Correlation analysis of red blood cell distribution width and neutrophil to lymphocyte ratio with total imaging load of cerebral small vessel disease_West China Medical Journal

Authors：

SUN Chen ¹ ,  LIU Guorong ¹ , PAN Xiaohua ²

1. Department of Neurology, Baotou Central Hospital, Baotou Medical College, Inner Mongolia University of Science & Technology, Baotou, Inner Mongolia 014040, P. R. China;
2. Department of Neurology, Baotou Eighth Hospital, Baotou Medical College, Inner Mongolia University of Science & Technology, Baotou, Inner Mongolia 014040, P. R. China;

Corresponding author：

LIU Guorong, Email: guorongliu@vip.163.com

Keywords：

Red blood cell distribution width; neutrophil to lymphocyte ratio; cerebral small vessel disease; total imaging load

DOI：

10.7507/1002-0179.202303215

Video：

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Objective To investigate the correlation of red blood cell distribution width (RDW) and neutrophil to lymphocyte ratio (NLR) with total imaging load of cerebral small vessel disease (CSVD), and the clinical diagnostic value of RDW, NLR and their combined indicators for high load of CSVD imaging. Methods The medical records of CSVD patients hospitalized in the Department of Neurology of Baotou Central Hospital between October 2018 and October 2022 were retrospective collected. The total imaging load of CSVD was obtained by evaluating the cranial MRI and divided into a low load group and a high load group. The general clinical data, past medical history, and blood biochemical indicators were compared between the two groups. The correlation analysis method was used to analyze the relationship between the relevant indicators and the total imaging load. Logistic regression analysis was used to analyze the risk factors of the total imaging load of CSVD. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of the detection indicators for clinical diagnosis. Results A total of 320 patients were included. Among them, there were 201 cases (62.81%) in the low load imaging group and 119 cases (37.19%) in the high load imaging group. Excepted for age, gender, history of hypertension, RDW, and NLR (P<0.05), there was no statistically significant difference in the comparison of other indicators between the two groups (P>0.05). Spearman correlation analysis showed that RDW (r=0.445, P<0.001) and NLR (r=0.309, P<0.001) were positively correlated with the total imaging load of CSVD. The results of multivariate logistic regression analysis showed that age, male gender, RDW, and NLR were risk factors for high imaging load of CSVD. The areas under the ROC curve of RDW, NLR, and their combined indicators were 0.733, 0.644, and 0.792, respectively.Conclusions In patients with CSVD, the levels of RDW and NLR are related to the total imaging load of CSVD, which are independent risk factors for high imaging load of CSVD. The levels of RDW and NLR have clinical diagnostic value in predicting CSVD high load.

Citation： SUN Chen, LIU Guorong, PAN Xiaohua. Correlation analysis of red blood cell distribution width and neutrophil to lymphocyte ratio with total imaging load of cerebral small vessel disease. West China Medical Journal, 2023, 38(5): 674-679. doi: 10.7507/1002-0179.202303215 Copy

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2.	Klarenbeek P, van Oostenbrugge RJ, Rouhl RP, et al. Ambulatory blood pressure in patients with lacunar stroke: association with total MRI burden of cerebral small vessel disease. Stroke, 2013, 44(11): 2995-2999.
3.	李丹阳, 刘畅. 红细胞分布宽度与脑白质疏松的相关性研究. 锦州医科大学学报, 2020, 41(5): 17-21.
4.	满程, 刘畅, 李丹阳. 中性粒细胞/淋巴细胞比值与不同病变部位脑白质疏松的相关性研究. 山西医药杂志, 2021, 50(4): 527-530.
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8.	中华医学会心血管病学分会介入心脏病学组, 中华医学会心血管病学分会动脉粥样硬化与冠心病学组, 中国医师协会心血管内科医师分会血栓防治专业委员会, 等. 稳定性冠心病诊断与治疗指南. 中华心血管病杂志, 2018, 46(9): 680-694.
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10.	Fan M, Lv J, Yu C, et al. Family history, tobacco smoking, and risk of ischemic stroke. J Stroke, 2019, 21(2): 175-183.
11.	徐群. 脑小血管病影像标志共识指南解读. 神经病学与神经康复学杂志, 2016, 12(1): 17-23.
12.	Staals J, Makin SDJ, Doubal FN, et al. Stroke subtype, vascular risk factors, and total MRI brain small-vessel disease burden. Neurology, 2014, 83(14): 1228-1234.
13.	Huijts M, Duits A, van Oostenbrugge RJ, et al. Accumulation of MRI markers of cerebral small vessel disease is associated with decreased cognitive function. A study in first-ever lacunar stroke and hypertensive patients. Front Aging Neurosci, 2013, 5: 72.
14.	朱翠婷, 胡文立. 头晕/眩晕患者脑小血管病总负荷的危险因素分析. 中国卒中杂志, 2022, 17(4): 354-359.
15.	Wu WW, Wang Y, Xu J, et al. Explore the correlation between cerebral vessel characteristics with cognitive impairment among elder individuals: a community study from China. BMC Neurol, 2021, 21(1): 484.
16.	段雅鑫, 滕振杰, 胡明, 等. 脑小血管病动态血压变异性与脑小血管病影像总负荷的相关性. 中国神经精神疾病杂志, 2022, 48(6): 321-327.
17.	Klarenbeek P, van Oostenbrugge RJ, Lodder J, et al. Higher ambulatory blood pressure relates to enlarged Virchow-Robin spaces in first-ever lacunar stroke patient. J Neurol, 2013, 260(1): 115-121.
18.	Rönnbäck C, Hansson E. The importance and control of low-grade inflammation due to damage of cellular barrier systems that may lead to systemic inflammation. Front Neurol, 2019, 10: 533.
19.	Zhang Y, Zhang Z, Zhang M, et al. Correlation between retinal microvascular abnormalities and total magnetic resonance imaging burden of cerebral small vessel disease in patients with type 2 diabetes. Front Neurosci, 2021, 15: 727998.
20.	Hasic S, Kadic D, Kiseljakovic E, et al. Serum uric acid could differentiate acute myocardial infarction and unstable angina pectoris in hyperuricemic acute coronary syndrome patients. Med Arch, 2017, 71(2): 115-118.
21.	王依宁, 廖子蔚, 寻志杰, 等. 脑小血管病与血NLR、PLR及褪黑素的相关性分析. 科学养生, 2022, 25(21): 93-95.

