Chung Darda, Lee Kee Ook, Choi Jung-Won, Kim Nam Keun, Kim Ok-Joon, Kim Sang-Heum, Oh Seung-Hun, Kim Won Chan
Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
Institute for Clinical Research, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
Front Neurol. 2020 Sep 9;11:1022. doi: 10.3389/fneur.2020.01022. eCollection 2020.
The blood neutrophil/lymphocyte ratio (NLR) is a marker of peripheral inflammation, with a high NLR associated with an increased risk of cardiovascular events and poor prognosis in ischemic stroke. However, few data are available on the differential impact of the blood NLR on different silent cerebral vascular pathologies, including cerebral large-artery atherosclerosis (LAA) and cerebral small-vessel disease (CSVD), in neurologically healthy individuals. We evaluated cardiovascular risk factors, brain magnetic resonance imaging (MRI), and MR angiography of 950 individuals without any neurological diseases. The study participants were divided into three groups according to NLR tertile (low, middle, and high). The presences of extracranial (EC) and intracranial (IC) atherosclerosis were considered to indicate LAA on brain MR angiography. The presences of silent lacunar infarction (SLI) and cerebral white matter hyperintensities (WMHs) were analyzed as indices of CSVD on brain MRI. In univariate analysis, the high NLR tertile group showed a high prevalence of old age, hyperlipidemia, and renal dysfunction and higher fasting glucose. Multivariable logistic regression analysis revealed that indices of LAA (EC atherosclerosis [odds ratio: 1.88; 95% confidence interval: 1.14-3.09; = 0.01] and IC atherosclerosis [odds ratio: 1.87; 95% confidence interval: 1.15-3.06; = 0.01]) were more prevalent in the highest NLR tertile group than in the lowest NLR tertile group after adjustment for cardiovascular risk factors. However, no significant differences were found in the prevalence of CSVD indices (SLI and WMHs) among the three NLR tertile groups. A high NLR is associated with the development of cerebral LAA but not CSVD.
血液中性粒细胞/淋巴细胞比值（NLR）是外周炎症的一个标志物，NLR升高与心血管事件风险增加及缺血性卒中预后不良相关。然而，关于血液NLR对神经功能正常个体不同隐匿性脑血管病变（包括大脑大动脉粥样硬化（LAA）和脑小血管病（CSVD））的差异影响，目前可用的数据较少。我们评估了950名无任何神经疾病个体的心血管危险因素、脑磁共振成像（MRI）和磁共振血管造影。研究参与者根据NLR三分位数分为三组（低、中、高）。脑磁共振血管造影上颅外（EC）和颅内（IC）动脉粥样硬化的存在被视为LAA的指标。脑MRI上无症状腔隙性梗死（SLI）和脑白质高信号（WMH）的存在作为CSVD的指标进行分析。在单变量分析中，高NLR三分位数组显示老年、高脂血症、肾功能不全的患病率较高，空腹血糖也较高。多变量逻辑回归分析显示，在调整心血管危险因素后，LAA指标（EC动脉粥样硬化[比值比：1.88；95%置信区间：1.14 - 3.09；P = 0.01]和IC动脉粥样硬化[比值比：1.87；95%置信区间：1.15 - 3.06；P = 0.01]）在最高NLR三分位数组比最低NLR三分位数组更普遍。然而，三个NLR三分位数组之间CSVD指标（SLI和WMH）的患病率没有显著差异。高NLR与大脑LAA的发生相关，但与CSVD无关。
