Correlation Analysis Of Neutrophils / Lymphocytes Ratio And Carotid Atherosclerosis In Peritoneal Dialysis Patients

Objective:To explore the correlation between neutrophil to lymphocyte ratio(NLR)and carotid atherosclerosis(CAS)in peritoneal dialysis(PD)patients.Methods:We comprehensively searched the literatures on the correlation between NLR and carotid atherosclerosis in PubMed,Embase,Cochrane Library,Web of Science,Chinese science and technology journal database,Wanfang Data Knowledge Service platform and China Knowledge Network database,and extracted the data of the literatures meeting the inclusion criteria.All extracted data was processed using Stata14.0 software,and it’s to provides an evidence-based basis for further clinical research.After that,we selected 126 PD patients who attended our renal department from december 2020 to july 2022.At the same time,we probed their carotid intima-media thickness(CIMT)and collected relevant data.Based on the median NLR,the included cases were divided into low NLR group and high NLR group.Comparisons of general and clinical indicators between the two groups were performed by t test,nonparametric rank sum test or χ2 test.NLR and carotid atherosclerosis were analysed by Spearman correlation;logistic regression was performed for risk factors for CAS.Finally,the diagnostic efficacy of NLR in carotid atherosclerosis was studied using ROC curves.Results:1.Meta analysis of 24 studies showed that NLR level in CAS group was higher than that in control group(SMD=0.52,95%CI(0.38,0.66),P<0.05),and there was no significant publication bias,the results had a certain stability.This study provides an evidence-based basis for further clinical research.2.The white blood cell(WBC),neutrophil(NEU),NLR,triglyceride(TG),total cholesterol(TC),uric acid(UA),phosphorus(P),high-sensitivity C-reactive protein(hsCRP)and CIMT in the low NLR group were fewer than those in the high NLR group(P<0.05).Lymphocyte(LYM),hemoglobin(Hb)and albumin(Alb)were higher than those in high NLR group(P<0.05).3.CIMT with age(r=0.261,P<0.05),hypertension(r=0.219,P<0.05),diabetes(r=0.225,P<0.05),NLR(r=0.597,P<0.05),TG(r=0.319,P<0.001),TC(r=0.329,P<0.001)were positively correlated;There was a negative correlation with LYM(r=-0.289,P<0.001).4.Binary logistic regression analysis showed an independent positive correlation between NLR and CAS(β=1.139,OR=3.123,95%CI 1.922～5.074,P<0.001).5.NLR predicted the diagnostic efficacy of CAS as AUC=0.850(95%CI 0.785～0.915,P<0.001),sensitivity as 75.7%,specificity as 80.8%.Conclusion:The results of this meta-analysis show that NLR is an important indicator to monitor carotid atherosclerosis in non-dialysis patients.Further studies suggest that NLR is positively associated with carotid atherosclerosis in PD patients,which may help predict carotid atherosclerosis in PD patients.This study provides some theoretical basis for its potential treatment.