Clinical analysis of peripheral blood NLR and NHR in carotid atherosclerosis in patients with end-stage renal disease
Clinical Medicine|更新时间:2026-01-09
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Clinical analysis of peripheral blood NLR and NHR in carotid atherosclerosis in patients with end-stage renal disease
Journal of Army Medical UniversityVol. 44, Issue 13, Pages: 1395-1400(2022)
作者机构:
637000 四川 南充,川北医学院附属医院肾内科
作者简介:
基金信息:
the Scientific Research Project of Sichuan Provincial Health Commission(19ZD006);the Special Project of Science and Technology Strategic Cooperation of Nanchong City and Municipal Schools(20SXQT0287)
Kun YANG, Qinyun LI, Jingzhu WANG, et al. Clinical analysis of peripheral blood NLR and NHR in carotid atherosclerosis in patients with end-stage renal disease[J]. Journal of Army Medical University, 2022, 44(13): 1395-1400.
DOI:
Kun YANG, Qinyun LI, Jingzhu WANG, et al. Clinical analysis of peripheral blood NLR and NHR in carotid atherosclerosis in patients with end-stage renal disease[J]. Journal of Army Medical University, 2022, 44(13): 1395-1400. DOI: 10.16016/j.2097-0927.202111207.
Clinical analysis of peripheral blood NLR and NHR in carotid atherosclerosis in patients with end-stage renal disease
To investigate the clinical value of neutrophil/lymphocyte ratio (NLR) and neutrophil/high-density lipoprotein cholesterol ratio (NHR) for carotid atherosclerosis (CAS) in patients with end-stage renal disease (ESRD).
Methods
2
A total of 220 ESRD patients [glomerular filtration rate
<
15 mL/(min·1.73 m
2
)
]
admitted in our department from January 2017 to January 2021 were recruited in this study. According to the results of neck color Doppler ultrasound
they were divided into CAS group (
n
=80) and non-CAS group (
n
=140). Their general data
results of blood routine test
biochemical indexes and hs-CRP level were collected
and then NLR
NHR
monocyte to high-density lipoprotein cholesterol ratio (MHR)
and platelet to lymphocyte ratio (PLR) were calculated.
Results
2
The CAS group had significant older age
higher NLR
NHR
PLR and MHR
and lower hemoglobin
albumin and HDL levels when compared with the non-CAS group (
P
<
0.05). Multivariate logistic regression analysis showed that older age (
OR
=1.067
95%
CI
: 1.035~1.099
P
<
0.001)
elevated NLR (
OR
=1.295
95%
CI
: 1.066~1.574
P
=0.009)
and increased NHR (
OR
=2.143
95%
CI
: 1.620~2.834
P
<
0.001) were risk factors for CAS
and risen hemoglobin (
OR
=0.945
95%
CI
: 0.923~0.967
P
<
0.001) were protective factors for CAS in ESRD patients. ROC curve analysis indicated that NLR (AUC=0.759
95%
CI
: 0.696~0.82
P
<
0.000 1)
NHR (AUC=0.755
95%
CI
: 0.691~0.820
P
<
0.000 1) and their combination (AUC=0.793
95%
CI
: 0.733~0.853
P
<
0.000 1) had certain predictive values for CAS in ESRD patients.
Conclusion
2
NLR and NHR
as inflammatory indexes
are independent risk factors for CAS in ESRD patients. Their combination might have better predictive value for CAS in these patients.
关键词
Keywords
references
MOODY W E, EDWARDS N C, CHUE C D, et al . Arterial disease in chronic kidney disease[J ] . Heart, 2013, 99(6): 365-372. DOI: 10.1136/heartjnl-2012-302818.
LOZANO R, NAGHAVI M, FOREMAN K, et al . Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010[J ] . Lancet, 2012, 380(9859): 2095-2128. DOI: 10.1016/S0140-6736(12)61728-0.
TALEB S. Inflammation in atherosclerosis[J]. Arch Cardiovasc Dis, 2016, 109(12): 708-715. DOI: 10.1016/j.acvd.2016.04.002.
BALTA S, CELIK T, MIKHAILIDIS D P, et al . The relation between atherosclerosis and the neutrophil-lymphocyte ratio[J ] . Clin Appl Thromb Hemost, 2016, 22(5): 405-411. DOI: 10.1177/1076029615569568.
HUANG J B, CHEN Y S, JI H Y, et al . Neutrophil to high-density lipoprotein ratio has a superior prognostic value in elderly patients with acute myocardial infarction: a comparison study[J ] . Lipids Health Dis, 2020, 19(1): 59. DOI: 10.1186/s12944-020-01238-2.
NDREPEPA G, IIJIMA R, KUFNER S, et al . Association of progression or regression of coronary artery atherosclerosis with long-term prognosis[J ] . Am Heart J, 2016, 177: 9-16. DOI: 10.1016/j.ahj.2016.03.016.
