Abstract
The objective of this study was to explore the association of glucose to lymphocyte ratio (GLR) with all-cause and cardio-cerebrovascular mortality in diabetic adults. The cohort of 8,149 adults with diabetes was included in this study. The association between GLR and mortality was examined using weighted multivariable Cox regression equations. Restricted cubic splines (RCS) were conducted to further explore the non-linear relationship. Kaplan-Meier (KM) survival analyses were performed to assess trends in the risk of mortality at different levels of GLR. Additionally, subgroup analyses and interaction tests were conducted to detect differences among groups. After adjusting for all covariates, we found that GLR presented a positive association with mortality. Further RCS revealed that this positive association was non-linear. GLR and mortality exhibited significance only after the inflection points, with HR (95% CI) of 1.21 (1.16, 1.27) for all-cause mortality and 1.33 (1.21, 1.43) for cardio-cerebrovascular mortality. KM survival analyses revealed that the risk of mortality increased with elevated GLR. This cohort study uncovered a non-linear positive association between GLR and mortality in the diabetic population, suggesting that GLR could be an indicator of poor prognosis in diabetes.