Association between platelet-to-lymphocyte ratio and blood urea nitrogen levels in pediatric populations: evidence from the NHANES (2009-2018).

BACKGROUND

Blood urea nitrogen (BUN) reflects renal function and protein metabolism, while the platelet-to-lymphocyte ratio (PLR) is a common inflammatory marker. Though studied in adults, their relationship with children is unclear. This study aims to explore this association in children aged 12-18 years using National Health and Nutrition Examination Survey (NHANES) 2009-2018 data and evaluate PLR as a potential non-invasive marker for renal function.

METHODS

Given the physiological differences between children and adults, this study utilized data from the NHANES to explore the association between PLR and BUN levels in a pediatric population. This cross-sectional study used NHANES data collected between 2009 and 2018. A total of 2,086 participants were included after excluding individuals with missing data or an age range beyond 12-18 years.

RESULTS

A significant negative correlation between PLR and BUN was found in this study, which remained consistent even after adjusting for a wide range of variables (P<0.001). Subgroup analyses further confirmed the robustness of this association across sex, race, and body mass index categories. Restricted cubic spline analysis revealed a significant non-linear negative association with an inflection point at PLR of 118.45. The decline in BUN levels became more pronounced when PLR exceeded the threshold.

CONCLUSIONS

This study demonstrated a negative correlation between PLR and BUN levels in children, suggesting that PLR could be used as a potential non-invasive marker for assessing renal function. More large-scale prospective studies are needed to substantiate our findings.