{
    "abstract": "Recent evidence links diet and physical activity with type 2 diabetes mellitus (T2DM) remission, but emerging findings suggest that immune system dysregulation may play a crucial role. This study aimed to investigate the associations between neutrophils and T2DM remission.\nWe conducted a comprehensive analysis of newly-diagnosed T2DM patients (N\u2009=\u2009183) from the CORDIOPREV study, without glucose-lowering treatment, and were randomized to follow either a Mediterranean or low-fat diet. Patients were classified into two groups: Responders, who achieved T2DM remission (n\u2009=\u200973), and Non-Responders, who did not achieve remission during the 5-year dietary intervention (n\u2009=\u2009110). Neutrophil count and their related-ratio (NER, NBR, NLR and NHR, normalized with erythrocytes, basophils, lymphocytes, and HDL respectively) were measured at the baseline and 5 years of follow-up.\nThe lowest baseline tertile of neutrophil count was associated with an increased likelihood of T2DM remission among patients following a Mediterranean diet (but not for low-fat diet) when compared with the highest tertile [adjusted HR of 4.23 (95% CI: 1.53-11.69)], in which similar results were observed for NER and NHR. When considering clinical and neutrophil variables, the predictive capacity of this model yielded an AUC of 0.783 (95% CI: 0.680-0.822). Furthermore, after 5-years, Responders exhibited lower neutrophil count compared to Non-responders (p\u2009=\u20090.006) and a significant decrease in neutrophil count (p\u2009=\u20090.001) compared to baseline. This decrease in neutrophil count in Responders who consumed a Mediterranean diet exhibited a significant increase in Insulin Sensitivity and Disposition Index (p\u2009=\u20090.011 and p\u2009=\u20090.018) after the follow-up period.\nThese findings suggest that neutrophil count can help in identifying patients that are more likely to achieve T2DM remission following a Mediterranean diet, suggesting a role on insulin sensitivity and \u03b2-cell function. Further research holds promise for providing valuable insights into the pathophysiology of T2DM.\nID: NCT00924937; URL Clinical trial: https://clinicaltrials.gov/study/NCT00924937?cond=NCT00924937&rank=1 .",
    "authors": [
        {
            "affiliation": "Lipids and Atherosclerosis Unit, Department of Internal Medicine, Hospital Universitario Reina Sof\u00eda, Cordoba, Spain.\nDepartment of Medical and Surgical Sciences, Universidad de Cordoba, Cordoba, Spain.\nMaimonides Institute for Biomedical Research in Cordoba (IMIBIC), Cordoba, Spain.\nCIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.",
            "firstname": "Hatim",
            "initials": "H",
            "lastname": "Boughanem"
        },
        {
            "affiliation": "Lipids and Atherosclerosis Unit, Department of Internal Medicine, Hospital Universitario Reina Sof\u00eda, Cordoba, Spain.\nDepartment of Medical and Surgical Sciences, Universidad de Cordoba, Cordoba, Spain.\nMaimonides Institute for Biomedical Research in Cordoba (IMIBIC), Cordoba, Spain.\nCIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.",
            "firstname": "Francisco M",
            "initials": "FM",
            "lastname": "Gutierrez-Mariscal"
        },
        {
            "affiliation": "Lipids and Atherosclerosis Unit, Department of Internal Medicine, Hospital Universitario Reina Sof\u00eda, Cordoba, Spain.\nDepartment of Medical and Surgical Sciences, Universidad de Cordoba, Cordoba, Spain.\nMaimonides Institute for Biomedical Research in Cordoba (IMIBIC), Cordoba, Spain.\nCIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.",
            "firstname": "Antonio Pablo",
            "initials": "AP",
            "lastname": "Arenas-de Larriva"
        },
        {
