Higher Neutrophil-To-Lymphocyte Ratio Was Associated with Increased Risk of Chronic Kidney Disease in Overweight/Obese but Not Normal-Weight Individuals

Abstract

Background: Inflammation has been proposed to play potential roles in the development and progression of chronic kidney disease (CKD). We evaluated the relationship of neutrophil-to-lymphocyte ratio (NLR), a systemic inflammation marker, with CKD in normal-weight and overweight/obese adults. Methods: This cross-sectional study included 2846 apparently healthy adults who underwent a health examination between August 2000 and April 2002. Normal weight was defined as a body mass index (BMI, kg/m2) of 18.5–24, while overweight/obesity was defined as a BMI of ≥24. CKD was defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2. Logistic and linear regression analysis was performed to explore the NLR–CKD relationship. Results: Of the 2846 participants (1777 men and 1069 women), there were 348 CKD individuals (12.3%), with 262 (14.7%) men and 86 (8%) women. A total of 1011 men (56.9%) and 408 women (38.2%) were overweight or obese. Compared with the normal-weight participants, CKD prevalence was higher in the overweight/obese women (6.1% vs. 11.3%, p = 0.002), but not in the overweight/obese men (14.5% vs. 14.9%, p = 0.793). CKD percentages in the NLR quartile groups were 9.4%, 11.5%, 15.4%, and 22.7% in men (p < 0.0001) and 6.4%, 7.1%, 10.5%, and 8.2% in women (p = 0.2291). After adjustment for confounders, each increment of one unit of NLR was associated with a higher CKD risk in the overweight/obese men (adjusted odds ratio (OR) = 1.37, 95% confidence interval (CI) = 1.03–1.82, p = 0.03) and women (adjusted OR = 1.77, 95% CI = 1.08–2.90, p = 0.023), whereas NLR was not associated with CKD in normal-weight men or women. Further, in the overweight/obese participants with an eGFR of 50–70 mL/min/1.73 m2, univariable linear regression analysis revealed a significant negative correlation between NLR and eGFR for men (p = 0.004) and women (p = 0.009). Conclusions: It was found that higher NLR was associated with an increased CKD risk in overweight/obese but not in normal-weight men and women in an adult health examination dataset. Our study suggests a role of NLR for CKD prediction in overweight/obese individuals.

Association between Pre-Pregnancy Overweightness/Obesity and Pregnancy Outcomes in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

“…Second, though various criteria for diagnosis of PCOS have been proposed by different societies, including National Institutes of Health (NIH) in 1990, Rotterdam criteria in 2003, and Androgen Excess and PCOS Society (AE-PCOS) in 2006 [ 62 , 63 , 64 ], most of the cohort studies enrolled into this meta-analysis adopted Rotterdam criteria, and only one study conducted in 1992 using ultrasound image as diagnostic method was included [ 40 ]. Third, the definitions of BMI were heterogenous in the literatures [ 65 , 66 , 67 , 68 , 69 , 70 , 71 ]. Generally, studies conducted in western countries used WHO classification for nutritional status, whereas studies in China partly used WHO classification, partly used lower cutoff for overweightness and obesity (i.e., BMI 24 kg/m 2 and 28 kg/m 2 ) compared to the WHO classification.…”

Association between systemic inflammatory indicators with the survival of chronic kidney disease: a prospective study based on NHANES

“…Emerging evidence suggested that NLR was associated with several comorbidities, including insulin resistance and CVD (31,32). Consistently, high levels of NLR were also determined to be related to the occurrence, and poor nutritional status as well as worse prognosis of CKD (33)(34)(35)(36)(37). Of note, Yoshitomi and colleagues observed that CKD patients with high NLR showed a nearly 1.7-fold increased risk for poor renal outcome when compared with the low NLR group in Japan (35).…”

Prevalence of Chronic Kidney Disease in a High-Risk Population in Urban Lahore, Pakistan: A Cross-sectional Study

“…This challenges the prevailing notion that CKD is predominantly linked to obesity. Some studies have shown that obesity is a significant risk factor for CKD development, independent of factors like type 2 diabetes mellitus and hypertension [ 31 ]. Another systematic review and meta-analysis showed that obese individuals have a 1.81 times higher risk of CKD [ 32 ].…”