The Combined Impact of Neutrophil-to-Lymphocyte Ratio and Type 2 Diabetic Mellitus on Significant Coronary Artery Disease and Carotid Artery Atherosclerosis.
10.4250/jcu.2016.24.2.115
- Author:
Bong Joon KIM
1
;
Sang Hoon CHO
;
Kyoung Im CHO
;
Hyun Su KIM
;
Jung Ho HEO
;
Tae Joon CHA
Author Information
1. Division of Cardiology, Department of Internal Medicine, Convergence Medicine & Exercise Science Research Institute, Kosin University School of Medicine, Busan, Korea. kyoungim74@gmail.com
- Publication Type:Original Article
- Keywords:
Diabetes mellitus;
Neutrophil-to-lymphocyte ratio;
Coronary artery disease;
Carotid artery atherosclerosis
- MeSH:
Atherosclerosis*;
Carotid Arteries*;
Constriction, Pathologic;
Coronary Angiography;
Coronary Artery Disease*;
Coronary Vessels*;
Diabetes Mellitus;
Diabetes Mellitus, Type 2;
Humans;
Logistic Models;
Odds Ratio;
Prevalence;
Risk Factors;
Ultrasonography
- From:Journal of Cardiovascular Ultrasound
2016;24(2):115-122
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Neutrophil-to-lymphocyte ratio (NLR) has recently emerged as a new important inflammatory marker for predicting cardiovascular events. This study aimed to evaluate the combined impact of NLR and type 2 diabetes mellitus (T2DM) on significant coronary artery disease (CAD) and carotid artery atherosclerosis. METHODS: This study includes a total of 828 patients evaluated by coronary angiography and carotid ultrasonography. Significant CAD was defined as at least one vessel with stenosis greater than 50%. We employed logistic regression models to investigate the association of NLR and T2DM with significant CAD. The goodness-of-fit and discriminability of the models were assessed by the loglikelihood ratio test and C-index, respectively. Also, we investigated the clinical relevance of the categorized NLR that classifies patients into three risk groups (low, intermediate, high). RESULTS: According to logistic regression analysis, both NLR {adjusted odds ratio (OR) 1.31, p < 0.001} and T2DM (adjusted OR 2.46, p = 0.006) were independent risk factors of significant CAD. The addition of NLR and T2DM into a logistic regression model including conventional cardiovascular risk factors significantly improved the goodness-of-fit (p < 0.001) and the discriminability of the model (p = 0.004). Also, T2DM patients assigned into the high risk group (NLR > 2) showed the greater prevalence of significant CAD and carotid artery atherosclerosis compared with patients without T2DM or type 2 diabetic patients assigned into the low risk group (NLR ≤ 1). CONCLUSION: Our results suggest that type 2 diabetic patients with high inflammatory state would be more vulnerable to significant CAD and carotid artery atherosclerosis.
