Liu Dongjing, Fan Xiaonan, Wang Junwei, Weng Ruihui, Tu Jun, Wang Jinghua, Ning Xianjia, Zhao Yu
Department of Science and Education, Shenzhen Third People's Hospital and The Second Hospital Affiliated with The Southern University of Science and Technology, Shenzhen, Guangdong, People's Republic of China.
National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital and The Second Hospital Affiliated with The Southern University of Science and Technology, Shenzhen, Guangdong, People's Republic of China.
J Inflamm Res. 2025 Apr 28;18:5715-5726. doi: 10.2147/JIR.S513811. eCollection 2025.
This study aimed to assess the association of the Neutrophil-to-Lymphocyte Ratio (NLR) and Monocyte-to-Lymphocyte Ratio (MLR) in predicting stroke incidence and all-cause mortality in low-income elderly populations.
This prospective cohort study included participants who were middle-aged or elderly individuals from a low-income population in China. Participants were selected into the cohort and complete baseline assessments, which included questionnaire surveys, physical examinations, blood tests, and carotid artery ultrasound evaluations. Cox proportional hazards regression analysis was used to assess the associations of the NLR and MLR with the incidence of stroke and all-cause mortality. The predictive performance of the model was evaluated using the area under the receiver operating characteristic curve (AUC-ROC).
A total of 3948 participants were enrolled in the study. Over a median follow-up period of 7 years, 262 participants experienced stroke events and 227 participants died. After adjusting for potential confounding variables, the final model revealed that a higher NLR was significantly associated with an increased risk of stroke (HR: 1.776, 95% CI: 1.250-2.254, P = 0.001) and all-cause mortality (HR: 1.558, 95% CI: 1.148-2.116, P = 0.004). Furthermore, a higher MLR was found to be associated with an increased risk of all-cause mortality (HR: 1.397, 95% CI: 1.054-1.852, P = 0.020), but no significant association was observed between MLR and stroke incidence. ROC analysis revealed that the AUC for NLR in predicting stroke was 0.55 (95% CI: 0.52-0.59, P=0.005), while the AUC for MLR was 0.58 (95% CI: 0.54-0.62, P<0.001). Similarly, the AUC for NLR in predicting all-cause mortality was 0.57 (95% CI: 0.53-0.61, P<0.001), and the AUC for MLR was 0.61 (95% CI: 0.57-0.65, P<0.001).
These findings indicate that NLR is associated with an increased risk of stroke and all-cause mortality, while higher MLR is associated with all-cause mortality but not with stroke incidence. However, the modest predictive performance of both markers suggests that their clinical utility remains limited. Further research is needed to validate these associations and explore their potential role in comprehensive risk assessment models.
本研究旨在评估中性粒细胞与淋巴细胞比值（NLR）和单核细胞与淋巴细胞比值（MLR）在预测低收入老年人群中风发病率和全因死亡率方面的相关性。
这项前瞻性队列研究纳入了来自中国低收入人群的中年或老年参与者。参与者被纳入队列并完成基线评估，包括问卷调查、体格检查、血液检查和颈动脉超声评估。采用Cox比例风险回归分析来评估NLR和MLR与中风发病率及全因死亡率的相关性。使用受试者工作特征曲线下面积（AUC-ROC）评估模型的预测性能。
本研究共纳入3948名参与者。在中位随访7年期间，262名参与者发生中风事件，227名参与者死亡。在调整潜在混杂变量后，最终模型显示较高的NLR与中风风险增加显著相关（HR：1.776，95%CI：1.250-2.254，P = 0.001）和全因死亡率增加显著相关（HR：1.558，95%CI：1.148-2.116，P = 0.004）。此外，发现较高的MLR与全因死亡率风险增加相关（HR：1.397，95%CI：1.054-1.852，P = 0.020），但未观察到MLR与中风发病率之间存在显著关联。ROC分析显示，NLR预测中风的AUC为0.55（95%CI：0.52-0.59，P = 0.005），而MLR的AUC为0.58（95%CI：0.54-0.62，P<0.001）。同样，NLR预测全因死亡率的AUC为0.57（95%CI：0.53-0.61，P<0.001），MLR的AUC为0.61（95%CI：0.57-0.65，P<0.001）。
这些发现表明，NLR与中风风险和全因死亡率增加相关，而较高的MLR与全因死亡率相关，但与中风发病率无关。然而，这两种标志物的预测性能一般，表明它们的临床应用仍然有限。需要进一步研究来验证这些关联，并探索它们在综合风险评估模型中的潜在作用。
