Bilge ÖZCAN, Meryem Ümit KURBAN
Turkish Journal of Internal Medicine - 2026;8(1):75-80
Objective: To evaluate six-month changes in hemogram-derived inflammatory indices (neutrophil-to-lymphocyte ratio [NLR], systemic immune-inflammation index [SII], systemic inflammation response index [SIRI], and aggregate index of systemic inflammation [AISI]) and their association with glycemic parameters in patients with type 2 diabetes mellitus (T2DM) under routine clinical care. Methods: This retrospective cohort study analyzed electronic medical records of 183 adults with T2DM from a single center (2022-2023). All patients had paired laboratory measurements approximately six months apart. Primary analysis examined overall changes in glycemic parameters (fasting glucose, HbA1c) and inflammatory indices using Wilcoxon signed-rank tests; correlations were assessed with Spearman's rho. Results: Over six months, all four inflammatory indices decreased significantly: NLR (2.14 ->1.66, p<0.001, r=0.87), SII (593.6 ->476.0, p<0.001, r=0.74), SIRI (0.88 ->0.70, p<0.001, r=0.70), and AISI (231.5 ->188.0, p<0.001, r=0.63). Fasting glucose decreased (125 ->109 mg/dL, p<0.001, r=0.80), while HbA1c showed a small reduction (7.00% ->6.80%, p<0.001, r=0.23). Changes in glycemic parameters correlated poorly with changes in inflammatory indices (all | rho|<0.20). Conclusion: Hemogram-derived inflammatory indices improve markedly and consistently in T2DM patients over six months of real-world treatment. These improvements are largely independent of glycemic response, suggesting that NLR, SII, SIRI, and AISI may capture anti-inflammatory effects not reflected by HbA1c. These low-cost, universally available indices may serve as complementary markers in routine T2DM care.