1. Wardlaw JM, Smith EE, Biessels GJ, et al. Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. Lancet Neurol, 2013, 12(8): 822-838.
2. Klarenbeek P, van Oostenbrugge RJ, Rouhl RP, et al. Ambulatory blood pressure in patients with lacunar stroke: association with total MRI burden of cerebral small vessel disease. Stroke, 2013, 44(11): 2995-2999.
3. 李丹阳, 刘畅. 红细胞分布宽度与脑白质疏松的相关性研究. 锦州医科大学学报, 2020, 41(5): 17-21.
4. 满程, 刘畅, 李丹阳. 中性粒细胞/淋巴细胞比值与不同病变部位脑白质疏松的相关性研究. 山西医药杂志, 2021, 50(4): 527-530.
5. 胡文立, 杨磊, 李譞婷, 等. 中国脑小血管病诊治专家共识2021. 中国卒中杂志, 2021, 16(7): 716-726.
6. 中国高血压防治指南修订委员会, 高血压联盟(中国), 中华医学会心血管病学分会, 等. 中国高血压防治指南(2018年修订版). 中国心血管杂志, 2019, 24(1): 24-56.
7. 中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2020年版)(上). 中国实用内科杂志, 2021, 41(8): 668-695.
8. 中华医学会心血管病学分会介入心脏病学组, 中华医学会心血管病学分会动脉粥样硬化与冠心病学组, 中国医师协会心血管内科医师分会血栓防治专业委员会, 等. 稳定性冠心病诊断与治疗指南. 中华心血管病杂志, 2018, 46(9): 680-694.
9. 王维维, 申致远, 李凡, 等. 高血压病合并脑小血管病的危险因素及与认知功能的关系. 中国神经精神疾病杂志, 2022, 48(7): 392-397.
10. Fan M, Lv J, Yu C, et al. Family history, tobacco smoking, and risk of ischemic stroke. J Stroke, 2019, 21(2): 175-183.
11. 徐群. 脑小血管病影像标志共识指南解读. 神经病学与神经康复学杂志, 2016, 12(1): 17-23.
12. Staals J, Makin SDJ, Doubal FN, et al. Stroke subtype, vascular risk factors, and total MRI brain small-vessel disease burden. Neurology, 2014, 83(14): 1228-1234.
13. Huijts M, Duits A, van Oostenbrugge RJ, et al. Accumulation of MRI markers of cerebral small vessel disease is associated with decreased cognitive function. A study in first-ever lacunar stroke and hypertensive patients. Front Aging Neurosci, 2013, 5: 72.
14. 朱翠婷, 胡文立. 头晕/眩晕患者脑小血管病总负荷的危险因素分析. 中国卒中杂志, 2022, 17(4): 354-359.
15. Wu WW, Wang Y, Xu J, et al. Explore the correlation between cerebral vessel characteristics with cognitive impairment among elder individuals: a community study from China. BMC Neurol, 2021, 21(1): 484.
16. 段雅鑫, 滕振杰, 胡明, 等. 脑小血管病动态血压变异性与脑小血管病影像总负荷的相关性. 中国神经精神疾病杂志, 2022, 48(6): 321-327.
17. Klarenbeek P, van Oostenbrugge RJ, Lodder J, et al. Higher ambulatory blood pressure relates to enlarged Virchow-Robin spaces in first-ever lacunar stroke patient. J Neurol, 2013, 260(1): 115-121.
18. Rönnbäck C, Hansson E. The importance and control of low-grade inflammation due to damage of cellular barrier systems that may lead to systemic inflammation. Front Neurol, 2019, 10: 533.
19. Zhang Y, Zhang Z, Zhang M, et al. Correlation between retinal microvascular abnormalities and total magnetic resonance imaging burden of cerebral small vessel disease in patients with type 2 diabetes. Front Neurosci, 2021, 15: 727998.
20. Hasic S, Kadic D, Kiseljakovic E, et al. Serum uric acid could differentiate acute myocardial infarction and unstable angina pectoris in hyperuricemic acute coronary syndrome patients. Med Arch, 2017, 71(2): 115-118.
21. 王依宁, 廖子蔚, 寻志杰, 等. 脑小血管病与血NLR、PLR及褪黑素的相关性分析. 科学养生, 2022, 25(21): 93-95.

West China Medical Journal

Correlation analysis of red blood cell distribution width and neutrophil to lymphocyte ratio with total imaging load of cerebral small vessel disease

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