ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
A Community‑Based Study of Platelet‑to‑White Blood Cell Ratio and New‑Onset Type 2 Diabetes in Older Adults
Provisionally accepted
- 1First People's Hospital of Kunshan, Kunshan, China
- 2Qingyang Community Health Service Center, Kunshan, China
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Purpose: The platelet-to-white blood cell ratio (PWR) is a potential hematological indicator of dynamic changes in chronic inflammation. We aimed to investigate the association between the PWR and the risk of new-onset type 2 diabetes (T2D) in older adults. Methods: This retrospective community-based cohort study included 7571 community-dwelling older adults without diabetes from Kunshan, Jiangsu, China, who underwent health check-ups between January 2018 and December 2023. The PWR was calculated as the platelet count divided by the white blood cell count. The primary outcome was new-onset T2D. Associations were assessed using Cox proportional hazards models to compute hazard ratios (HRs) and 95% confidence intervals (CIs). Results: During follow-up, 773 incident T2D cases occurred, and higher baseline PWR was significantly associated with a lower risk of T2D. Participants in the highest PWR quartile had a 24.0% lower risk (HR 0.760, 95% CI 0.615-0.940, P=0.011) compared to the lowest quartile. Restricted cubic spline analysis revealed an approximately linear, inverse dose-response relationship (P overall<0.001, P non-linear=0.282). Subgroup and sensitivity analyses confirmed the robustness of this association. Conclusions: A higher baseline PWR is independently associated with a reduced risk of new-onset T2D in older adults, suggesting its potential as a simple, cost-effective inflammatory biomarker for T2D risk assessment in this population.
Keywords: cohort study, Community elderly population, Inflammation, Platelet-white cell ratio, type 2 diabetes
Received: 08 Dec 2025; Accepted: 29 Jan 2026.
Copyright: © 2026 Sheng, Xu and Pan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ying Pan
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