Leukocyte-Based Inflammatory Profiles Across Dyslipidemia Phenotypes: Patterns of Eosinophil-Related Indices

<i>Background and Objectives:</i> Dyslipidemia, a modifiable cardiovascular risk factor, is associated with chronic low-grade inflammation. While leukocyte-derived indices have been investigated in this context, eosinophil-related inflammatory markers remain underexplored. This study examined patterns of eosinophil-to-lymphocyte ratio (ELR) and eosinophil-adjusted systemic inflammation response index (EA-SIRI) across dyslipidemia phenotypes. <i>Materials and Methods:</i> In this retrospective study, adult subjects were classified into six dyslipidemia phenotypes. Leukocyte-derived indices were evaluated across groups, and analyses included comparisons of medians, prevalence rates, tertile distributions, odds ratios, and risk estimates. <i>Results:</i> Both ELR and EA-SIRI were significantly higher in individuals with atherogenic dyslipidemia (ELR: 0.18; EA-SIRI: 1.53) and combined dyslipidemia (ELR: 0.17; EA-SIRI: 1.49) compared to the normolipidemic group (ELR: 0.11; EA-SIRI: 0.92). Notably, these patterns were more pronounced in males aged <40 years and younger females (<40), suggesting sex- and age-related variations in eosinophil-related inflammatory responses to dyslipidemia. Moreover, the highest tertiles of both ELR and EA-SIRI exhibited higher triglycerides and lower HDL-C compared to the lowest tertiles (<i>p</i> < 0.001). The odds of atherogenic dyslipidemia were more than doubled in individuals with elevated ELR (OR = 2.02; <i>p</i> < 0.001) and EA-SIRI (OR = 2.19; <i>p</i> < 0.001). ROC curve analysis indicated modest discriminative power for identifying atherogenic dyslipidemia, with ELR and EA-SIRI yielding AUC of 0.60 (<i>p</i> < 0.001) and 0.62 (<i>p</i> < 0.001), respectively. <i>Conclusions:</i> Our findings suggest eosinophil-related inflammation contributes to immunometabolic dysregulation underlying dyslipidemia. ELR and EA-SIRI may offer insights into inflammation-driven lipid disturbances and help detect subclinical inflammatory activity associated with atherogenic lipid profiles.