Department of Nephrology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou, 510120, China.
Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China.
Int Urol Nephrol. 2024 Feb;56(2):675-682. doi: 10.1007/s11255-023-03704-z. Epub 2023 Jul 19.
The ratio of neutrophil to lymphocyte (NLR) is a novel inflammatory factor that is elevated in systemic lupus erythematosus (SLE). However, the relationship between NLR and renal pathological manifestations in patients with lupus nephritis (LN) has not been investigated.
A retrospective study included 240 SLE patients, in which 186 patients with renal involvement and 124 LN patients underwent renal biopsy, 125 healthy volunteers and 125 chronic kidney disease (CKD) controls. Patients with SLE disease activity 2000 (SLEDAI-2 K) > 9 and ≤ 9 were defined as severely active and mildly active, respectively. Clinical parameters and renal pathological data were collected from medical records. The correlations between NLR and clinicopathological features were analyzed.
The NLR of SLE group was significantly higher than that of the sex-age matched control groups. Patients with nephritis had higher NLR levels than those without nephritis (P = 0.044). Increased NLR was observed in severely active group compared to mildly active group (P = 0.020). NLR was significantly positively related with SLEDAI score, Renal SLEDAI score, C-reactive protein (CRP), 24-h urine protein, renal activity index (AI), cellular crescents and tubular atrophy, and negatively correlated with serum albumin. NLR was significantly decreased after treatment. Based on the receiver operating characteristic (ROC) curve, the best NLR cut-off value to predict severe activity of SLE and cellular crescents in renal pathology was 2.19 and 3.16, respectively.
NLR may be a non-invasive and potential inflammatory marker in evaluating clinical and renal pathological activity in LN patients.
中性粒细胞与淋巴细胞比值（NLR）是系统性红斑狼疮（SLE）中升高的新型炎症因子。然而，狼疮肾炎（LN）患者的 NLR 与肾脏病理表现之间的关系尚未得到研究。
一项回顾性研究纳入了 240 例 SLE 患者，其中 186 例有肾脏受累，124 例为 LN 患者接受了肾活检，125 例健康志愿者和 125 例慢性肾脏病（CKD）对照。SLE 疾病活动度 2000（SLEDAI-2K）>9 和≤9 的患者分别定义为重度活动和轻度活动。从病历中收集临床参数和肾脏病理数据。分析 NLR 与临床病理特征的相关性。
SLE 组的 NLR 明显高于性别年龄匹配的对照组。有肾炎的患者 NLR 水平高于无肾炎的患者（P=0.044）。与轻度活动组相比，重度活动组的 NLR 升高（P=0.020）。NLR 与 SLEDAI 评分、肾脏 SLEDAI 评分、C 反应蛋白（CRP）、24 小时尿蛋白、肾脏活动指数（AI）、细胞性新月体和肾小管萎缩呈显著正相关，与血清白蛋白呈显著负相关。治疗后 NLR 显著降低。基于受试者工作特征（ROC）曲线，预测 SLE 重度活动和肾脏病理细胞性新月体的最佳 NLR 截断值分别为 2.19 和 3.16。
NLR 可能是评估 LN 患者临床和肾脏病理活动的一种非侵入性和有潜力的炎症标志物。
