Correlation between novel inflammatory markers and carotid atherosclerosis: A retrospective case-control study

PLoS One. 2024 May 29;19(5):e0303869. doi: 10.1371/journal.pone.0303869. eCollection 2024.

Abstract

Objective: Carotid atherosclerosis is a chronic inflammatory disease, which is a major cause of ischemic stroke. The purpose of this study was to analyze the relationship between carotid atherosclerosis and novel inflammatory markers, including platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), platelet to neutrophil ratio (PNR), neutrophil to lymphocyte platelet ratio (NLPR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI), in order to find the best inflammatory predictor of carotid atherosclerosis.

Method: We included 10015 patients who underwent routine physical examinations at the physical examination center of our hospital from January 2016 to December 2019, among whom 1910 were diagnosed with carotid atherosclerosis. The relationship between novel inflammatory markers and carotid atherosclerosis was analyzed by logistic regression, and the effectiveness of each factor in predicting carotid atherosclerosis was evaluated by receiver operating characteristic (ROC) curve and area under the curve (AUC).

Result: The level of PLR, LMR and PNR in the carotid atherosclerosis group were lower than those in the non-carotid atherosclerosis group, while NLR, NLPR, SII, SIRI and AISI in the carotid atherosclerosis group were significantly higher than those in the non-carotid atherosclerosis group. Logistic regression analysis showed that PLR, NLR, LMR, PNR, NLPR, SII, SIRI, AISI were all correlated with carotid atherosclerosis. The AUC value of NLPR was the highest, which was 0.67, the cut-off value was 0.78, the sensitivity was 65.8%, and the specificity was 57.3%. The prevalence rate of carotid atherosclerosis was 12.4% below the cut-off, 26.6% higher than the cut-off, and the prevalence rate increased by 114.5%.

Conclusion: New inflammatory markers were significantly correlated with carotid atherosclerosis, among which NLPR was the optimum inflammatory marker to predict the risk of carotid atherosclerosis.

MeSH terms

  • Aged
  • Biomarkers* / blood
  • Blood Platelets / metabolism
  • Blood Platelets / pathology
  • Carotid Artery Diseases* / blood
  • Case-Control Studies
  • Female
  • Humans
  • Inflammation* / blood
  • Lymphocytes
  • Male
  • Middle Aged
  • Monocytes / metabolism
  • Neutrophils
  • ROC Curve
  • Retrospective Studies

Substances

  • Biomarkers

Grants and funding

The study was supported by the National Natural Science Foundation of China (Grant No.81571373, No.81601217, No.82001491), Natural Science Foundation of Hubei Province of China (Grant No. 2017CFB627), Health Commission of Hubei Province scientific research project (Grant No. WJ2021M247) and Scientific Research Fund of Wuhan Union Hospital (Grant No.2019). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.