| Objective: To evaluate the correlation between neutrophil/lymphocyte ratio(NLR),inflammation and nutritional in maintenance hemodialysis(MHD)patients.Methods: 134 MHD patients from Blood Purification Center of hospital,aged 29-82 years,who received hemodialysis 3 times per week,4 hours each time were include in this single-center cross-sectional study.Data on patient demographic,gender,age,body mass index and years of dialysis were collected.Fasting blood samples were collected before hemodialysis for detection of inflammatory markers.C-reactive protein(CRP)level was measured by immunoturbidimetry,tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)were measured by enzyme-linked immunoassay.Nutritional markers such as albumin(Alb),prealbumin(PA),transferrin(TRF)were detected by biochemical analyzer.Body mass index(BMI),triceps skin fold thickness(TSF),mid-arm circumference(MAC),and malnutrition-inflammation score(MIS)also were collected.Calculated NLR according to blood routine.The correlation between inflammatory,nutritional markers and NLR were analyzed respectively.Multiple linear regression model was used to observe the common factor that affects NLR.Dividing NLR into four groups(Q1-Q4),the indexes of differences between NLR four groups were compared.Multiple logistic regression was used to analyze the relationship between different NLR levels,inflammation and nutritional status.Results: A total of 134 patients with complete data were included,including65 males and 69 females,aged(55.35 ± 11.68)years old.NLR was positively correlated with TNF-α(r = 0.535,P<0.001)and IL-6(r = 0.335,P<0.001).No significant correlation was found between NLR and CRP(r = 0.161,P>0.05).NLR was negatively correlated with BMI(r =-0.584,P<0.001)、Alb(r =-0.283,P<0.001),PA(r =-0.336,P<0.001)and TSF(r =-0.194,P=0.025).No significant correlation was found between NLR and TRF(r =-0.134,P>0.05),MAC(r =-1.000,P>0.05),MIS(r = 0.074,P>0.05).In the multiple linear regression model,TNF-α and IL-6 can be used as the common influencing factors of NLR(P<0.001),BMI,Alb,PA,and TSF can be used as the common influencing factors of NLR(P<0.05).Grouping according to the NLR interquartile range shows that the NLR level is affected by the age(P=0.044).Multiple logistic regression analysis showed that the effect of TNF-α on NLR in the higher level group was greater than the lower level group.The effects of TNF-α levels in the Q2,Q3,and Q4 groups on NLR were 1.14 times(95%CI: 1.03～1.26),1.19 times(95%CI:1.07～1.32),and 1.31 times(95%CI: 1.17～1.48)than the Q1 group.The effect of BMI on NLR in the lower level group was greater in the higher level group.The impact of BMI levels in Q2,Q3,and Q4 on NLR was 0.69 times(95%CI:0.55～0.86),0.72 times(95%CI: 0.59～1.32),0.49 times(95%CI: 0.37～0.64)of Q1 group.Conclusion: NLR of MHD patients was positively correlated with TNF-αand IL-6,and negatively correlated with BMI,Alb,PA and TSF.NLR was correlated with multiple inflammatory and nutritional indicators.TNF-α and IL-6can be used as the common influencing factors of NLR,while BMI,Alb,PA and TSF can be used as the common influencing factors of NLR.The influence of TNF-α on NLR in the higher level NLR group is greater than the lower level NLR group,and the influence of BMI on NLR in the lower level NLR group is greater than the higher level NLR group.Inflammatory factors and nutritional status may be factors affecting NLR,and the influence level varies with different levels of NLR.However,this study was a cross-sectional correlation study,and there were limitations in causal inference.NLR may become a new inflammatory and nutritional marker in MHD patients,and provide certain reference value for the clinical diagnosis and treatment of MHD patients. |
PDF Full Text Request