Sun Xiaoyang, Lin Jie, Wang Zhenao, Zhang Chenfang, Zhao Kai, Zhang Xuewen, Sheng Jiyao
Department of Hepatobiliary and Pancreatic Surgery, The Second Hospital of Jilin University, Changchun, Jilin, China.
BMC Gastroenterol. 2025 May 29;25(1):415. doi: 10.1186/s12876-025-04000-z.
Inflammation plays a key role in the development of gallstones, and the C-reactive protein to lymphocyte ratio (CLR) has been introduced as a promising biomarker for evaluating inflammatory processes. Nonetheless, its correlation with gallstone prevalence remains ambiguous. This study aims to evaluate the potential link between CLR levels and gallstone prevalence.
This study utilized data from the National Health and Nutrition Examination Survey, covering the periods from March 2017 to 2020 and 2021 to 2023. Multivariate logistic regression was employed to examine the association between CLR and gallstone prevalence. Furthermore, smoothed curve fitting, subgroup analysis, and interaction testing were performed to provide a comprehensive evaluation. We also employed receiver operating characteristic (ROC) curves to determine the predictive ability of the index for gallstones.
Among the 13,386 participants included in this study, 1,444 were diagnosed with gallstones. In a fully adjusted model, a small but statistically significant positive association between CLR and the prevalence of gallstones was observed (odds ratio [OR] = 1.07, 95% CI: 1.01-1.12). Compared to individuals in the lowest tertile of CLR (T1), those in the middle tertile (T2) showed a non-significant increase in gallstone prevalence (OR = 1.10, 95% CI: 0.94-1.29), while the highest tertile (T3) exhibited a statistically significant elevation (OR = 1.20, 95% CI: 1.03-1.41). Smoothed curve fitting further confirmed this positive relationship. Bonferroni-corrected subgroup analysis demonstrated a statistically significant association between CLR and gallstones in the "Married/Living with Partner" subgroup (P < 0.0015), while no significant associations were observed in the other subgroups. Additionally, Bonferroni-corrected interaction tests indicated no significant interactions between CLR and gallstones across all subgroups (P for interaction > 0.0038).
Higher CLR was associated with higher gallstone prevalence. However, additional large-scale prospective studies are required to further investigate the role of CLR in the prevalence of gallstones.
炎症在胆结石的形成过程中起关键作用，C反应蛋白与淋巴细胞比值（CLR）已被视为评估炎症过程的一种有前景的生物标志物。尽管如此，其与胆结石患病率的相关性仍不明确。本研究旨在评估CLR水平与胆结石患病率之间的潜在联系。
本研究利用了美国国家健康与营养检查调查的数据，涵盖2017年3月至2020年以及2021年至2023年这两个时间段。采用多因素逻辑回归分析来检验CLR与胆结石患病率之间的关联。此外，进行了平滑曲线拟合、亚组分析和交互作用检验以提供全面评估。我们还采用受试者工作特征（ROC）曲线来确定该指标对胆结石的预测能力。
本研究纳入的13386名参与者中，有1444人被诊断患有胆结石。在一个完全调整模型中，观察到CLR与胆结石患病率之间存在微小但具有统计学意义的正相关（比值比[OR]=1.07，95%置信区间：1.01 - 1.12）。与CLR处于最低三分位数（T1）的个体相比，处于中间三分位数（T2）的个体胆结石患病率虽有增加但无统计学意义（OR = 1.10，95%置信区间：0.94 - 1.29），而处于最高三分位数（T3）的个体则呈现出具有统计学意义的升高（OR = 1.20，95%置信区间：1.03 - 1.41）。平滑曲线拟合进一步证实了这种正相关关系。经Bonferroni校正的亚组分析表明，在“已婚/与伴侣同住”亚组中，CLR与胆结石之间存在统计学意义的关联（P < 0.0015），而在其他亚组中未观察到显著关联。此外，经Bonferroni校正的交互作用检验表明，在所有亚组中CLR与胆结石之间均无显著交互作用（交互作用P > 0.0038）。
较高的CLR与较高的胆结石患病率相关。然而，需要进一步开展大规模前瞻性研究以深入探究CLR在胆结石患病率中的作用。
