中性粒细胞/淋巴细胞比值与代谢综合征的相关性研究

目的研究中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)与代谢综合征(metabolic syndrome,MS)的关系。方法本研究为回顾性研究,2011年10月—2013年12月就诊且资料完整的MS患者122例为MS组,另从同期体检的个体中按照年龄相仿、性别相同的原则挑选健康个体122例作为对照组。根据血常规检测结果中的中性粒细胞计数和淋巴细胞计数结果计算出患者的NLR。对照组与MS组临床特征的比较采用Wilcoxin配对检验(差值呈偏态分布的资料)或配对t检验(差值呈正态分布的资料),分类资料的比较采用Fisher确切概率法。采用受试者工作特征(receiver operating characteristic,ROC)曲线法分析白细胞计数、淋巴细胞和中性粒细胞计数、NLR对MS的鉴别效率。ROC曲线下面积(area under curve,AUC)的比较采用Delong等提出的方法,P0.05为差异有统计学意义。结果与对照组相比,MS组患者高血压的发病率、空腹血糖水平、甘油三酯水平、白细胞计数、中性粒细胞计数和NLR75/47、(8.2±1.9)、(3.3±4.0)mmol/L、(7.66±1.73)×109/L、(5.39±1.34)×109/L、3.03±1.48]明显增高(均P0.05),淋巴细胞计数和高密度脂蛋白胆固醇浓度(2.09±0.97)×109/L、(0.87±0.36)mmol/L]则明显降低(均P0.05)。符合四条诊断标准的MS患者,中性粒细胞计数和NLR明显高于符合三项诊断标准的患者(均P0.05)。白细胞计数和淋巴细胞计数在两组患者之间的区别则无统计学意义(均P0.05)。在上述四个参数中,以NLR的曲线下面积最大,与其他三个参数之间的差异均有统计学意义(均P0.05)。结论 NLR可以反映MS病情,其与MS的关联强度可能高于白细胞计数、淋巴细胞计数和中性粒细胞计数。

Correlation between neutrophil / lymphocyte ratio and metabolic syndrome

Objective To investigate the correlation between neutrophil / lymphocyte ratio （NLR） and metabolic syndrome （MS）. Methods This was a retrospective study. 122 cases of MS with complete medical data seeking medical attention from October 2011 to December 2013 were selected as MS group. A total of 122 age - and sex - matched healthy individuals receiving healthy examination were as the controls. NLR, which was defined as the ratio of neutrophil and lymphocyte counts, was calculated from the routine blood test. Wilcoxin test （skewed distribution data） or t test （normal distribution data） was used to compare clinical features between the two groups, and Fisher exact test was used to compare classified data. ROC （receiver operating characteristic） curves were used to estimate the discriminate ability of white blood cell （WBC） ,neutrophil and lymphocyte counts, as well as NLR. Delong＇s method was employed to compare the AUC of these indices, the result of P 〈 0.05 was of statistical significance. Results Compared with healthy controls, the incidence of hypertension, fasting glucose levels, triglyceride levels, WBC counts,neutrophil counts, and NLR increased significantly in MS group75/47, （8.2 ± 1.9） ,（3.3 ±4.0）mmol/L, （7.66 ±1.73）× 109/L,（5.39 ± 1.34） × 109/L, （3.03 ± 1.48） ; all P 〈 0.05 ], while lymphocyte counts and high - density lipoprotein cholesterol level decreased significantly （2.09 ± 0. 97）× 109/L, （0.87 ＋ 0.36）mmol/L; P 〈 0.05 ]. The patients who met four items of diagnostic criteria of MS had higher neutrophil counts and NLR than those who met three items（ P 〈0.05）. WBC and lymphocyte counts showed no significant difference between two groups（ all P 〉 0.05 ）. NLR had the highest area under curve （AUC）, which was significantly dif- ferent from the other three （ all P 〈 O. 05）. Conclusions NLR can reflect the severity of MS, its correlation with MS may be closer than WBC, neutrophill and lymphocyte counts.