Chuang Shao-Yuan, Hsu Yin-Chen, Chou Kuang-Wei, Chang Kuo-Song, Wong Chiong-Hee, Hsu Ya-Hui, Cheng Hao-Min, Chen Chien-Wei, Chen Pang-Yen
Institute of Population Health Science, National Health Research Institute, Miaoli 36001, Taiwan.
Institute of Public Health, National Yang Ming Chiao Tung University School of Medicine, Taipei 30010, Taiwan.
Brain Sci. 2023 Jul 18;13(7):1087. doi: 10.3390/brainsci13071087.
Cerebral Small Vessel Disease (CSVD) frequently affects the elderly, with inflammation playing a crucial role in related health complications, including dementia, stroke, and SVD. Studies, including animal experiments, indicate a strong link between inflammation and SVD progression. The Neutrophil-Lymphocyte Ratio (NLR) serves as a possible biomarker for ongoing inflammatory risks. A total of 720 adults aged 50 years or older from the community-based I-Lan Longitudinal Aging Study were included in this study. General linear regression and ordinally logistic regression analyses were performed to evaluate the association between NLR and CSVD. We further examined the presence of lacune, microbleed, and white matter hyperintensity (WMH) on brain MRI, which were used to construct a combined CSVD score. The NLR was positively associated with WMH (adjusted r = 0.109, = 0.003), microbleed (adjusted r = 0.102, = 0.006), and lacune (adjusted r = 0.100, = 0.008). After adjustments for smoking, drinking, and physical activity in the ordinal logistic regression analysis, age, gender, brachial Systolic Blood Pressure (SBP), fasting glucose, LDL-cholesterol, and Hs-CRP were compared among subjects with low tertile (T1), medium tertile (T2) and high tertile (T3) NLR. The results showed that T2 vs. T1 had an odds ratio of 1.23 (0.86-1.77); and T3 vs. T1 had an odds ratio of 1.87 (1.29-2.71) of CSVD scores in four groups (zero (reference group), one, two, and three or more). NLR could be used to assess the state of inflammation in cerebral vessels. A significant and positive correlation between NLR and CSVD was verified in this study. However, the practical clinical application of NLR in CSVD patients and prognosis prediction should be validated through more scientific attempts.
脑小血管病(CSVD)常影响老年人,炎症在包括痴呆、中风和SVD在内的相关健康并发症中起关键作用。包括动物实验在内的研究表明,炎症与SVD进展之间存在紧密联系。中性粒细胞与淋巴细胞比值(NLR)可能是持续炎症风险的生物标志物。本研究纳入了来自宜兰纵向老龄化社区研究的720名50岁及以上的成年人。进行了一般线性回归和有序逻辑回归分析,以评估NLR与CSVD之间的关联。我们进一步检查了脑MRI上腔隙、微出血和白质高信号(WMH)的存在情况,这些用于构建综合CSVD评分。NLR与WMH(调整后r = 0.109,P = 0.003)、微出血(调整后r = 0.102,P = 0.006)和腔隙(调整后r = 0.100,P = 0.008)呈正相关。在有序逻辑回归分析中对吸烟、饮酒和身体活动进行调整后,比较了低三分位数(T1)、中三分位数(T2)和高三分位数(T3)NLR的受试者的年龄、性别、肱动脉收缩压(SBP)、空腹血糖、低密度脂蛋白胆固醇和超敏C反应蛋白。结果显示,在四组(零(参照组)、一、二、三个或更多)的CSVD评分中,T2与T1的比值比为1.23(0.86 - 1.77);T3与T1的比值比为1.87(1.29 - 2.71)。NLR可用于评估脑血管炎症状态。本研究验证了NLR与CSVD之间存在显著正相关。然而,NLR在CSVD患者中的实际临床应用及预后预测应通过更多科学尝试进行验证。