Background and aim: In this study, we aimed to investigate the neutrophil/lymphocyte (N/L) ratio, variations in leukocytes and leukocyte subtypes, and the relationship between N/L ratio and insulin resistance (IR) in obesity. Materials and Methods: Ninety six patients and 40 healthy controls were included in this study. Patients’ blood glucose levels, insulin levels, and hemogram parameters upon 8 hours of fasting were determined. Body mass index (BMI) and homeostasis model assessment insulin resistance (HOMA-IR) values were calculated. Results: Neutrophil numbers were found to be higher among IR obese patients than among non-IR obese patients. The N/L ratio was, moreover, found to be higher among IR obese patients, when compared to non IR obese. A positive correlation was found between insulin resistance and both neutrophil and WBC counts. Another positive correlation was also found between insulin levels and the N/L ratio, WBC, and neutrophil counts. Discussion: In our study, leukocyte numbers and subtypes were determined to be higher among obese individuals than among healthy individuals. The N/L ratio had increased significantly only among obese patients who have insulin resistance. Further studies are needed in order to better demonstrate the relationship between the N/L ratio and insulin resistance/inflammation. Key Words: Neutrophil-Lymphocyte Ratio, Obesity, Insulin Resistance

Introduction and aim To investigate the effect of the prognostic nutritional index on treatment response and survival in patients with metastatic renal cell cancer. Methods We retrospectively analyzed the treatment modalities; the demographic, clinical and pathological features of 396 patients with RCC and prognostic nutritional index. Based on the median value, patients were grouped as having low and high prognostic nutritional index values. Kaplan-Meier method was used for survival analysis, and Cox-regression analysis was used for multivariate analysis. Results The median overall survival was 39 months (95% CI 26.1–51.8), 28 months (95% CI 17.9–38) and 7 months (95% CI 4.7–9.2) in patients with favorable, intermediate and poor International Metastatic Renal Cell Carcinoma Database Consortium risk group, respectively. The difference between the groups was statistically significant (p < 0001). Overall survival was 11 months (95% CI 7.5–14.5) in the low-prognostic nutritional index (prognostic nutritional index ≤38.5) group, and 41 months (95% CI 30.5–51.4) in the high prognostic nutritional index (prognostic nutritional index >38.5) group (p < 0.001). In Cox regression analysis, Eastern Cooperative Oncology Group performance score (HR: 2.5), time to systemic treatment (HR: 1.7) and prognostic nutritional index (HR: 1.8) were associated with overall survival. Conclusion In patients with renal cell cancer, prognostic nutritional index is closely related to survival and has prognostic significance.

BackgroundDiabetes mellitus is closely related to pancreas cancer. In this study we aimed to investigate the effect of hyperglycemia on tumor and inflammation markers, as well as pancreatic exocrine functions.MethodsA total of 98 consecutive diabetic patients with poor glycemic control, and 50 healthy controls were included in the study. We measured hsCRP, erythrocyte sedimentation rate (ESR), CA19-9, CEA, amylase and lipase in addition to routine biochemistry tests, before and after euglycemia was achieved.ResultsFasting blood glucose, HbA1c, CA19-9, CEA, hsCRP, ESR, triglycerides, AST, ALT, GGT, ALP, total cholesterol and LDL-C levels decreased significantly with the regulation of glycemic control. Amylase and lipase levels increased with the regulation of glycemic control. After glycemic control, CA19-9 and CEA levels were still higher, whereas amylase and lipase levels were still lower in the diabetic group compared with the control group. Basal HbA1c showed significant correlation with CA19-9, CEA, amylase and lipase.ConclusionsWe propose to repeat observations of tumor markers after hyperglycemia is resolved, in order to avoid unnecessary invasive tests. Our data also suggest that pancreatic exocrine function was improved with lowering blood glucose in a short period of time.

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