Cross-lagged Panel Model Analysis of Blood Inflammatory Index and Cardiovascular Risk in 633 Patients with Rheumatoid Arthritis
10.13288/j.11-2166/r.2025.23.010
- VernacularTitle:633例类风湿关节炎患者血液炎症指数与心血管风险的交叉滞后模型分析
- Author:
Qiuwei PENG
1
;
Quan JIANG
1
Author Information
1. Guang'anmen Hospital，China Academy of Chinese Medical Sciences，Beijing，100053
- Publication Type:Journal Article
- Keywords:
rheumatoid arthritis;
cardiovascular disease;
risk analysis;
cross-lagged panel model;
inflammatory index
- From:
Journal of Traditional Chinese Medicine
2025;66(23):2447-2452
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the relationship between hematological inflammatory indices and cardiovascular risk in rheumatoid arthritis （RA） patients， providing insights for cardiovascular risk management strategies. MethodsClinical data of RA patients were retrospectively collected at admission and follow-up （1 year±10 days between admission and follow-up）. The data included general information at admission， and peripheral blood neutrophil， lymphocyte， monocyte， platelet， triglyceride （TG）， and high-density lipoprotein cholesterol （HDL-C） levels at both admission and follow-up. Blood inflammatory indicators including neutrophil-to-lymphocyte ratio （NLR）， monocyte-to-lymphocyte ratio （MLR）， platelet-to-lymphocyte ratio （PLR）， systemic immune-inflammatory index （SII）， and systemic inflammatory response index （SIRI） and atherogenic index of plasma （AIP） were calculated. Cross-lagged panel model was used to analyze the relationship between blood inflammatory markers and AIP in patients with RA. Gender-stratified analyses were performed. ResultsA total of 633 RA patients were included in this study， of whom 141 were male （22.27%） and 492 were female （77.73%）. The proportions of smokers and drinkers， and body mass index were significantly higher in male than in female （P＜0.05）. At follow-up， the levels of NLR， MLR， PLR， SII， and SIRI in all 633 patients were higher than at admission （P＜0.05）， while there was no statistically significant difference in AIP levels between admission and follow-up （P＞0.05）. At admission， female patients had significantly higher levels of NLR， MLR， PLR， SII， SIRI， and AIP than male patients （P＜0.05）. Among 633 patients， significant bidirectional causal associations were found between NLR， MLR， PLR， SII， SIRI and AIP （P＜0.05）. Stratified temporal causal analysis based on gender showed that in females， NLR， MLR， PLR， SII and AIP were bidirectionally associated， while the relationship between AIP and SIRI was unidirectional （P＜0.05）. In males， SII and AIP were mutually correlated （P＜0.05）， while AIP→NLR， AIP→MLR， AIP→PLR， and AIP→SIRI showed unidirectional associations （P＜0.05）， and SIRI had no significant association with AIP （P＞0.05）. ConclusionThere is a bidirectional causal association between blood inflammatory markers and AIP in RA patients， and they can mutually predict changes in each marker after 1 year； the causal association between blood inflammatory markers and AIP is stronger in female than in male.
