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一般健康体检中未诊断高血压人群中性粒细胞与淋巴细胞比值与肾功能不全的相关性

Correlation between neutrophil-to-lymphocyte ratio and kidney dysfunction in undiagnosed hypertensive population from general health checkup.

作者信息

Chen Chen, Zhao Hai Yan, Zhang Yin Hua

机构信息

Yanbian University Hospital, Clinical Research Center, Yanji, China.

Department of Physiology & Biomedical Sciences, Ischemic/hypoxic Disease Institutes, Seoul National University, College of Medicine, Seoul, Korea.

出版信息

J Clin Hypertens (Greenwich). 2020 Jan;22(1):47-56. doi: 10.1111/jch.13749. Epub 2019 Dec 1.

Abstract

Recently, neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR) are frequently used to evaluate disease progression and outcome. Here, we aim to analyze the associations between NLR or MLR and kidney function in undiagnosed hypertensive individuals from general population during routine health checkup. Liver function was analyzed for comparison. From 2011 to 2016, 53 939 examiners have registered for health checkup in Yanbian University Hospital, Yanbian, China. Among 15 219 participants who have complete datasets, 4997 individuals were hypertensive (HTN, SBP/DBP: ≥ 140/90 mm Hg). NLR, glucose, lipids (Chol, TG, LDL), kidney (CREA, BUN), and liver (AST, ALT, GGT, ALB, TBIL) functional parameters were significantly higher in HTN. Pearman correlation analysis showed that NLR was positively correlated with SBP and CREA only in HTN. MLR was associated with CREA in both HTN and non-HTN. NLR or MLR was associated with liver functions similarly in HTN and non-HTN. The authors then divided NLR or MLR into tertiles (NLR: 0-1.7276, 1.7276-3, >3; MLR: 0-0.1845, 0.1845-0.3, >0.3). NLR was positively associated with BUN at NLR >1.7276 and with CREA at all tertiles in HTN. MLR was correlated with CREA and BUN at high MLR in non-HTN. Further analysis showed that age or gender did not affect the associations of NLR and MLR with kidney function in HTN, but strong association was observed in male or aged (>65 years old) non-HTN group. These results showed that NLR could be used as a cost-effective predictor of kidney abnormality in HTN patients even in a general population.

摘要

最近,中性粒细胞与淋巴细胞比值(NLR)和单核细胞与淋巴细胞比值(MLR)常被用于评估疾病进展和预后。在此,我们旨在分析在常规健康体检中来自普通人群的未诊断高血压个体中,NLR或MLR与肾功能之间的关联。同时分析肝功能以作比较。2011年至2016年,53939名体检者在中国延边大学附属医院进行了健康体检登记。在15219名拥有完整数据集的参与者中,4997人患有高血压(HTN,收缩压/舒张压:≥140/90 mmHg)。高血压患者的NLR、血糖、血脂(胆固醇、甘油三酯、低密度脂蛋白)、肾脏(肌酐、尿素氮)和肝脏(谷草转氨酶、谷丙转氨酶、γ-谷氨酰转肽酶、白蛋白、总胆红素)功能参数显著更高。Pearman相关性分析表明,仅在高血压患者中NLR与收缩压和肌酐呈正相关。MLR在高血压和非高血压患者中均与肌酐相关。在高血压和非高血压患者中,NLR或MLR与肝功能的关联相似。作者随后将NLR或MLR分为三分位数(NLR:0 - 1.7276、1.7276 - 3、>3;MLR:0 - 0.1845、0.1845 - 0.3、>0.3)。在高血压患者中,当NLR>1.7276时NLR与尿素氮呈正相关,在所有三分位数时均与肌酐呈正相关。在非高血压患者中,高MLR时MLR与肌酐和尿素氮相关。进一步分析表明,年龄或性别并不影响高血压患者中NLR和MLR与肾功能的关联,但在男性或年龄大于65岁的非高血压组中观察到强关联。这些结果表明,即使在普通人群中,NLR也可作为高血压患者肾脏异常的一种经济有效的预测指标。

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