 female; mean age 38.13 ± 13.98). Patients with normal plasma glucose (n = 27), impaired fasting glucose (n = 18), and diabetes mellitus (n = 16) were categorized into three different groups. NLR and PLR were compared between the study groups and were evaluated according to IGF-1 levels.

Results: There were no statistically significant differences in NLR and PLR measurements among the study groups (p > 0.05). However, there were significant positive correlations between NLR and IGF-1 levels and between PLR and IGF-1 levels when all patients were evaluated (r = 0.334, p = 0.011 and r = 0.277, p = 0.035, respectively).

Conclusions: This is the first report studying the relationship of NLR and PLR with glucose status and IGF-1 levels in acromegaly patients. Our study results suggest that subclinical inflammation may play a role in increased incidence of mortality and morbidity, which depends on uncontrolled IGF-1 levels in patients with acromegaly.

Keywords: Inflammation; acromegaly; diabetes; impaired fasting glucose.

MeSH terms

  • Acromegaly / blood*
  • Acromegaly / immunology
  • Adolescent
  • Adult
  • Aged
  • Biomarkers / blood
  • Blood Cell Count
  • Blood Glucose / analysis*
  • Blood Platelets / cytology*
  • Blood Platelets / immunology
  • Female
  • Humans
  • Inflammation / blood
  • Insulin-Like Growth Factor I / analysis*
  • Lymphocytes / cytology*
  • Lymphocytes / immunology
  • Male
  • Middle Aged
  • Neutrophils / cytology*
  • Neutrophils / immunology
  • Retrospective Studies
  • Young Adult


  • Biomarkers
  • Blood Glucose
  • Insulin-Like Growth Factor I