Prognostic Role of Neutrophil to High-Density Lipoprotein Cholesterol Ratio for All-Cause and Cardiovascular Mortality in the General Population

Jiang, Ming; Sun, Jin-Yu; Zou, Huayiyang; Li, Menghuan; Su, Zhenyang; Sun, Wei; Kong, Xiangqing

doi:10.3389/fcvm.2022.807339

Cited by 19 publications

(23 citation statements)

References 34 publications

(47 reference statements)

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“… 2 A study based on an inflammatory model in vitro and in vivo displayed that neutrophils play a pathogenic role in the immune-inflammatory response in atherosclerosis pathogenesis. 33 Neutrophils are one of the first cells to react in the blood after an ischemic stroke. They can lead to the breakdown of the BBB and brain damage by mediating various inflammatory factors such as ROS, proteases, and cytokines.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil to High-Density Lipoprotein Ratio is Associated with Hemorrhagic Transformation in Patients with Acute Ischemic Stroke

Jin¹,

Zheng²,

Liao³

et al. 2022

JIR

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Background: Hemorrhagic transformation (HT) is one of the most common and severe complications in patients with acute ischemic stroke (AIS). It indicates a poor prognosis in AIS patients. However, the association of neutrophil to high-density lipoprotein ratio (NHR) with HT remains unclear. Purpose: This study examined whether the NHR has a predictive effect on HT in AIS patients and explored the predictive cutoff value of the NHR. Methods: This is a retrospective study and consecutively included AIS patients admitted to the Department of Neurology of the First Affiliated Hospital of Wannan Medical College between December 2019 and January 2022. All subjects had blood samples collected within 24 h of admission, and neutrophil counts and high-density lipoprotein counts were detected. HT was diagnosed with hemorrhage on subsequent magnetic resonance imaging (MRI) or computed tomography (CT) of the brain. Univariate logistic regression analysis was performed to identify confounding factors, and multivariate logistic regression analysis determined the correlation between NHR and HT. Receiver operating characteristic (ROC) curves were used to evaluate the clinical predictive value of NHR. Results: A total of 725 patients were finally included in this study, of which 87 (12%) developed HT. The median NHR value in the HT group was 4.31, which was significantly higher than that in the non-HT group, and the difference was statistically significant [4.31 (3.54-6.24) vs 3.63 (2.68-4.64), p < 0.001]. The binary logistic regression analysis showed that NHR was independently associated with HT in AIS patients (OR: 1.180, 95% CI: 1.036-1.344, p = 0.013). The area under ROC curve (AUC) of NHR for predicting HT in AIS patients was 0.633 (95% CI: 0.567-0.699, p < 0.001), and its optimal cutoff were 3.52. Conclusion:The NHR was a reliable and simple independent predictor of HT in AIS patients.

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Section: Discussionmentioning

confidence: 99%

Neutrophil to High-Density Lipoprotein Ratio is Associated with Hemorrhagic Transformation in Patients with Acute Ischemic Stroke

Jin¹,

Zheng²,

Liao³

et al. 2022

JIR

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“…Demographic data, including age, sex and race, were collected by questionnaires. People who had smoked over 100 cigarettes during their lifetime were regarded as smokers ( 21 ). A history of present illness (e.g., heart failure, coronary artery disease and stroke) and medication treatment were obtained from self-reported personal interview data.…”

Section: Methodsmentioning

confidence: 99%

Remnant cholesterol is associated with cardiovascular mortality

Zhang

Zhu

et al. 2022

Front. Cardiovasc. Med.

