全血细胞计数衍生的炎症标志物与中年及老年人虚弱和死亡风险的关系。

Association between complete blood count-derived inflammatory markers and the risk of frailty and mortality in middle-aged and older adults.

机构信息

Clinical Laboratory, The First Affiliated Hospital of Wannan Medical College, Wuhu, China.

Department of Kidney Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China.

出版信息

Front Public Health. 2024 Jul 31;12:1427546. doi: 10.3389/fpubh.2024.1427546. eCollection 2024.

DOI:10.3389/fpubh.2024.1427546

PMID:39145178

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11323558/

Abstract

OBJECTIVE

This study aimed to evaluate the association between six complete blood count (CBC)-derived inflammatory markers [neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammatory index (SII), systemic inflammatory response index (SIRI), and pan-immune inflammation value (PIV)] and the risk of frailty and mortality.

METHODS

Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 1999-2018. Mortality was identified using the National Death Index until December 31, 2019. Multiple logistic regression analysis was conducted to evaluate the association between six CBC-derived inflammatory markers and frailty. The Cox regression model assessed the association between six CBC-derived inflammatory markers and mortality in frail populations. Restricted cubic spline (RCS) was used to visualize the association of the six CBC-derived inflammatory markers with mortality risk. The predictive value of CBC-derived inflammatory markers for mortality was further assessed using a random survival forest (RSF) approach.

RESULTS

This study analyzed data from a total of 16,705 middle-aged and older participants. Among them, 6,503 participants were frail, with a mortality rate of 41.47%. Multiple logistic regression analysis showed that NLR, MLR, PLR, SII, SIRI, and PIV were positively associated with frailty risk. The Cox regression model revealed that participants in the highest quartile had a significantly increased risk of death compared to those in the lowest quartile: NLR (HR = 1.73, 95% CI:1.54, 1.94), MLR (HR = 1.71, 95% CI:1.51, 1.93), PLR (HR = 1.28, 95%CI: 1.15, 1.43), SII (HR = 1.50, 95%CI:1.34, 1.68), SIRI (HR = 1.88, CI 95%:1.67, 2.12), PIV (HR = 1.55, 95%CI:1.38, 1.73). Random survival forest (RSF) analyses demonstrated that MLR had the highest predictive value for mortality risk middle-aged and older adult frail participants.

CONCLUSION

The results suggest that CBC-derived inflammatory markers are associated with a higher risk of frailty as well as mortality in the middle and old-aged population of the United States.

摘要

目的

本研究旨在评估六种全血细胞计数（CBC）衍生的炎症标志物[中性粒细胞与淋巴细胞比值（NLR）、单核细胞与淋巴细胞比值（MLR）、血小板与淋巴细胞比值（PLR）、系统免疫炎症指数（SII）、系统炎症反应指数（SIRI）和整体免疫炎症值（PIV）]与衰弱和死亡风险之间的关联。

方法

数据来自 1999 年至 2018 年的全国健康和营养检查调查（NHANES）。通过国家死亡指数确定截至 2019 年 12 月 31 日的死亡率。使用多因素逻辑回归分析评估六种 CBC 衍生炎症标志物与衰弱之间的关系。Cox 回归模型评估了在衰弱人群中六种 CBC 衍生炎症标志物与死亡率之间的关系。受限立方样条（RCS）用于可视化六种 CBC 衍生炎症标志物与死亡率风险之间的关系。使用随机生存森林（RSF）方法进一步评估了 CBC 衍生炎症标志物对死亡率的预测价值。

结果

本研究共分析了来自 16705 名中老年人的数据。其中，6503 名参与者衰弱，死亡率为 41.47%。多因素逻辑回归分析表明，NLR、MLR、PLR、SII、SIRI 和 PIV 与衰弱风险呈正相关。Cox 回归模型显示，与最低四分位组相比，四分位组最高的参与者死亡风险显著增加：NLR（HR=1.73，95%CI：1.54，1.94），MLR（HR=1.71，95%CI：1.51，1.93），PLR（HR=1.28，95%CI：1.15，1.43），SII（HR=1.50，95%CI：1.34，1.68），SIRI（HR=1.88，95%CI：1.67，2.12），PIV（HR=1.55，95%CI：1.38，1.73）。随机生存森林（RSF）分析表明，MLR 对中年和老年衰弱参与者的死亡率风险具有最高的预测价值。