| Objective: To explore the association of Platelet/Lymphocyte Ratio(PLR)and Neutrophil/Lymphocyte Ratio(NLR)with Protein Energy Wasting(PEW)among maintenance hemodialysis(MHD)patients.Methods: A multicenter cross-sectional study was conducted in eleven hemodialysis centers of Guizhou province from June to August,2017.Clinical data(age,sex,dialysis-vintage,complications and medication history,etc),physical parameters(height,weight,upper arm midpoint circumference,triceps skinfold thickness,etc),body composition data(lean body mass,fat mass,etc)and laboratory values(blood routine,serum albumin,creatinine,cholesterol,etc)of MHD patients were collected.PLR and NLR were calculated according to routine blood test.All patients were divided into four groups(Q1~Q4)respectively according to the quartile of PLR and NLR,8 groups in total and each group contained 234 patients.Logistic regression models were applied to analyze the relationships between PLR,NLR and PEW.The power of PLR and NLR to predict PEW was evaluated by receiver operating characteristic curves(ROC).Results: 936 MHD patients were enrolled,including 519 males and 417 females.The average age was 55.6±15.6 years old and the prevalence of PEW of all patients was 46.2%(432/936).Compared with Q1~Q3 of PLR,the upper arm muscle circumference,fat mass percentage,serum albumin,prealbumin and creatinine of PLR Q4 were lower.And the prevalence of PEW of PLR Q4 is higher,while the prevalence of PEW showed no differences among four groups of NLR.Logistic regression analysis showed that,compared with group Q1 of PLR in unadjusted models,patients in group Q3&Q4 of PLR were 2.07(95%CI: 1.03~4.13,P=0.014)and 2.73(95%CI:1.58~4.74,P<0.001)times more likely to suffer from PEW.PLR was also significantly associated with the occurrence of PEW after adjusting age,sex,dialysis-vintage,history of hypertension,history of diabetes,white blood cell,hemoglobin and parathyroid hormone.Compared with group Q1 of PLR,patients in group Q3&Q4 of PLR were 2.70 times(95%CI:1.25~5.88,P=0.012)and 2.76 times(95%CI:1.25~6.07,P=0.012)times more likely to suffer from PEW.ROC showed that the best cut-off value of PLR to predict PEW is 106.6(AUC=0.61,95%CI:0.56~0.66,P<0.001),while the AUC of NLR is 0.55(P=0.091).Conclusion: For MHD patients,only PLR could be a relative factor of PEW and it exhibited the predictive power of PEW rather than NLR. |
