Division of Nephrology, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Division of Nephrology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
PLoS One. 2023 Oct 25;18(10):e0286612. doi: 10.1371/journal.pone.0286612. eCollection 2023.
Inflammation plays a major role in the pathogenesis of chronic kidney disease (CKD), but the relationship between systemic inflammation and CKD-mineral bone disease is unclear. We aimed to investigate whether the neutrophil-to-lymphocyte ratio (NLR) is related to abdominal aortic calcification (AAC) and bone mineral density (BMD) in dialysis patients. In this cross-sectional analysis using baseline data of a multicenter cohort, a total of 759 patients were divided into three groups according to NLR level, and the associations between NLR and Kauppila AAC score (AACS) and BMD were assessed. The highest tertile NLR group had more males, alcohol consumers, higher diabetes prevalence, and higher comorbidity index than the lowest tertile NLR group. Fasting glucose and C-reactive protein levels were higher, while serum albumin, serum iron, and lipid profiles except triglycerides were lower in the highest tertile group. AACS was significantly higher in the highest tertile group than in the lowest and middle tertile groups (p = 0.017), but the mean areal BMD and T-score of the lumbar spine and femur were not different between groups. NLR level was positively correlated with AACS in all aortic wall segments except L1 and L3 anterior. In multivariable logistic regression analysis, the highest tertile NLR group was independently associated with AAC (odds ratio 2.876, 95% confidence interval 1.250-6.619, p = 0.013) but was not associated with osteoporosis in the lumbar spine and femur after adjusting for confounding factors. The NLR can be used as a potential indicator of AAC in dialysis patients.
炎症在慢性肾脏病 (CKD) 的发病机制中起主要作用，但全身炎症与 CKD-矿物质骨病之间的关系尚不清楚。我们旨在研究中性粒细胞与淋巴细胞比值 (NLR) 是否与透析患者的腹主动脉钙化 (AAC) 和骨密度 (BMD) 相关。在这项使用多中心队列的基线数据进行的横断面分析中，根据 NLR 水平将 759 名患者分为三组，并评估 NLR 与 Kauppila AAC 评分 (AACS) 和 BMD 的相关性。最高 NLR 组的男性、饮酒者、糖尿病患病率和合并症指数均高于最低 NLR 组。空腹血糖和 C 反应蛋白水平较高，而血清白蛋白、血清铁和血脂谱（除甘油三酯外）在最高 NLR 组中较低。最高 NLR 组的 AACS 明显高于最低和中间 NLR 组（p = 0.017），但腰椎和股骨的平均面积 BMD 和 T 评分在各组之间没有差异。NLR 水平与除 L1 和 L3 前外所有主动脉壁节段的 AACS 呈正相关。在多变量逻辑回归分析中，最高 NLR 组与 AAC 独立相关（优势比 2.876，95%置信区间 1.250-6.619，p = 0.013），但在调整混杂因素后，与腰椎和股骨骨质疏松无关。NLR 可作为透析患者 AAC 的潜在指标。
