The neutrophil-lymphocyte ratio as a marker of systemic endothelial dysfunction in asymptomatic subjects

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• 作者：Diego Martí ; nez-Urbistondo ; Almudena Beltrá ; n ; Oscar Beloqui ; Ana Huerta ; ^{ahuerta@unav.es}
• 关键词：Neutrophil&ndash ; lymphocyte ratio ; Urinary albumin/creatinine ratio ; Endothelial dysfunction ; Cardiovascular risk ; Asymptomatic subjects
• 刊名：Nefrología (English Edition)
• 出版年：2016
• 出版时间：July-August 2016
• 年：2016
• 卷：36
• 期：4
• 页码：397-403
• 全文大小：255 K
• 卷排序：36

文摘

The neutrophil-to-lymphocyte ratio has demonstrated to be a prognostic inflammatory marker in cardiovascular disease. The objective of this study is to evaluate the association between neutrophil–lymphocyte ratio and pathologic urinary albumin/creatinine ratio as an early marker of cardiovascular risk and systemic endothelial dysfunction, associated with microvascular disease, in asymptomatic subjects.Materials and methodsA unicenter cross-sectional study was conducted, including 1816 asymptomatic subjects. Patients with previous cardiovascular disease, those who were treated with ACE inhibitors and/or angiotensin II receptor blockers and patients with albumin/creatinine ratio over 300 mg/g were excluded. The outcome of the study was the presence of a pathologic urinary albumin/creatinine ratio.ResultsThe neutrophil–lymphocyte ratio was significantly associated with altered urinary albumin/creatinine ratio in the univariate analysis and after adjustment for other known endothelial and cardiovascular risk factors (age, hypertension, dyslipidaemia, diabetes or altered glomerular filtration rate). Based on the sensitivity and specificity of different neutrophil–lymphocyte ratio thresholds, 3 risk groups were created for altered urinary albumin/creatinine ratio: low risk in those with neutrophil–lymphocyte ratio <1.5, intermediate risk in patients between 1.5 and 3, and high risk in those with neutrophil- to-lymphocyte ratio >3. These groups were found to have a statistically significant and independent prognostic power for altered urinary albumin/creatinine ratio in asymptomatic patients.ConclusionsThe neutrophil–lymphocyte ratio appears to be a cost-efficient, non-invasive and independent potential marker of systemic endothelial dysfunction in asymptomatic subjects.