Zhang Yi, Li Tingzhen, Chen Qixin, Shen Maobiao, Fu Xinyang, Liu Changjin
Department of Urology, Kaiping Central Hospital, Kaiping, Jiangmen, China.
Department of Nail and Breast Surgery, Kaiping Central Hospital, Kaiping, Jiangmen, China.
Sci Rep. 2024 Dec 30;14(1):32014. doi: 10.1038/s41598-024-83733-5.
Erectile dysfunction(ED), a prevalent condition within the male genitourinary system, significantly impairs the quality of life for affected men. Although certain inflammatory indicators, such as the neutrophil-to-lymphocyte ratio(NLR), systemic inflammatory response index (SIRI), and systemic immune-inflammation index(SII), have been linked to ED, the correlation with other markers and their impact on survival outcomes in ED patients remain largely unexplored. This research aims to investigate the correlation between inflammatory biomarkers derived from a complete blood cell count(CBC) and the occurrence of ED. Data regarding ED were extracted from the 2001-2004 National Health and Nutrition Examination Survey(NHANES), and mortality events were ascertained through the National Death Index up to December 2019. The CBC-derived inflammatory indicators assessed in this study included the NLR, derived neutrophil-to-lymphocyte ratio(dNLR), monocyte-to-lymphocyte ratio(MLR), neutrophil-monocyte to lymphocyte ratio (NMLR), SIRI, and SII. The prognostic significance of these CBC-derived inflammatory indicators was evaluated using random survival forests(RSF) analysis. Our study encompassed a cohort of 3,639 individuals, among whom 1,031 were diagnosed with ED. Among individuals with ED, 610 experienced all-cause mortality. Following adjustment for all confounding variables, it was observed that elevated levels of NLR(OR = 1.09, 95%CI 1.00-1.19, p = 0.021), MLR (OR = 2.97, 95% CI 1.18-7.50, p = 0.01), NMLR(OR = 1.10, 95% CI 1.01-1.11, p = 0.006), and SIRI(OR = 1.11, 95% CI 1.01-1.22, p = 0.017) were associated with an increased prevalence of ED. Among participants with ED, those in the highest quartile of NLR(HR = 1.06, 95% CI 1.00-1.11, p = 0.032), MLR(HR = 2.00, 95% CI 1.33-3.01, p < 0.001), NMLR (HR = 1.06, 95% CI 1.01-1.11, p = 0.024), and SII(HR = 1.00, 95% CI 1.00-1.00, p = 0.015) exhibited an elevated risk of all-cause mortality compared to those in the lower levels of inflammation-derived indicators. Our research suggests that, compared with other inflammatory markers derived from complete blood cell count, MLR has the highest predictive power for the prevalence of ED and all-cause mortality in these populations.
勃起功能障碍（ED）是男性生殖泌尿系统的一种常见病症，严重损害了受影响男性的生活质量。尽管某些炎症指标，如中性粒细胞与淋巴细胞比值（NLR）、全身炎症反应指数（SIRI）和全身免疫炎症指数（SII），已被证明与ED有关，但与其他标志物的相关性及其对ED患者生存结果的影响在很大程度上仍未得到充分研究。本研究旨在探讨全血细胞计数（CBC）得出的炎症生物标志物与ED发生之间的相关性。有关ED的数据取自2001 - 2004年国家健康与营养检查调查（NHANES），并通过国家死亡指数确定直至2019年12月的死亡事件。本研究评估的CBC衍生炎症指标包括NLR、衍生中性粒细胞与淋巴细胞比值（dNLR）、单核细胞与淋巴细胞比值（MLR）、中性粒细胞 - 单核细胞与淋巴细胞比值（NMLR）、SIRI和SII。使用随机生存森林（RSF）分析评估这些CBC衍生炎症指标的预后意义。我们的研究纳入了3639名个体，其中1031人被诊断为ED。在患有ED的个体中，有610人经历了全因死亡。在对所有混杂变量进行调整后，发现NLR水平升高（OR = 1.09，95%CI 1.00 - 1.19，p = 0.021）、MLR（OR = 2.97，95%CI 1.18 - 7.50，p = 0.01）、NMLR（OR = 1.10，95%CI 1.01 - 1.11，p = 0.006）和SIRI（OR = 1.11，95%CI 1.01 - 1.22，p = 0.017）与ED患病率增加相关。在患有ED的参与者中，处于NLR最高四分位数的人（HR = 1.06，95%CI 1.00 - 1.11，p = 0.032）、MLR（HR = 2.00，95%CI 1.33 - 3.01，p < 0.001）、NMLR（HR = 1.06，95%CI 1.01 - 1.11，p = 0.024）和SII（HR = 1.00，95%CI 1.00 - 1.00，p = 0.015）与炎症衍生指标水平较低的人相比，全因死亡风险升高。我们的研究表明，与全血细胞计数得出的其他炎症标志物相比，MLR对这些人群中ED患病率和全因死亡率具有最高的预测能力。
