International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashad, Iran.
Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashad, Iran.
Endocrinol Diabetes Metab. 2024 May;7(3):e00479. doi: 10.1002/edm2.479.
We aimed to compare the association of three novel inflammatory indicators with metabolic syndrome (MetS) among Mashhad stroke and heart atherosclerotic disorder (MASHAD) cohort participants.
According to the International Diabetes Federation (IDF) criteria, the cohort participants were divided into the MetS(+) and MetS(-) groups. The lymphocyte to high-density lipoprotein cholesterol (HDL-C) ratio (LHR), high-sensitivity C-reactive protein (hs-CRP) to HDL-C ratio (HCHR) and hs-CRP to lymphocyte ratio (HCLR) were calculated and were compared between the groups. Binary logistic regression (LR) analysis was performed to find the association of the indices with the presence of MetS among men and women. Receiver-operating characteristic (ROC) curve analysis was used to establish cut-off values in predicting MetS for men and women. p-Values <0.05 were considered as statistically significant.
Among a total of 8890 participants (5500 MetS(-) and 3390 MetS(+)), LHR, HCHR and HCLR were significantly higher in the MetS(+) group than in MetS(-) group (p < 0.001). In LR analysis, after adjusting for multiple cofounders, LHR remained an independent factor for the presence of MetS among men (OR: 1.254; 95% CI: 1.202-1.308; p < 0.001) and women (OR: 1.393; 95% CI: 1.340-1.448; p < 0.001). HCHR also remained an independent factor for the presence of MetS only in women (OR: 1.058; 95% CI: 1.043-1.073; p < 0.001). ROC curve analysis showed that LHR had the higher AUC for predicting MetS in both men (AUC: 0.627; 95% CI: 0.611-0.643; p < 0.001) and women (AUC: 0.683; 95% CI: 0.670, 0.696; p < 0.001).
This suggests that among both genders, the LHR as an inexpensive and easy-to-access marker has a better diagnostic performance and could be a promising alternative to the traditional expensive inflammatory markers such as hs-CRP for the evaluation of inflammation in patients with MetS.
本研究旨在比较马什哈德卒中与心脏动脉粥样硬化紊乱（MASHAD）队列参与者中三种新型炎症指标与代谢综合征（MetS）的相关性。
根据国际糖尿病联合会（IDF）的标准，将队列参与者分为 MetS（+）和 MetS（-）组。计算淋巴细胞与高密度脂蛋白胆固醇（HDL-C）比值（LHR）、高敏 C 反应蛋白（hs-CRP）与 HDL-C 比值（HCHR）和 hs-CRP 与淋巴细胞比值（HCLR），并比较两组之间的差异。采用二元逻辑回归（LR）分析评估这些指标与男性和女性 MetS 之间的相关性。使用受试者工作特征（ROC）曲线分析确定用于预测男性和女性 MetS 的截断值。p 值<0.05 被认为具有统计学意义。
在总共 8890 名参与者（5500 名 MetS（-）和 3390 名 MetS（+））中，MetS（+）组的 LHR、HCHR 和 HCLR 显著高于 MetS（-）组（p<0.001）。在 LR 分析中，在校正多个混杂因素后，LHR 仍然是男性（比值比[OR]：1.254；95%置信区间[CI]：1.202-1.308；p<0.001）和女性（OR：1.393；95%CI：1.340-1.448；p<0.001）中 MetS 存在的独立因素。HCHR 也是女性中 MetS 存在的独立因素（OR：1.058；95%CI：1.043-1.073；p<0.001）。ROC 曲线分析表明，LHR 在预测男性（AUC：0.627；95%CI：0.611-0.643；p<0.001）和女性（AUC：0.683；95%CI：0.670，0.696；p<0.001）中 MetS 的 AUC 更高。
这表明，在两性中，LHR 作为一种廉价且易于获取的标志物，具有更好的诊断性能，并且可能是评估 MetS 患者炎症的替代传统昂贵的炎症标志物（如 hs-CRP）的有前途的选择。
