WITHDRAWN: Systemic Inflammation in Prediabetes: A Retrospective Comparative Analysis of Hematological Inflammatory Indices

Background Prediabetes is increasingly recognized as a metabolically active state associated with inflammatory alterations. Low-grade systemic inflammation may already be present before the onset of overt diabetes; however, accessible biomarkers reflecting this process in the prediabetic stage remain insufficiently defined. This study aimed to evaluate systemic inflammation in prediabetic individuals using hematological inflammatory indices and C-reactive protein (CRP), and to compare these markers with those of normoglycemic individuals. Additionally, the relationships between glycemic parameters and inflammatory markers were investigated. Methods This retrospective cross-sectional study included adult individuals who attended the Internal Medicine outpatient clinics of Gaziantep University Şahinbey Training and Research Hospital between 2021 and 2024. Participants were classified as prediabetic or normoglycemic according to established diagnostic criteria (American Diabetes Association and World Health Organization). Hematological inflammatory indices, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), mean platelet volume (MPV), red cell distribution width–standard deviation (RDW-SD), and CRP were analyzed. Group comparisons were performed using independent samples t-tests, and associations between glycemic parameters and inflammatory markers were evaluated using correlation and multivariable linear regression analyses adjusted for age and sex. Results Prediabetic individuals exhibited significantly higher fasting plasma glucose and HbA1c levels compared with normoglycemic controls (both p<0.001). Inflammatory markers including NLR, PLR, MLR, and CRP were also significantly elevated in the prediabetes group (all p<0.05). In contrast, MPV and RDW-SD did not differ significantly between groups (p>0.05). Correlation analysis showed that HbA1c was positively associated with NLR (r: 0.356 p<0.001), PLR (r: 0.434 p<0.001), and CRP (r:0.202 p<0.05), whereas fasting plasma glucose showed weaker and mostly nonsignificant correlations with inflammatory indices. In multivariable linear regression analyses adjusted for age and sex, HbA1c was independently associated with both neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio. Conclusions Prediabetes is associated with increased systemic inflammation as reflected by elevated leukocyte-derived hematological indices and CRP. The stronger association between HbA1c and inflammatory markers compared with fasting glucose suggests that cumulative glycemic burden may better capture early inflammatory activity. Simple hematological indices may serve as potential supportive markers in the assessment of inflammatory status in prediabetic individuals. Clinical trial number: Not applicable