Hospital Israelita Albert Einstein,São Paulo, SP - Brasil.
Universidade de São Paulo,São Paulo, SP - Brasil.
Arq Bras Cardiol. 2022 Apr;118(4):729-734. doi: 10.36660/abc.20201163.
Neutrophil-to-lymphocyte ratio (NLR) has been proposed as an inflammatory marker that might be associated with coronary atherosclerosis, although most of the current data is restricted to the acute setting. Additionally, the association of NLR with extracoronary atherosclerosis and stable disease remains unclear.
To analyze the association between NLR and abdominal aortic atherosclerosis (AAAt).
We included asymptomatic individuals who underwent a health screening program. AAAt was measured by ultrasound. Absolute leukocyte and lymphocyte counts were used to calculate the NLR. The level of significance for statistical analysis was 0.05.
Among 36,985 individuals (age: 42±10 years, 72% male), AAAt was identified in 7%. Those with AAAt were older and more likely to be male and diabetic. Presence of AAAt was associated with increased NLR (odds ratio [OR] 1.17; 95% confidence interval [CI] 1.13-1.21). However, this association was no longer significant when the analysis was adjusted for risk factors (OR 1.02; 95% CI 0.97-1.06), mostly due to the inclusion of age in the model. When neutrophils and lymphocytes were analyzed separately, the negative association between lymphocytes and AAAt was inverted once age was accounted for, suggesting a strong confounding effect of age on the relationship between lymphocytes and atherosclerosis. Finally, the association of neutrophils and AAAt lost significance after an additional adjustment for traditional risk factors, but not age alone.
Although the NLR was associated with AAAt, this was largely due to the confounding effect of age. Overall, the results suggest a limited role of leukocyte measurements as biomarkers of AAAt.
中性粒细胞与淋巴细胞比值（NLR）已被提出作为一种炎症标志物，可能与冠状动脉粥样硬化有关，尽管目前大多数数据仅限于急性情况。此外，NLR 与冠状动脉外粥样硬化和稳定疾病的关系尚不清楚。
分析 NLR 与腹主动脉粥样硬化（AAAt）的相关性。
我们纳入了参加健康筛查计划的无症状个体。通过超声测量 AAAt。使用绝对白细胞和淋巴细胞计数来计算 NLR。统计分析的显著性水平为 0.05。
在 36985 名个体（年龄：42±10 岁，72%为男性）中，AAAt 的检出率为 7%。患有 AAAt 的个体年龄较大，更可能为男性和糖尿病患者。AAAt 的存在与 NLR 升高相关（比值比 [OR] 1.17；95%置信区间 [CI] 1.13-1.21）。然而，当分析调整危险因素时，这种相关性不再显著（OR 1.02；95%CI 0.97-1.06），这主要是由于年龄纳入了模型。当单独分析中性粒细胞和淋巴细胞时，一旦考虑到年龄，淋巴细胞与 AAAt 之间的负相关关系就会反转，表明年龄对淋巴细胞与动脉粥样硬化之间关系的强烈混杂影响。最后，在进一步调整传统危险因素后，中性粒细胞与 AAAt 的相关性失去了意义，但单独调整年龄则不然。
尽管 NLR 与 AAAt 相关，但这主要是由于年龄的混杂影响。总体而言，结果表明白细胞测量作为 AAAt 的生物标志物的作用有限。
