Neutrophil-Lymphocyte Ratio (NLR) is Positively Associated with Impaired Cognitive Performance inPatients with Metabolic Syndrome

Abstract Metabolic syndrome (MetS) is known to be related to mild cognitive impairment (MCI). A prognostic biomarker for the MCI condition in these patients has not been thoroughly determined. A neutrophil-lymphocyte ratio (NLR) has been widely used as a biomarker for the progression of cancers and cardiovascular diseases. However, its association with the MCI condition in patients with MetS is not known. The present study aimed to investigate the correlation between NLR and cognitive function in patients with MetS. A total of sixty patients with MetS (45-65 years old) were enrolled in the present study, and their metabolic parameters, including plasma levels of glucose, insulin, lipid profiles, inflammatory markers, and the complete blood count, were determined. The NLR level was calculated by the ratio of neutrophils to lymphocytes derived from the complete blood count. The Montreal Cognitive Assessment (MoCA) test was used to determine the cognitive performance in patients with MetS. Most patients with MetS have the possibility of an MCI condition. Moreover, glycated hemoglobin (HbA1C), fasting plasma glucose (FPG), and NLR were negatively correlated with the MoCA scores of these patients. Interestingly, NLR was the strongest independent factor which correlated with the MoCA score. Collectively, poor glycemic control and increased NLR levels may be used as possible predictors for poorer cognitive performance outcomes in patients with MetS. Keywords: Metabolic syndrome; Mild cognitive impairment; Neutrophil-lymphocyte ratio; Prognostic marker; Montreal cognitive assessment