Correlation Between Peripheral Blood Inflammatory Indexes And Carotid Atherosclerosis

Objective: To explore the correlation between peripheral blood inflammatory indexes such as neutrophil-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR)and monocyte-high density lipoprotein cholesterol ratio(MHR)and carotid atherosclerosis.Methods: A retrospective study was conducted to select 604 inpatients who underwent color Doppler ultrasound examination of carotid artery in central hospital of wuhan from December 2020 to December 2021,including 369 patients with carotid atherosclerosis and 235 patients without carotid atherosclerosis.Patients with carotid atherosclerosis were further divided into unstable plaque group and stable plaque group,with 154 patients and 96 patients.The general data and peripheral blood test results of patients were collected and compared between groups.Multivariate Logistic regression was used to analyze the influencing factors of carotid atherosclerosis and unstable carotid plaque.The predictive value of NLR,PLR and MHR was evaluated by the receiver’s working characteristic(ROC)curve.Spearman bivariate correlation was used to analyze the correlation between the maximum plaque length(MPL)of carotid artery and laboratory indexes.Results:1.Univariate analysis showed that the male proportion,hyperlipidemia prevalence rate,smoking proportion,age,systolic blood pressure,diastolic blood pressure,low density lipoprotein cholesterol,fasting blood glucose,NLR,PLR and MHR levels in the carotid atherosclerosis group were higher than those in the non-carotid atherosclerosis group,and the difference was statistically significant(P < 0.05);The level of high density lipoprotein cholesterol in carotid atherosclerosis group was lower than that in non-carotid atherosclerosis group,and the difference was statistically significant(P < 0.05).2.Multivariate Logistic regression analysis showed that NLR(OR=6.410,95%CI:3.897～10.542,P < 0.001),PLR(OR=1.018,95%CI:1.011～1.026,P < 0.001),and PLR(0.001).P < 0.05),low density lipoprotein cholesterol(OR=1.509,95%CI:1.177～1.936,P < 0.05),age(OR=1.078,95%CI:1.042～1.116,P < 0.001)were the main causes of cervical spondylosis.3.ROC curve analysis shows that the AUC of NLR,PLR and MHR are0.792(95%CI:0.758～ 0.824,P < 0.001)and 0.704(95%CI:0.666～0.741,P < 0.001)respectively.Comparison of the predictive efficacy of the three methods for carotid atherosclerosis: NLR > PLR > MHR(z = 3.675,P < 0.001;Z=2.132,P=0.033)。4.Univariate analysis showed that the male proportion,smoking proportion,serum uric acid,NLR and MHR in unstable plaque group were higher than those in stable plaque group,and the difference was statistically significant(P < 0.05).5.Multivariate Logistic regression analysis showed that NLR(OR=5.617,95%CI:3.025～10.428,P < 0.001)was an independent risk factor for carotid plaque instability.6.ROC curve analysis showed that the area under the curve(AUC)of NLR was 0.746(95%CI:0.687～0.799,P < 0.001).When the diagnostic cut-off value of NLR was 2.15,the sensitivity and specificity of predicting carotid unstable plaque were 74.68% and 63.54%.7.Spearman bivariate correlation analysis showed that NLR,MHR,serum uric acid were positively correlated with carotid MPL(P < 0.05).There was a negative correlation between HDL-C and carotid MPL(P < 0.01).The correlation between MHR and carotid MPL was the highest(r=0.526).Conclusion: High levels of NLR,PLR and MHR can be used as risk factors for carotid atherosclerosis,among which NLR and PLR are expected to be predictive indicators of carotid atherosclerosis.NLR is not only an independent risk factor for carotid plaque instability,but also can predict plaque instability.The level of MHR is positively correlated with the maximum plaque length of carotid artery,which is valuable for evaluating the severity of carotid atherosclerosis.