Nutrition, Metabolism and Cardiovascular Diseases

2018

DOI: 10.1016/j.numecd.2017.10.022

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Neutrophil-to-Lymphocyte Ratio is a strong predictor of atherosclerotic carotid plaques in older adults

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Salvatore Di Marca

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Emanuela Cataudella

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et al.

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Cited by 91 publications

(73 citation statements)

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“…Clinical studies of these immunologic parameters have been carried out not only for cancer but also for other kinds of disease. Recent studies have shown that these immunologic parameters are also associated with prognosis in cases of atherosclerotic carotid plaques, Guillain‐Barre syndrome, liver fibrosis and hepatitis C virus‐related liver disease …”

Section: Introductionmentioning

confidence: 99%

Association of preoperative total lymphocyte count with prognosis in resected left‐sided pancreatic cancer

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et al. 2019

ANZ Journal of Surgery

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Background: Immunologic factors such as neutrophil-lymphocyte ratio and platelet-lymphocyte ratio play an important role in predicting the oncologic outcome of patients in pancreatic ductal adenocarcinoma (PDAC). It is hypothesized that host immunity represented by total lymphocyte count at diagnostic stage would influence oncologic outcome in left-sided PDAC. Methods: Between January 1992 and August 2017, total of 112 patients who underwent distal pancreatectomy for left-sided PDAC were included and analysed. Results: At the time of the diagnosis, total lymphocyte count at diagnosis of left-sided PDAC was 1.8 AE 0.7 10 3 /μL (mean value AE standard deviation). Among different cut-off values, 1.7 showed most powerful significant differences in long-term oncologic outcomes. The patients with preoperative lymphocyte count (≤1.7) was associated with early recurrence (median 8.4 months versus 18.1 months, P = 0.011) and shorter survival (median 18.6 months versus 35.9 months, P = 0.028). Patients with preoperative total lymphocyte count over 1.7 showed higher white blood cell count (P < 0.001), platelet count (P = 0.039), neutrophil count (P = 0.004) and monocyte count (P = 0.001). However, more interestingly, neutrophil-lymphocyte ratio (P < 0.001) and platelet-lymphocyte ratio (P < 0.001) were found to be significantly higher in those with total lymphocyte count less than 1.7. Lymphocyte to monocyte ratio was inversely related to preoperative total lymphocyte count (P < 0.001). Only age was identified to be significantly different (P = 0.007). However, other clinicopathological parameters generally known to be related to tumour aggressiveness, were not different between two groups. Conclusion: In conclusion, preoperative total lymphocyte at diagnostic stage is simple, and good prognostic factor in left-sided pancreatic cancer.

“…Clinical studies of these immunologic parameters have been carried out not only for cancer but also for other kinds of disease. Recent studies have shown that these immunologic parameters are also associated with prognosis in cases of atherosclerotic carotid plaques, Guillain‐Barre syndrome, liver fibrosis and hepatitis C virus‐related liver disease …”

Section: Introductionmentioning

confidence: 99%

Association of preoperative total lymphocyte count with prognosis in resected left‐sided pancreatic cancer

¹

,

²

,

³

et al. 2019

ANZ Journal of Surgery

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Background: Immunologic factors such as neutrophil-lymphocyte ratio and platelet-lymphocyte ratio play an important role in predicting the oncologic outcome of patients in pancreatic ductal adenocarcinoma (PDAC). It is hypothesized that host immunity represented by total lymphocyte count at diagnostic stage would influence oncologic outcome in left-sided PDAC. Methods: Between January 1992 and August 2017, total of 112 patients who underwent distal pancreatectomy for left-sided PDAC were included and analysed. Results: At the time of the diagnosis, total lymphocyte count at diagnosis of left-sided PDAC was 1.8 AE 0.7 10 3 /μL (mean value AE standard deviation). Among different cut-off values, 1.7 showed most powerful significant differences in long-term oncologic outcomes. The patients with preoperative lymphocyte count (≤1.7) was associated with early recurrence (median 8.4 months versus 18.1 months, P = 0.011) and shorter survival (median 18.6 months versus 35.9 months, P = 0.028). Patients with preoperative total lymphocyte count over 1.7 showed higher white blood cell count (P < 0.001), platelet count (P = 0.039), neutrophil count (P = 0.004) and monocyte count (P = 0.001). However, more interestingly, neutrophil-lymphocyte ratio (P < 0.001) and platelet-lymphocyte ratio (P < 0.001) were found to be significantly higher in those with total lymphocyte count less than 1.7. Lymphocyte to monocyte ratio was inversely related to preoperative total lymphocyte count (P < 0.001). Only age was identified to be significantly different (P = 0.007). However, other clinicopathological parameters generally known to be related to tumour aggressiveness, were not different between two groups. Conclusion: In conclusion, preoperative total lymphocyte at diagnostic stage is simple, and good prognostic factor in left-sided pancreatic cancer.

