中性粒细胞与淋巴细胞比值及其与肥胖人群中促炎介质、内脏脂肪和颈动脉内膜中层厚度的关系。

Neutrophil-to-lymphocyte ratio and its relation with pro-inflammatory mediators, visceral adiposity and carotid intima-media thickness in population with obesity.

机构信息

Division of Biomedical Research, Department of Experimental Metabolism and Clinical Research, Centro Médico Nacional "20 de Noviembre", Mexico City, Mexico.

Internal Medicine Department, Hospital General de Xoco, SEDESA, Mexico City, Mexico.

出版信息

Eur J Clin Invest. 2019 May;49(5):e13085. doi: 10.1111/eci.13085. Epub 2019 Mar 7.

DOI:10.1111/eci.13085

PMID:30740673

Abstract

BACKGROUND

Atherosclerosis represents a cardiovascular risk. Chronic inflammation is a key factor for atherogenic progression. Neutrophil-to-lymphocyte ratio (NLR) has been proposed as a novel biomarker for cardiovascular risks. We aimed to explore whether NLR was related to surrogate pro-atherogenic promoters driving atherogenic progression, as measured by carotid intima-media thickness (CIMT).

STUDY DESIGN

Thirty-one patients with obesity candidates for bariatric surgery were recruited from Centro Médico Nacional "20 de Noviembre", ISSSTE, Mexico City. The results are part of the "CROP" study (NCT03561987). NLR was calculated from routine complete blood count, and its relation with plasma pro-inflammatory mediators (hsCRP, TNF-α and IL-1β), adipokines (adiponectin and leptin), adiposity markers (visceral adipose tissue [VAT] determined from CT scan image and VAT individual adipocyte area at histological sample) and CIMT were determined.

RESULTS

Neutrophil-to-lymphocyte ratio correlated with hsCRP (Spearman's r = 0.70 [95% CI 0.46 to 0.85], P < 0.01), TNF-α (r = 0.69 [0.44 to 0.84], P < 0.0001) and adiponectin (r = -0.69 [-0.84 to -0.45], P < 0.03), as well as with VAT individual adipocyte area (r = 0.64 [0.37 to 0.81], P < 0.0001) and with VAT area (r = 0.43; [0.07 to 0.68], P < 0.01). Leptin and adiponectin showed further independent association with higher NLR (multivariate regression analysis OR 7.9 [95% CI 1.1 to 56.2] P = 0.03 and 0.1 [0.01 to 1.0] P = 0.05, respectively). Moreover, NLR distribution significantly varied between subgroups divided according to progressive CIMT (P = 0.05); whereas adiponectin and VAT adipocyte area associated with CIMT > 0.9 mm (univariate analysis OR 0.1 [0.01 to 1.0] P = 0.05 and 13.1 [1.4 to 126.3] P = 0.03, respectively).

CONCLUSION

Neutrophil-to-lymphocyte ratio was related to pro-inflammatory, adiposity biomarkers and progressive subclinical atherogenesis.

摘要

背景

动脉粥样硬化代表心血管风险。慢性炎症是动脉粥样硬化进展的关键因素。中性粒细胞与淋巴细胞比值（NLR）已被提议作为心血管风险的新型生物标志物。我们旨在探讨 NLR 是否与颈动脉内膜中层厚度（CIMT）测量的促动脉粥样硬化促进剂有关。

研究设计

31 名肥胖候选减重手术的患者从墨西哥城的 Centro Médico Nacional "20 de Noviembre"，ISSSTE 招募。结果是“CROP”研究的一部分（NCT03561987）。NLR 是从常规全血细胞计数中计算得出的，其与血浆促炎介质（hsCRP、TNF-α 和 IL-1β）、脂联素和瘦素、肥胖标志物（从 CT 扫描图像确定的内脏脂肪组织 [VAT] 和组织学样本中每个脂肪细胞的 VAT 面积）和 CIMT 之间的关系。

结果

中性粒细胞与淋巴细胞比值与 hsCRP（Spearman r = 0.70 [95% CI 0.46 至 0.85]，P < 0.01）、TNF-α（r = 0.69 [0.44 至 0.84]，P < 0.0001）和脂联素（r = -0.69 [-0.84 至 -0.45]，P < 0.03）相关，也与 VAT 个体脂肪细胞面积（r = 0.64 [0.37 至 0.81]，P < 0.0001）和 VAT 面积（r = 0.43；[0.07 至 0.68]，P < 0.01）相关。瘦素和脂联素进一步与更高的 NLR 独立相关（多变量回归分析 OR 7.9 [95% CI 1.1 至 56.2]，P = 0.03 和 0.1 [0.01 至 1.0]，P = 0.05）。此外，根据 CIMT 的进展，NLR 分布在按 CIMT 逐渐增加的亚组之间显著不同（P = 0.05）；而脂联素和 VAT 脂肪细胞面积与 CIMT > 0.9 mm 相关（单变量分析 OR 0.1 [0.01 至 1.0]，P = 0.05 和 13.1 [1.4 至 126.3]，P = 0.03）。