            "affiliation": "Lipids and Atherosclerosis Unit, Department of Internal Medicine, Hospital Universitario Reina Sof\u00eda, Cordoba, Spain.\nDepartment of Medical and Surgical Sciences, Universidad de Cordoba, Cordoba, Spain.\nMaimonides Institute for Biomedical Research in Cordoba (IMIBIC), Cordoba, Spain.\nCIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.",
            "firstname": "Jos\u00e9 D",
            "initials": "JD",
            "lastname": "Torres-Pe\u00f1a"
        },
        {
            "affiliation": "Lipids and Atherosclerosis Unit, Department of Internal Medicine, Hospital Universitario Reina Sof\u00eda, Cordoba, Spain.\nDepartment of Medical and Surgical Sciences, Universidad de Cordoba, Cordoba, Spain.\nMaimonides Institute for Biomedical Research in Cordoba (IMIBIC), Cordoba, Spain.\nCIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.",
            "firstname": "Juan L",
            "initials": "JL",
            "lastname": "Romero-Cabrera"
        },
        {
            "affiliation": "Lipids and Atherosclerosis Unit, Department of Internal Medicine, Hospital Universitario Reina Sof\u00eda, Cordoba, Spain.\nDepartment of Medical and Surgical Sciences, Universidad de Cordoba, Cordoba, Spain.\nMaimonides Institute for Biomedical Research in Cordoba (IMIBIC), Cordoba, Spain.\nCIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.",
            "firstname": "Oriol Alberto",
            "initials": "OA",
            "lastname": "Rangel-Zu\u00f1iga"
        },
        {
            "affiliation": "Lipids and Atherosclerosis Unit, Department of Internal Medicine, Hospital Universitario Reina Sof\u00eda, Cordoba, Spain.\nDepartment of Medical and Surgical Sciences, Universidad de Cordoba, Cordoba, Spain.\nMaimonides Institute for Biomedical Research in Cordoba (IMIBIC), Cordoba, Spain.\nCIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.",
            "firstname": "Helena",
            "initials": "H",
            "lastname": "Garc\u00eda-Fern\u00e1ndez"
        },
        {
            "affiliation": "Lipids and Atherosclerosis Unit, Department of Internal Medicine, Hospital Universitario Reina Sof\u00eda, Cordoba, Spain.\nDepartment of Medical and Surgical Sciences, Universidad de Cordoba, Cordoba, Spain.\nMaimonides Institute for Biomedical Research in Cordoba (IMIBIC), Cordoba, Spain.\nCIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.",
            "firstname": "Alicia",
            "initials": "A",
            "lastname": "Podadera-Herreros"
        },
        {
            "affiliation": "Biochemical Laboratory, Reina Sofia University Hospital, C\u00f3rdoba, Spain.",
            "firstname": "Fernando",
            "initials": "F",
            "lastname": "Rodr\u00edguez-Cantalejo"
        },
        {
            "affiliation": "Institute of Experimental Pathology (ExPat), Center of Molecular Biology of Inflammation (ZMBE), University of M\u00fcnster, M\u00fcnster, Germany.",
            "firstname": "Oliver",
            "initials": "O",
            "lastname": "Soehnlein"
        },
        {
            "affiliation": "CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.\nDepartment of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Malaga, Spain. Institute of Biomedical Research in Malaga (IBIMA)-Bionand Platform, University of Malaga, Malaga, Spain.",
            "firstname": "Manuel",
            "initials": "M",
            "lastname": "Macias-Gonzalez"
        },
        {
            "affiliation": "CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.\nDepartment of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Malaga, Spain. Institute of Biomedical Research in Malaga (IBIMA)-Bionand Platform, University of Malaga, Malaga, Spain.",
            "firstname": "Francisco J",
            "initials": "FJ",
            "lastname": "Tinahones"
        },
        {
            "affiliation": "Lipids and Atherosclerosis Unit, Department of Internal Medicine, Hospital Universitario Reina Sof\u00eda, Cordoba, Spain.\nDepartment of Medical and Surgical Sciences, Universidad de Cordoba, Cordoba, Spain.\nMaimonides Institute for Biomedical Research in Cordoba (IMIBIC), Cordoba, Spain.\nCIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.",
