The Association of Lipoprotein(a) and Neutrophil-to-Lymphocyte Ratio Combination with Atherosclerotic Cardiovascular Disease in Chinese Patients.
The Association of Lipoprotein(a) and Neutrophil-to-Lymphocyte Ratio Combination with Atherosclerotic Cardiovascular Disease in Chinese Patients.
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DOI：
10.2147/ijgm.s410840
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发表时间：
2023
影响因子：
2.3
通讯作者：
中科院分区：
文献类型：
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脂蛋白（a）[Lp（a）]与动脉粥样硬化性心血管疾病（ASCVD）风险的相关性可通过慢性全身性炎症改变。嗜中性粒细胞与淋巴细胞比率（NLR）是对各种感染性和非感染性刺激的免疫应答的可靠且容易获得的标志物。本研究的目的是评估Lp（a）和NLR在预测ASCVD风险和冠状动脉斑块特征中的联合作用。本研究纳入了1618例接受冠状动脉计算机断层扫描血管造影（CTA）并进行ASCVD风险评估的患者。采用CTA评价冠状动脉粥样硬化斑块的特征，采用多因素Logistic回归模型分析脂蛋白（a）和NLR与ASCVD的关系。有斑块者血浆Lp（a）和NLR明显升高。高Lp（a）定义为血浆Lp（a）水平> 75 nmol/L，高NLR定义为NLR > 1.686。根据NLR正常与否及血浆Lp（a）水平高低分为nLp（a）/NLR-、hLp（a）/NLR-、nLp（a）/NLR+和hLp（a）/NLR+四类。后3组患者发生ASCVD的风险均高于nLp（a）/NLR-对照组，其中hLp（a）/NLR+组发生ASCVD的风险最高（OR = 2.39，95%CI = 1.49-3.83，P = 0.000）。hLp（a）/NLR+组不稳定斑块的发生率为29.94%，显著高于nLp（a）/NLR+、hLp（a）/NLR-和nLp（a）/NLR-组（分别为20.83%、26.54%和22.58%），与nLp（a）/NLR-组相比，hLp（a）/NLR+组中不稳定斑块的风险显著增加（OR = 1.67，95%CI = 1.04-2.68，P = 0.035）。与nLp（a）/NLR-组相比，hLp（a）/NLR+组中稳定斑块的风险未显著增加（OR = 1.73，95%CI = 0.96-3.10，P = 0.066）。在ASCVD患者中，Lp（a）升高和NLR升高与不稳定冠状动脉斑块增加相关。
The association of lipoprotein(a) [Lp(a)] with atherosclerotic cardiovascular disease (ASCVD) risk can be modified by chronic systemic inflammation. The neutrophil-to-lymphocyte ratio (NLR) is a reliable and easily available marker of immune response to various infectious and non-infectious stimuli. The purpose of this study was to assess the combined effects of Lp(a) and NLR in predicting the ASCVD risk and coronary artery plaque traits. This study included 1618 patients who had coronary computed tomography angiography (CTA) with risk assessment of ASCVD. CTA was used to evaluate the traits of coronary atherosclerotic plaques, and the association of ASCVD with Lp(a) and NLR was assessed by multivariate logistic regression models. Plasma Lp(a) and NLR were significantly increased in patients having plaques. High Lp(a) was defined as the plasma Lp(a) level > 75 nmol/L and high NLR as NLR > 1.686. The patients were grouped into four categories according to normal or high NLR and plasma Lp(a) as nLp(a)/NLR-, hLp(a)/NLR-, nLp(a)/NLR+ and hLp(a)/NLR+. The patients in the latter three groups had higher risk of ASCVD compared to the reference group nLp(a)/NLR-, with the highest ASCVD risk in the hLp(a)/NLR+ group (OR = 2.39, 95% CI = 1.49–3.83, P = 0.000). The occurrence of unstable plaques was 29.94% in the hLp(a)/NLR+ group, which was significantly higher than groups nLp(a)/NLR+, hLp(a)/NLR- and nLp(a)/NLR- with 20.83%, 26.54% and 22.58%, respectively, and there was a significantly increased risk of unstable plaque in the hLp(a)/NLR+ group compared to the nLp(a)/NLR- group (OR = 1.67, 95% CI = 1.04–2.68, P = 0.035). The risk of stable plaque was not significantly increased in the hLp(a)/NLR+ group compared to the nLp(a)/NLR- group (OR = 1.73, 95% CI = 0.96–3.10, P = 0.066). The concomitant presence of elevated Lp(a) and higher NLR is associated with increased unstable coronary artery plaques in patients with ASCVD.