Impact of Early Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Decrease After Continuous Positive Airway Pressure on Glycaemic Control in Type 2 Diabetes with Obstructive Sleep Apnea.

Purpose: The aim of this study is to evaluate the relationship between changes in Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) within 7 days after Continuous positive airway pressure (CPAP) treatment and long-term glycaemic control.

Methods: This study retrospectively included 650 Type 2 diabetes (T2DM) and Obstructive sleep apnea (OSA) patients treated with CPAP. Patients were divided into two groups based on whether long-term glycaemic control was effective or ineffective, and differences in baseline and disease-related characteristics between the two groups were compared. We constructed a multi factor logistic regression model to analyze the impact of the decrease in NLR and PLR within the first 7 days after treatment on long-term glycaemic control. We used restricted cubic spline analysis and Receiver Operating Characteristic (ROC) curve analysis to evaluate the relationship between the decrease in NLR and PLR and long-term glycaemic control.

Results: In three multiple logistic regression models, it was observed that the decrease in NLR and PLR was an independent factor affecting long-term glycaemic improvement. The limited cubic spline analysis showed that the decrease in NLR and PLR was linearly or approximately linearly positively correlated with long-term glycaemic improvement. The interaction indicates that in patients who use CPAP for a longer period of time every night, the decrease in NLR has a stronger impact on long-term glycaemic improvement. The ROC curve indicates that both NLR and PLR have good and similar predictive abilities in terms of the magnitude of decline.

Conclusion: The decrease in NLR and PLR within 7 days after the start of CPAP treatment is significantly correlated with long-term glycaemic improvement in T2DM patients with OSA, and there is a significant interaction with the duration of CPAP use per night. This study suggests that the decrease in NLR and PLR can serve as potential predictors of CPAP efficacy, providing new ideas for early intervention and optimization of treatment plans.