中性粒细胞/高密度脂蛋白胆固醇与肌肉减少症的关联

Relationship of neutrophil to high density lipoprotein cholesterol ratio with sarcopenia

摘要:

[目的] 探讨中性粒细胞/高密度脂蛋白胆固醇比值（neutrophil-to-high-density lipoprotein cholesterol ratio, NHR） 与肌肉减少症之间的关联。[方法] 本研究查阅2011—2018 年美国国家健康和营养调查（National Health and Nutrition ExaminationSurvey, NHANES） 数据库，选择了4 个周期中符合条件的20 岁及以上的受试者。采用单因素和多变量逻辑回归分析评估NHR与肌肉减少症之间的联系，利用限制性样条分析（RCS） 表征剂量反应关系，并通过阈值效应分析计算出肌肉减少症人群中的拐点。最后，亚组分析进一步验证了研究结果的稳健性。[结果] 总共有10 059 例纳入本研究，9 160 例为非肌肉减少症，899人为肌肉减少症。肌肉减少症者的中性粒细胞[(4.9±1.8) vs (4.2±1.7), P＜0.001] 和NHR [(4.3±2.1) vs (3.4±1.8), P＜0.001] 显著高于非肌肉减少症者。完全调整逻辑回归模型表明，NHR 每增加1 单位，肌肉减少症的患病率增加16% （OR=1.16, 95%CI 1.12~1.21）。将NHR 转换为分类变量后，发现高水平的NHR 与肌肉减少症患病率的增加相关。限制性样条分析发现，NHR 与肌肉减少症的患病率呈正向线性剂量-反应关系。通过阈值效应分析表明，肌肉减少症人群中的拐点NHR=2.82，且拐点左侧NHR的变化对肌肉减少症患病率的影响更大。亚组分析结果表明，NHR 与肌肉减少症患病率的正相关联系保持稳定一致。[结论]NHR 与肌肉减少症患病风险呈正向相关，可能作为早期检测肌肉减少症并指导治疗的生物标志物。

Abstract:

[Objective] To investigate the relationship between neutrophil to high density lipoprotein cholesterol ratio (NHR) and sarco-penia. [Methods] In this study, eligible subjects aged ≥20 years were selected from the National Health and Nutrition Examination Survey(NHANES) database of 4 cycles survey from 2011 to 2018. Univariate and multivariate logistic regression analyses were used to evaluatethe relation between NHR and sarcopenia, restricted spline analysis (RCS) was used to characterize the dose-response relationship, andthreshold effect analysis was used to calculate the inflection point in the sarcopenia population. Finally, subgroup analysis further verifiedthe robustness of the results. [Results] A total of 10 059 persons were included in the study, including 9 160 without sarcopenia and 899with sarcopenia. The sarcopenia group proved significantly greater than the non-sarcopenia group in terms of neutrophils [(4.9±1.8) vs (4.2±1.7), P＜0.001] and NHR [(4.3±2.1) vs (3.4±1.8), P＜0.001]. Fully adjusted logistic regression models showed that for every 1 unit increasein NHR, the prevalence of sarcopenia increased by 16% (OR=1.16, 95%CI 1.12~1.21). After converting NHR into categorical variables,high levels of NHR were found to be associated with an increase in the prevalence of sarcopenia. Restricted spline analysis showed a posi-tive linear dose-response relationship between NHR and sarcopenia. Threshold effect analysis showed that the inflection point NHR in sar-copenia population was 2.82 and the change of NHR on the left side of the inflection point had a greater impact on sarcopenia. Subgroupanalysis showed that the positive relation between NHR and sarcopenia remained consistent. [Conclusion] NHR is positively associatedwith the risk of sarcopenia, and may be used as a biomarker for early detection and treatment of sarcopenia.