Relationship Between Neutrophil To Lymphocyte Ratio And Carotid Atherosclerosis In Patients With Primary Sjogren's Syndrome

Objective: To study the relationship between neutrophil to lymphocyte ratio(NLR)and carotid atherosclerosis in patients with primary Sjogren's syndrome,and to explore the value of NLR in the early diagnosis of carotid atherosclerosis in patients with primary Sjogren's syndrome.Methods: 148 patients with primary Sjogren's syndrome who were treated at the Third People's Hospital of Chengdu from January 2013 to May 2019 were retrospectively selected as the case group,and 148 healthy subjects were included as the control group.The two groups were compared for age,gender,previous medical history data and laboratory test data.The patients with primary Sjogren's syndrome(148 cases)were divided into the hormone/immunosuppressant group(n=64)and the non-hormone/immunosuppressant group(n=84)according to whether they used hormone/immunosuppressant in the last 3 months.The neutrophil count,lymphocyte count,and NLR were compared between the two groups of patients,and analyzed whether the use of hormone/immunosuppressant had an effect on NLR.According to the results of carotid ultrasound,the patients with primary Sjogren's syndrome(148cases)were divided into the group with carotid atherosclerosis(n=88)and the group without carotid atherosclerosis(n=60).The two groups were compared for age,gender,previous medical history data,laboratory test data and NLR.Multivariate logistic regression was used to analyze the influencing factors of carotid atherosclerosis in patients with primary sjogren's syndrome.The receiver operating characteristic curve(ROC)was used to analyze the predictive value of NLR for carotid atherosclerosis in patients with primary Sjogren's syndrome.Results: 1.Compared with the case group and the control group,there were statistically significant differences in neutrophil count,lymphocyte count and NLR(P<0.05),and the NLR of the case group was significantly higher than that of the control group.There were no statistically significant difference between the two groups in gender,history of hypertension,history of diabetes,age,white blood cell count,triglyceride,cholesterol,low density lipoprotein cholesterol,and high density lipoprotein cholesterol(P>0.05).2.Compared with the hormone/immunosuppressant group and the non-hormone/immunosuppressant group,the white blood cell count,neutrophil count,lymphocyte count and NLR have no statistically significant difference(P>0.05).3.Compared with the group with carotid atherosclerosis and the group without carotid atherosclerosis,age,white blood cell count,neutrocyte count,lymphocyte count,NLR,cholesterol,low-density lipoprotein cholesterol,and history of hypertension showed statistically significant difference(P<0.05).And the NLR of the group with carotid atherosclerosis was significantly higher than that of the group without carotid atherosclerosis.There were no statistically significant difference between the two groups in gender,history of diabetes,triglyceride,and high density lipoprotein cholesterol(P>0.05).4.Multivariate logistic regression analysis showed that age(OR:1.102,95%CI:1.029~1.179,P=0.005),hypertension(OR:5.246,95%CI:1.192~23.087,P=0.028),and NLR(OR:22.843,95%CI:6.919~75.417,P =0.001)were independent risk factors for carotid atherosclerosis in patients with Sjogren's syndrome.5.The ROC curve showed that the area under the ROC curve was 0.886,the 95% CI was 0.832~0.941,P=0.001.The best diagnostic threshold of NLR was 2.64,the sensitivity was 93.2%,and the specificity was 73.3%,indicating that NLR has certain predictive value for carotid atherosclerosis in patients with primary Sjogren's syndrome.Conclusion: NLR is an independent risk factor for carotid atherosclerosis in patients with primary Sjogren's syndrome.NLR has certain predictive value for carotid atherosclerosis in patients with primary Sjogren's syndrome.NLR of 2.64 is the best diagnostic threshold for judging the occurrence of carotid atherosclerosis in patients with primary Sjogren's syndrome.