“…These counts provide additional risk stratification beyond conventional risk scores such as predicting mortality in cardiovascular diseases [18]. A high NLR is a predictor of atherosclerosis progression [8,19,20]. As a protective factor for blood vessels, HDL-C has been observed in both healthy people [10] and CAD patients [11] as associated with NLR levels at lower levels.…”

Section: Discussionmentioning

confidence: 99%

Variability in blood lipid affects the neutrophil to lymphocyte ratio in patients who have undergone elective percutaneous coronary intervention: A retrospective study

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et al. 2020

Preprint

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Background Atherosclerosis is associated with chronic inflammation and lipid metabolism. The neutrophil to lymphocyte ratio (NLR) as an indicator of inflammation has been confirmed to be associated with cardiovascular disease prognosis. However, few studies have explored the effects of blood lipid variability on NLR. We aimed to explore the relationship between variability in blood lipid levels and NLR. Methods The association between variability in blood lipids and NLR was assessed with both univariate and multivariate linear regression. Multivariate linear regression was also performed for a subgroup analysis. Results The variability of HDL-C ([ꞵ] 4.008, SE 0.503, p-value<0.001) and LDL-C ([ꞵ] 0.626, SE 0.164, p-value<0.001) were risk factors for the NLR value, although baseline LDL-C and HDL-C were not risk factors for NLR values. Variability of HDL-C ([ꞵ] 4.328, SE 0.578, p-value<0.001) and LDL-C ([ꞵ] 0.660, SE 0.183, p-value<0.001) were risk factors for NLR variability. Subgroup analysis demonstrated that the relationship between variability of LDL-C and NLR was consistent with the trend of the total sample for those with or without diabetes mellitus, controlled blood lipid, statins, atorvastatin or rosuvastatin. The relationship between the variability of HDL-C and NLR was consistent with the trend of the total sample in all subgroups. Conclusion The variability of HDL-C and LDL-C are risk factors for the value and variability of NLR, while the relationship between variability of HDL-C and NLR is more stable than the variability of LDL-C in the subgroup analysis.

“…Neutrophil-to-lymphocyte ratio as a marker for inflammation can be an important tool in this context, as it has already emerged as an important marker for atherosclerotic disease, vascular calcification and also as a prognostic factor in CKD hypertensive patients [15,18,27]. Furthermore, neutrophil-to-lymphocyte ratio is a predictive factor for vascular calcification in end-stage renal disease [27].…”

Section: Discussionmentioning

confidence: 99%

“…Inflammation plays an essential role in the pathomechanisms of atherosclerotic disease; additionally, NLR is recognised as a predictor of subclinical and clinical atherosclerotic disease [14,15]. Recent data suggest that NLR may be an indicator for the prevalence and severity of coronary artery disease and also for the extent of aortic arch calcification (AAC) [16,17].…”

Section: Introductionmentioning

confidence: 99%

Markers of Atherosclerosis in Hypertensive Patients with Less Advanced Chronic Kidney Disease

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et al. 2019

Acta Medica Marisiensis

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Objective: Our study aimed to validate the neutrophil-to-lymphocyte ratio (NLR) as a marker for aortic arch calcification in hypertensive patients with less advanced chronic kidney disease (CKD).Methods: A number of forty-four hypertensive patients with chronic kidney disease (categories G3a and G3b – 2012 KDIGO nomenclature) were included in the study. Considering the presence of aortic arch calcification (AAC) on chest X-ray, the study population was divided into two groups: 27 patients AAC present and seventeen without aortic arch calcification. Laboratory data were collected for each patient and NLR was computed. Comorbidities were also recorded: stable coronary artery disease, lower extremity arterial disease and hypertensive heart disease.Results: A positive correlation between neutrophil-to-lymphocyte ratio and aortic arch calcification in hypertensive CKD patients was identified. Furthermore, advanced age, increased alkaline phosphatase and increased erythrocyte sedimentation rate had a positive association with aortic arch calcification. We found no statistical correlation between neutrophil-to-lymphocyte ratio and other laboratory features in both groups of patients.Conclusions: Neutrophil-to-lymphocyte ratio may be viewed as a potential risk factor for vascular calcification in patients with moderate chronic kidney disease; nevertheless, future extensive studies are necessary. In the management of hypertensive patients, general medicine might particularly benefit of this simple, readily available inflammatory marker.

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