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BackgroundGenetic, observational, and clinical intervention studies indicate that circulating levels of remnant cholesterol (RC) are associated with cardiovascular diseases. However, the predictive value of RC for cardiovascular mortality in the general population remains unclear.MethodsOur study population comprised 19,650 adults in the United States from the National Health and Nutrition Examination Survey (NHANES) (1999–2014). RC was calculated from non-high-density lipoprotein cholesterol (non-HDL-C) minus low-density lipoprotein cholesterol (LDL-C) determined by the Sampson formula. Multivariate Cox regression, restricted cubic spline analysis, and subgroup analysis were applied to explore the relationship of RC with cardiovascular mortality.ResultsThe mean age of the study cohort was 46.4 ± 19.2 years, and 48.7% of participants were male. During a median follow-up of 93 months, 382 (1.9%) cardiovascular deaths occurred. In a fully adjusted Cox regression model, log RC was significantly associated with cardiovascular mortality [hazard ratio (HR) 2.82; 95% confidence interval (CI) 1.17–6.81]. The restricted cubic spline curve indicated that log RC had a linear association with cardiovascular mortality (p for non-linearity = 0.899). People with higher LDL-C (≥130 mg/dL), higher RC [≥25.7/23.7 mg/dL in males/females corresponding to the LDL-C clinical cutoff point (130 mg/dL)] and abnormal HDL-C (<40/50 mg/dL in males/females) levels had a higher risk of cardiovascular mortality (HR 2.18; 95% CI 1.13–4.21 in males and HR 2.19; 95% CI 1.24–3.88 in females) than the reference group (lower LDL-C, lower RC and normal HDL-C levels).ConclusionsElevated RC levels were associated with cardiovascular mortality independent of traditional risk factors.

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“…11 14-18 In addition, a general population from the USA showed that NHR is a predictor of all-cause and cardiovascular mortality. 19 LHR was proposed by Chen et al 12 as a novel inflammatory indicator. Consistent with the results from Chen et al, 12 other studies have confirmed the role of LHR in predicting the presence and severity of metabolic syndrome.…”

Section: Original Researchmentioning

confidence: 99%

“…Moreover, it has been found that MHR and NHR are risk factors for severe stenosis and poor prognosis in patients with CAD 11 14-18. In addition, a general population from the USA showed that NHR is a predictor of all-cause and cardiovascular mortality 19. LHR was proposed by Chen et al 12 as a novel inflammatory indicator.…”

Section: Introductionmentioning

confidence: 99%

MHR and NHR but not LHR were associated with coronary artery disease in patients with chest pain with controlled LDL-C

Liu

Zhen

et al. 2022

Journal of Investigative Medicine

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Several leukocyte to high-density lipoprotein cholesterol (HDL-C) ratios, including monocyte to HDL-C ratio (MHR), neutrophil to HDL-C ratio (NHR) and lymphocyte to HDL-C ratio (LHR), have been proposed as novel inflammatory indicators. We performed a cross-sectional study to investigate the relationships between these leukocyte to HDL-C ratios and coronary artery disease (CAD) in patients with chest pain with controlled low-density lipoprotein cholesterol (LDL-C). A total of 3482 patients with chest pain with LDL-C <1.8 mmol/L were enrolled. We evaluated the relationships between MHR, NHR, LHR and HDL-C and the occurrence of CAD as well as severe stenosis. We found that in patients with chest pain, higher MHR (adjusted OR=2.83, 95% CI 1.61 to 4.99, p<0.001) and NHR (adjusted OR=1.08, 95% CI 1.04 to 1.13, p<0.001), as well as lower HDL-C (adjusted OR=0.53, 95% CI 0.36 to 0.78, p=0.001), but not higher LHR (adjusted OR=1.06, 95% CI 0.94 to 1.20, p=0.341), had a stronger association with the occurrence of CAD. Moreover, unlike LHR (adjusted OR=1.02, 95% CI 0.93 to 1.13, p=0.654), higher MHR (adjusted OR=2.10, 95% CI 1.43 to 3.07, p<0.001) and NHR (adjusted OR=1.06, 95% CI 1.04 to 1.09, p<0.001) and lower HDL-C (adjusted OR=0.38, 95% CI 0.26 to 0.56, p<0.001) were risk factors for severe stenosis. A receiver operating characteristic curve analysis exhibited comparable abilities between MHR and NHR in predicting the presence and severity of CAD. In conclusion, even though patients with chest pain have achieved LDL-C <1.8 mmol/L, the inflammatory indicators MHR and NHR maintained their predictive abilities and remained associated with the occurrence and severity of CAD.

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Prognostic Role of Neutrophil to High-Density Lipoprotein Cholesterol Ratio for All-Cause and Cardiovascular Mortality in the General Population

Cited by 19 publications

References 34 publications

Neutrophil to High-Density Lipoprotein Ratio is Associated with Hemorrhagic Transformation in Patients with Acute Ischemic Stroke

Neutrophil to High-Density Lipoprotein Ratio is Associated with Hemorrhagic Transformation in Patients with Acute Ischemic Stroke

Remnant cholesterol is associated with cardiovascular mortality

MHR and NHR but not LHR were associated with coronary artery disease in patients with chest pain with controlled LDL-C

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