Li Li, Wang Mengjie, Jia Ting, Jiang Xiaowan, Yang Fan, Wang Zhongjing, Zhang Xuyan
Department of Endocrinology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Key Laboratory for Molecular Diagnosis of Hubei Province, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Endocrinol (Lausanne). 2024 Aug 30;15:1434580. doi: 10.3389/fendo.2024.1434580. eCollection 2024.
This study explored the utility of NLR (neutrophil-to-lymphocyte ratio) as a marker to predict Lower Extremity Peripheral Artery Disease (PAD) in the Chinese population, as well as to assess its consistency and diagnostic value with digital subtraction angiography.
Patients were distributed into three groups according to the angiography in lower limb arterial: group L1, plaque with no stenosis; group L2, plaque with luminal stenosis and group L3, total vascular occlusion. Changes in the neutrophil-to-lymphocyte ratio were documented and compared among groups.
Compared to group L1, NLR was significantly increased in L2 (1.76 2.35, =0.037) and L3 (1.76 3.60, 0.001), with a gradual decrease in ABI (Ankle-Brachial Index, 1.11 1.02 0.94, 0.001). Those older patients with higher prevalence of hypertension (=0.002), obesity (=0.032), or reduced high-density lipoprotein cholesterol (=0.020) were more likely to develop PAD; higher glycosylated hemoglobin (=0.045), low-density lipoprotein cholesterol (=0.006), and systolic blood pressure (0.001) levels led to a greater tendency to suffer stenosis or even occlusion; the probability of severe stenosis (>70%) increased to 2.075 times for every 1 increase in NLR, while it was 46.8% for every 0.1 increase in ABI. The optimal NLR cut-off value to predict severe stenosis in PAD was 2.73. Receiver operating characteristic curve analysis of the inflammatory biomarkers and severe stenosis prediction displayed an area under the curve of 0.81.
NLR could serve as a new noninvasive and accurate marker in predicting PAD.
本研究探讨中性粒细胞与淋巴细胞比值（NLR）作为预测中国人群下肢外周动脉疾病（PAD）的标志物的效用，并评估其与数字减影血管造影的一致性和诊断价值。
根据下肢动脉血管造影将患者分为三组：L1组，有斑块但无狭窄；L2组，有斑块且管腔狭窄；L3组，血管完全闭塞。记录并比较各组中性粒细胞与淋巴细胞比值的变化。
与L1组相比，L2组（1.76对2.35，P = 0.037）和L3组（1.76对3.60，P < 0.001）的NLR显著升高，踝臂指数（ABI）逐渐降低（1.11对1.02对0.94，P < 0.001）。高血压患病率较高（P = 0.002）、肥胖（P = 0.032）或高密度脂蛋白胆固醇降低（P = 0.020）的老年患者更易发生PAD；糖化血红蛋白（P = 0.045）、低密度脂蛋白胆固醇（P = 0.006）和收缩压（P < 0.001）水平升高导致发生狭窄甚至闭塞的倾向更大；NLR每升高1，严重狭窄（>70%）的概率增加至2.075倍，而ABI每升高0.1，概率为46.8%。预测PAD严重狭窄的最佳NLR临界值为2.73。炎症生物标志物与严重狭窄预测的受试者工作特征曲线分析显示曲线下面积为0.81。
NLR可作为预测PAD的一种新的非侵入性准确标志物。
