The Role of Glucose-to-Lymphocyte Ratio in Patients with Cardiovascular Disease: A Population-Based Cross-Sectional Study

Background: Systemic inflammation and glucose metabolism dysfunction were closely relevant to cardiovascular disease. Glu-cose to lymphocyte ratio (GLR), a novel inflammatory marker, has been recognized as a reliable prognosis factor in inflammatory diseases. However, there are no published studies on the association of cardiovascular disease with GLR, and this study aims to elucidate the potential relationship between cardiovascular disease and GLR.Methods and Results: We conducted a cross-sectional analysis in participants who were recruited in the survey of NHANES (2015-2020), with 8642 participants included in this study, including 1807 participants with cardiovascular disease (CVD). Com-pared with the non-CVD group, GLR and neutrophils lymphocyte ratio (NLR) were significantly higher in the CVD group (GLR: 3.78 & PLUSMN; 2.40 vs 2.88 & PLUSMN; 1.71,p < 0.001 ; NLR: 2.58 & PLUSMN; 1.62 vs 2.07 & PLUSMN; 1.15, p < 0.001). After adjusting for cardiovascular risk fac-tors, the prevalence of individual CVD was independently and positively related to GLR, with an odds ratio of 1.08 (95% CI: 1.01-1.15). In subgroup analysis, stratified by age, gender, body mass index (BMI), ratio of income to poverty, smoking status, and diabetes mellitus (DM), the significant positive associations of GLR levels with CVD were found in participants who were female, smokers, higher BMI, lower income, with hypertension and DM. Furthermore, there was a positive relationship between GLR and CVD (OR 1/4: 2.10 (95% CI: 1.30-3.60, p < 0.001)) only in the elder.Conclusions: This study reveals that GLR levels are positively and independently correlated to the prevalence of CVD, suggesting that GLR may be an effective predictor of systemic inflammatory response levels, plasma glucose levels, and cardiovascular risk.