Department of Medical Education, Taichung Veterans General Hospital, Taichung 40705, Taiwan.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan.
Int J Environ Res Public Health. 2022 Jun 30;19(13):8077. doi: 10.3390/ijerph19138077.
Background: Inflammation has been proposed to play potential roles in the development and progression of chronic kidney disease (CKD). We evaluated the relationship of neutrophil-to-lymphocyte ratio (NLR), a systemic inflammation marker, with CKD in normal-weight and overweight/obese adults. Methods: This cross-sectional study included 2846 apparently healthy adults who underwent a health examination between August 2000 and April 2002. Normal-weight was defined as a body mass index (BMI, kg/m2) of 18.5−24, while overweight/obesity was defined as a BMI of ≥24. CKD was defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2. Logistic and linear regression analysis was performed to explore the NLR−CKD relationship. Results: Of the 2846 participants (1777 men and 1069 women), there were 348 CKD individuals (12.3%), with 262 (14.7%) men and 86 (8%) women. A total of 1011 men (56.9%) and 408 women (38.2%) were overweight or obese. Compared with the normal-weight participants, CKD prevalence was higher in the overweight/obese women (6.1% vs. 11.3%, p = 0.002), but not in the overweight/obese men (14.5% vs. 14.9%, p = 0.793). CKD percentages in the NLR quartile groups were 9.4%, 11.5%, 15.4%, and 22.7% in men (p < 0.0001) and 6.4%, 7.1%, 10.5%, and 8.2% in women (p = 0.2291). After adjustment for confounders, each increment of one unit of NLR was associated with a higher CKD risk in the overweight/obese men (adjusted odds ratio (OR) = 1.37, 95% confidence interval (CI) = 1.03−1.82, p = 0.03) and women (adjusted OR = 1.77, 95% CI = 1.08−2.90, p = 0.023), whereas NLR was not associated with CKD in normal-weight men or women. Further, in the overweight/obese participants with an eGFR of 50−70 mL/min/1.73 m2, univariable linear regression analysis revealed a significant negative correlation between NLR and eGFR for men (p = 0.004) and women (p = 0.009). Conclusions: It was found that higher NLR was associated with an increased CKD risk in overweight/obese but not in normal-weight men and women in an adult health examination dataset. Our study suggests a role of NLR for CKD prediction in overweight/obese individuals.
炎症被认为在慢性肾脏病（CKD）的发展和进展中起潜在作用。我们评估了中性粒细胞与淋巴细胞比值（NLR）这一全身炎症标志物与正常体重和超重/肥胖成年人 CKD 之间的关系。
本横断面研究纳入了 2846 名接受 2000 年 8 月至 2002 年 4 月健康检查的貌似健康成年人。正常体重定义为体重指数（BMI，kg/m2）为 18.5-24，超重/肥胖定义为 BMI≥24。CKD 定义为估算肾小球滤过率（eGFR）＜60 mL/min/1.73 m2。采用 logistic 和线性回归分析探讨 NLR 与 CKD 的关系。
在 2846 名参与者（1777 名男性和 1069 名女性）中，有 348 名 CKD 患者（12.3%），其中 262 名（14.7%）为男性，86 名（8%）为女性。共有 1011 名男性（56.9%）和 408 名女性（38.2%）超重或肥胖。与正常体重者相比，超重/肥胖女性的 CKD 患病率更高（6.1%比 11.3%，p=0.002），但超重/肥胖男性的 CKD 患病率无显著差异（14.5%比 14.9%，p=0.793）。男性 NLR 四分位组的 CKD 百分比分别为 9.4%、11.5%、15.4%和 22.7%（p＜0.0001），女性分别为 6.4%、7.1%、10.5%和 8.2%（p=0.2291）。校正混杂因素后，NLR 每增加 1 单位，超重/肥胖男性（调整后的优势比（OR）=1.37，95%置信区间（CI）=1.03-1.82，p=0.03）和女性（调整后的 OR=1.77，95%CI=1.08-2.90，p=0.023）发生 CKD 的风险均更高，而 NLR 与正常体重男性或女性的 CKD 无关。此外，在 eGFR 为 50-70 mL/min/1.73 m2 的超重/肥胖参与者中，单变量线性回归分析显示 NLR 与男性（p=0.004）和女性（p=0.009）的 eGFR 呈显著负相关。
在成年体检数据集中，我们发现 NLR 升高与超重/肥胖男性和女性的 CKD 风险增加相关，而与正常体重者无关。本研究提示 NLR 可能有助于超重/肥胖个体的 CKD 预测。
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