            "firstname": "Elena M",
            "initials": "EM",
            "lastname": "Yubero Serrano"
        },
        {
            "affiliation": "Lipids and Atherosclerosis Unit, Department of Internal Medicine, Hospital Universitario Reina Sof\u00eda, Cordoba, Spain.\nDepartment of Medical and Surgical Sciences, Universidad de Cordoba, Cordoba, Spain.\nMaimonides Institute for Biomedical Research in Cordoba (IMIBIC), Cordoba, Spain.\nCIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.",
            "firstname": "Pablo",
            "initials": "P",
            "lastname": "Perez-Martinez"
        },
        {
            "affiliation": "Lipids and Atherosclerosis Unit, Department of Internal Medicine, Hospital Universitario Reina Sof\u00eda, Cordoba, Spain.\nDepartment of Medical and Surgical Sciences, Universidad de Cordoba, Cordoba, Spain.\nMaimonides Institute for Biomedical Research in Cordoba (IMIBIC), Cordoba, Spain.\nCIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.",
            "firstname": "Javier",
            "initials": "J",
            "lastname": "Delgado-Lista"
        },
        {
            "affiliation": "Lipids and Atherosclerosis Unit, Department of Internal Medicine, Hospital Universitario Reina Sof\u00eda, Cordoba, Spain. jlopezmir@uco.es.\nDepartment of Medical and Surgical Sciences, Universidad de Cordoba, Cordoba, Spain. jlopezmir@uco.es.\nMaimonides Institute for Biomedical Research in Cordoba (IMIBIC), Cordoba, Spain. jlopezmir@uco.es.\nCIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain. jlopezmir@uco.es.",
            "firstname": "Jos\u00e9",
            "initials": "J",
            "lastname": "L\u00f3pez-Miranda"
        }
    ],
    "conclusions": "These findings suggest that neutrophil count can help in identifying patients that are more likely to achieve T2DM remission following a Mediterranean diet, suggesting a role on insulin sensitivity and \u03b2-cell function. Further research holds promise for providing valuable insights into the pathophysiology of T2DM.",
    "copyrights": "\u00a9 2025. The Author(s).",
    "doi": "10.1038/s41387-025-00360-3",
    "journal": "Nutrition & diabetes",
    "keywords": [],
    "methods": null,
    "publication_date": "2025-03-28",
    "pubmed_id": "40148287\n35668219\n26076037\n16461555\n25887236\n28017281\n34462270\n36480153\n32529753\n33425484\n33931973\n36289459\n35525255\n29222373\n4337382\n31342228\n10480510\n30939855\n24687087\n34863046\n30993529\n32576516\n28734574\n33048064\n15780986\n31996800\n4827627\n33417682\n28254179\n27002116",
    "results": "The lowest baseline tertile of neutrophil count was associated with an increased likelihood of T2DM remission among patients following a Mediterranean diet (but not for low-fat diet) when compared with the highest tertile [adjusted HR of 4.23 (95% CI: 1.53-11.69)], in which similar results were observed for NER and NHR. When considering clinical and neutrophil variables, the predictive capacity of this model yielded an AUC of 0.783 (95% CI: 0.680-0.822). Furthermore, after 5-years, Responders exhibited lower neutrophil count compared to Non-responders (p\u2009=\u20090.006) and a significant decrease in neutrophil count (p\u2009=\u20090.001) compared to baseline. This decrease in neutrophil count in Responders who consumed a Mediterranean diet exhibited a significant increase in Insulin Sensitivity and Disposition Index (p\u2009=\u20090.011 and p\u2009=\u20090.018) after the follow-up period.",
    "title": "Effect of long-term Mediterranean versus low-fat diet on neutrophil count, and type 2 diabetes mellitus remission in patients with coronary heart disease: results from the CORDIOPREV study.",
    "xml": "<Element 'PubmedArticle' at 0x788502edb330>"
}