中性粒细胞与高密度脂蛋白胆固醇比值与冠状动脉狭窄严重程度的关系。
Relationship between neutrophils to HDL-C ratio and severity of coronary stenosis.
机构信息
Southwest Medical University, Luzhou, China.
School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
出版信息
BMC Cardiovasc Disord. 2021 Mar 6;21(1):127. doi: 10.1186/s12872-020-01771-z.
BACKGROUND
Lipid and inflammatory molecules play a key role in the development of inflammation. Neutrophil counts are used as markers of inflammation duration, and HDL-C is used as an anti-atherosclerosis component. However, few studies have been found to integrate these two indicators to explore coronary stenosis. We suggested that neutrophil count as a marker of inflammation persistence and HDL-C as an anti-atherosclerotic component should be integrated into a single biomarker NHR to explore its correlation with CAD degree and predict the severity of coronary stenosis among CAD patients.
METHODS
We examined 404 eligible patients who underwent coronary angiography. Based on the results of coronary angiography, patients in CAD group (n = 155) were defined as those having angiographic coronary stenosis of at least 50% lumen reduction in at least one major coronary artery (including left anterior descending artery, left circumflex artery, left main coronary artery, right coronary artery). Patients with luminal stenosis but no more than 50% were defined as CAD group (n = 49), and patients without luminal stenosis (n = 200) were regarded as control group. The relationship between various serum markers and the severity of coronary stenosis was examined by Spearman correlation analysis. Logistic regression analysis was performed to identify the influencing factors of the severity of coronary artery disease.
RESULTS
The modified Gensini score was positively correlated with neutrophil HDL-C ratio and negatively correlated with albumin and HDL-C. Multiple regression analysis showed that neutrophil HDL-C ratio were significantly associated with CAD. Neutrophil HDL-C ratio is an independent predictor of CAD. The ROC analysis provided a cut-off value of 1.51 for neutrophil HDL-C ratio to predict CAD with 94.8% sensitivity and 0.024 Yoden index, and area under the ROC curve of 0.617 (95% CI 0.560-0.675, P < 0.001).
CONCLUSION
Neutrophil HDL-C ratio is not only closely related to coronary artery stenosis, but also an independent predictor of severe coronary stenosis.
背景
脂质和炎症分子在炎症的发展中起着关键作用。中性粒细胞计数可作为炎症持续时间的标志物，而 HDL-C 可作为抗动脉粥样硬化成分。然而，很少有研究将这两个指标整合起来探讨冠状动脉狭窄。我们提出，中性粒细胞计数作为炎症持续的标志物，HDL-C 作为抗动脉粥样硬化成分，应该整合到一个单一的生物标志物 NHR 中，以探讨其与 CAD 程度的相关性，并预测 CAD 患者冠状动脉狭窄的严重程度。
方法
我们检查了 404 名符合条件的接受冠状动脉造影的患者。根据冠状动脉造影的结果，将 CAD 组（n=155）定义为至少一条主要冠状动脉（包括左前降支、左回旋支、左主干冠状动脉、右冠状动脉）管腔减少至少 50%的血管造影冠状动脉狭窄的患者。管腔狭窄但不超过 50%的患者定义为 CAD 组（n=49），管腔无狭窄的患者（n=200）定义为对照组。采用 Spearman 相关分析探讨各种血清标志物与冠状动脉狭窄严重程度的关系。采用 Logistic 回归分析确定冠状动脉疾病严重程度的影响因素。
结果
改良的 Gensini 评分与中性粒细胞 HDL-C 比值呈正相关，与白蛋白和 HDL-C 呈负相关。多因素回归分析显示，中性粒细胞 HDL-C 比值与 CAD 显著相关。中性粒细胞 HDL-C 比值是 CAD 的独立预测因子。ROC 分析为中性粒细胞 HDL-C 比值提供了预测 CAD 的截断值为 1.51，灵敏度为 94.8%，Yoden 指数为 0.024，ROC 曲线下面积为 0.617（95%CI 0.560-0.675，P<0.001）。
结论
中性粒细胞 HDL-C 比值不仅与冠状动脉狭窄密切相关，而且是严重冠状动脉狭窄的独立预测因子。
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