Zhou Qin, Shao Xiaofei, Xu Li, Zou Hequn, Chen Wenli
Department of Nephrology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China.
Kidney Blood Press Res. 2024;49(1):1066-1074. doi: 10.1159/000542625. Epub 2024 Nov 19.
Inflammation plays a key role in chronic kidney disease (CKD). Monocyte-to-lymphocyte ratio (MLR) is a novel inflammatory marker. The purpose of this study was to evaluate the relationship between MLR and inflammation in CKD patients.
In total, 1,809 subjects were recruited from Wanzhai Town, Zhuhai City, between December 2017 and March 2018 for a cross-sectional survey. Patients were categorized based on the absence (hypersensitive C-reactive protein [hsCRP] level ≦3 mg/L) or presence (hsCRP level >3 mg/L) of inflammation. Logistic regression models and MLR quartiles were used to explore the relationship between MLR and inflammation in CKD patients.
Among 1,809 subjects, 403 (22.2%) had CKD. Significant differences in systolic blood pressure, estimated glomerular filtration rate, white blood cell (WBC), neutrophil, monocyte, MLR, and interleukin-6 (IL-6) levels were observed between noninflammatory group and inflammatory group. The highest MLR quartile had higher Scr, WBC, neutrophil, monocyte, IL-6, and hsCRP values and lower eGFR and lymphocyte values. Comparing the lowest quartile of MLR, the OR (95% CI) of inflammation risk in the highest quartile was 2.30 (1.24-4.27) after adjustment for confounding factors. The area under the curve of MLR for predicting inflammation was 0.631. The cutoff point for the MLR was 0.153.
A high MLR was significantly and independently associated with inflammation in patients with CKD, making MLR a potential marker for inflammation in this demographic. MLR may also predict the severity of CKD.
炎症在慢性肾脏病（CKD）中起关键作用。单核细胞与淋巴细胞比值（MLR）是一种新型炎症标志物。本研究旨在评估CKD患者中MLR与炎症之间的关系。
2017年12月至2018年3月期间，从珠海市湾仔镇招募了1809名受试者进行横断面调查。根据是否存在炎症（超敏C反应蛋白[hsCRP]水平≤3mg/L为无炎症，hsCRP水平>3mg/L为有炎症）对患者进行分类。采用逻辑回归模型和MLR四分位数来探讨CKD患者中MLR与炎症之间的关系。
在1809名受试者中，403名（22.2%）患有CKD。非炎症组和炎症组在收缩压、估计肾小球滤过率、白细胞（WBC）、中性粒细胞、单核细胞、MLR和白细胞介素-6（IL-6）水平上存在显著差异。MLR最高四分位数组的血清肌酐（Scr）、WBC、中性粒细胞、单核细胞、IL-6和hsCRP值较高，而估算肾小球滤过率（eGFR）和淋巴细胞值较低。与MLR最低四分位数组相比，在调整混杂因素后，MLR最高四分位数组炎症风险的比值比（OR，95%可信区间）为2.30（1.24 - 4.27）。MLR预测炎症的曲线下面积为0.631。MLR的截断点为0.153。
高MLR与CKD患者的炎症显著且独立相关，使MLR成为该人群炎症的潜在标志物。MLR也可能预测CKD的严重程度。