SÁRKÖZY M, KOVÁCS Z Z A, KOVÁCS M G, et al . Mechanisms and modulation of oxidative/nitrative stress in type 4 cardio-renal syndrome and renal sarcopenia[J ] . Front Physiol, 2018, 9: 1648. DOI: 10.3389/fphys.2018.01648.
GARG A X, CLARK W F, HAYNES R B, et al . Moderate renal insufficiency and the risk of cardiovascular mortality: results from the NHANES I[J ] . Kidney Int, 2002, 61(4): 1486-1494. DOI: 10.1046/j.1523-1755.2002.00270.x.
COLLINS A J, FOLEY R N, CHAVERS B, et al . United States Renal Data System 2011 Annual Data Report: atlas of chronic kidney disease & end-stage renal disease in the United States[J ] . Am J Kidney Dis, 2012, 59(1 Suppl 1): A7, e1-A7, 420. DOI: 10.1053/j.ajkd.2011.11.015.
WEBER C, ZERNECKE A, LIBBY P. The multifaceted contributions of leukocyte subsets to atherosclerosis: lessons from mouse models[J]. Nat Rev Immunol, 2008, 8(10): 802-815. DOI: 10.1038/nri2415.
MONTECUCCO F, LIBERALE L, BONAVENTURA A, et al . The role of inflammation in cardiovascular outcome[J ] . Curr Atheroscler Rep, 2017, 19(3): 11. DOI: 10.1007/s11883-017-0646-1.
ROTZIUS P, THAMS S, SOEHNLEIN O, et al . Distinct infiltration of neutrophils in lesion shoulders in ApoE -/- mice[J ] . Am J Pathol, 2010, 177(1): 493-500. DOI: 10.2353/ajpath.2010.090480..
WANG X S, KIM H B, SZUCHMAN-SAPIR A, et al . Neutrophils recruited to the myocardium after acute experimental myocardial infarct generate hypochlorous aci d that oxidizes cardiac myoglobin[J ] . Arch Biochem Biophys, 2016, 612: 103-114. DOI: 10.1016/j.abb.2016.10.013.
PARK J S, CHA K S, LEE H W, et al . Predictive and protective role of high-density lipoprotein cholesterol in acute myocardial infarction[J ] . Cardiol J, 2019, 26(2): 176-185. DOI: 10.5603/CJ.a2018.0020.
YUNOKI K, NARUKO T, INABA M, et al . Gender-specific correlation between plasma myeloperoxidase levels and serum high-density lipoprotein-associated paraoxonase-1 levels in patients with stable and unstable coronary artery disease[J ] . Atherosclerosis, 2013, 231(2): 308-314. DOI: 10.1016/j.atherosclerosis.2013.08.037.
LIU Z, WU S Z, FAN Q L, et al . Value of NHR and MHR for predicting atherosclerotic stenosis at different altitudes[J ] . Chin J Geriatr Heart Brain Vessel Dis, 2021, 23(10): 1073-1076.
WANG X Q, FAN X D, JI S F, et al . Prognostic value of neutrophil to lymphocyte ratio in heart failure patients[J ] . Clin Chimica Acta, 2018, 485: 44-49. DOI: 10.1016/j.cca.2018.06.021.
GHAFFARI S, NADIRI M, POURAFKARI L, et al . The predictive value of total neutrophil count and neutrophil/lymphocyte ratio in predicting in-hospital mortality and complications after STEMI[J ] . J Cardiovasc Thorac Res, 2014, 6(1): 35-41. DOI: 10.5681/jcvtr.2014.007.
WALSH S R, COOK E J, GOULDER F, et al . Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer[J ] . J Surg Oncol, 2005, 91(3): 181-184. DOI: 10.1002/jso.20329.
ADAMSTEIN N H, MACFADYEN J G, ROSE L M, et al .The neutrophil-lymphocyte ratio and incident atherosclerotic events: analyses from five contemporary randomized trials[J ] . Eur Heart J, 2021, 42(9): 896-903. DOI: 10.1093/eurheartj/ehaa1034.
SPAHN D R, SCHOENRATH F, SPAHN G H, et al . Effect of ultra-short-term treatment of patients with iron deficiency or anaemia undergoing cardiac surgery: a prospective randomised trial[J ] . Lancet, 2019, 393(10187): 2201-2212. DOI: 10.1016/S0140-6736(18)32555-8.
ISHIGAMI J, GRAMS M E, NAIK R P, et al . Hemoglobin, albuminuria, and kidney function in cardiovascular risk: the ARIC(atherosclerosis risk in communities) study[J ] . J Am Heart Assoc, 2018, 7(2): e00720 9. DOI:10.1161/JAHA.117.007209.