Utility of neutrophil-to-high-density lipoprotein-cholesterol ratio in patients with coronary artery disease: a narrative review

Association of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio with coronary heart disease: Establishment and validation of a clinical nomogram model

The purpose of this study is to investigate the non-high-density lipoprotein cholesterol (non-HDL-C) to high-density lipoprotein cholesterol (HDL-C) ratio (NHHR) as a novel compound lipid index for atherosclerosis and explore its relationship with coronary heart disease (CHD). This study also aims to establish NHHR as a sensitive indicator for early prevention of CHD and to construct a clinical prediction model to further predict the occurrence of CHD. This study selected 707 patients who visited the First People's Hospital of Mengcheng County from January 2020 to May 2024, including 466 patients with CHD and a control group. Logistic regression analysis was used to analyze the correlation between NHHR and CHD. Patients were randomly divided into a training set and validation set in a 7:3 ratio. Multivariable logistic regression was used to screen for risk factors, and a nomogram model was constructed and validated. After adjusting for confounding factors, the results showed that for each increase of 1 standard deviation in NHHR, the risk of CHD increased by 42%, with a P-value of .003. In model 3, the risk of CHD for the highest quartile increased by 144%, with a P-value of .01. The smoothed curve fitting showed a nonlinear relationship between NHHR and CHD. Multivariable logistic analysis indicated that age, body mass index, smoke, hypertension, white blood cells, fasting plasma glucose, uric acid, and NHHR were independent risk factors for predicting the occurrence of CHD (P < .05), and a risk prediction nomogram model was constructed. The receiver operating characteristic curve analysis of the training set showed an AUC of 0.922 (95% CI: 0.900-0.945), and the AUC of the validation set was 0.902 (95% CI: 0.856-0.948), indicating good model accuracy. Calibration curve analysis showed that the calibration curves of the nomogram model were very close for predicting the occurrence of CHD in the training set and validation set, and the decision curve analysis also showed a good clinical net benefit of the nomogram model. The study results indicated a strong and nonlinear correlation between NHHR and CHD. Our constructed nomogram model has a certain predictive ability for the occurrence of CHD.

Sex differences of neutrophil to high-density lipoprotein cholesterol ratio in predicting the severity of coronary lesions in acute coronary syndrome patients

BACKGROUND

The neutrophil-to-high-density lipoprotein cholesterol ratio (NHR) is closely related to the occurrence and severeness of coronary stenosis in subjects with acute coronary syndrome (ACS). Men have higher NHR levels than women. The study was designed to examine the usefulness of NHR for predicting severe coronary stenosis in male and female ACS subjects.

METHODS

We enrolled 165 ACS patients (105 males and 60 females) who underwent coronary angiography. Clinical parameters; fasting glucose, creatinine, and uric acid levels; lipid profiles; and routine blood indices were measured. The NHR was computed by dividing the neutrophil numbers by the concentration of high-density lipoprotein cholesterol. Coronary stenosis severity was assessed using the Gensini score (GS). A GS˃41 points was regarded as a high GS.

RESULTS

The NHR was clearly greater in male ACS individuals than in their female counterparts (P = 0.001). The NHR was positively linked to the GS (r = 0.330, P = 0.001) in men, whereas there was no association between NHR and the GS in women (r=-0.0.032, P = 0.805). Univariate logistic regression analyses indicated that the NHR predicted a high GS in male ACS patients but not in their female counterparts. Multivariate logistic regression analyses indicated that a high NHR was an independent marker of severe coronary lesions in men (P = 0.001) but not in women (P = 0.274). The areas under the receiver operating characteristic curve of the NHR for the prediction of severe atherosclerosis were 0.681 (P = 0.001) and 0.560 (P = 0.431) in male and female subjects, respectively. An NHR value > 3.99 had a specificity and a sensitivity of 68% and 64%, respectively, for forecasting severe atherosclerosis in male subjects.

CONCLUSIONS

The NHR could be utilised to independently predict the severeness of coronary lesions in male ACS subjects but not in their female counterparts. Therefore, the NHR should be used with caution when screening female ACS patients for severe coronary restrictions.

Prognostic Value of Neutrophil, Monocyte, Lymphocyte, and Platelet/High-Density Lipoprotein Ratios in Ischemic Heart Disease: An NHANES Analysis

The prognostic value of easily accessible hematologic biomarkers, such as the neutrophil-to-HDL ratio, as well as the monocyte-to-HDL, lymphocyte-to-HDL, and platelet-to-HDL ratios, remains underexplored in patients with established ischemic heart disease (IHD). Community-dwelling adults aged ≥ 20 with established IHD from the National Health and Nutrition Examination Survey (NHANES) 1999-2018 were eligible. Mortality was tracked through linkage to the National Death Index (NDI) until the end of 2019. Cox regressions examined the associations between these hematologic ratios and all-cause mortality. Receiver operating characteristic (ROC) curve analysis assessed the predictive accuracy of these ratios for mortality. A total of 2265 patients were analyzed, with a median follow-up period of 80 months. After adjusting for demographic factors, lifestyle variables, and comorbidities, patients in the highest quartile of the neutrophil/HDL had a significantly increased all-cause mortality risk (aHR = 1.41, 95% CI: 1.13-1.77) compared to those in the lowest quartile. No significant associations were found between the other ratios and mortality. In conclusion, this study found that among the hematologic ratios analyzed, an elevated neutrophil-to-HDL ratio has the strongest potential for mortality risk stratification in community-dwelling patients with ischemic heart disease in the US, offering important guidance for both patients and clinicians.

Neutrophil-to-High-Density Lipoprotein Ratio (NHR) and Neutrophil-to-Lymphocyte Ratio (NLR) as prognostic biomarkers for incident cardiovascular disease and all-cause mortality: A comparison study

Cardiovascular diseases (CVD) remain a leading cause of global mortality, with atherosclerosis and inflammation playing pivotal roles in their development. The neutrophil-to-lymphocyte ratio (NLR) and neutrophil-to-HDL cholesterol ratio (NHR) have emerged as potential biomarkers for assessing CVD risk. In this community-based cohort study conducted in Taiwan, involving 3278 participants, we investigated the associations between NHR, NLR, and the risks of CVD and all-cause mortality. Our findings revealed that both NHR and NLR were effective in identifying individuals at high risk for CVD. However, when assessing their joint effect, NHR alone demonstrated a stronger predictive value for CVD prognosis than NLR or the combination of both markers. Furthermore, NLR alone showed potential as a predictor of all-cause mortality when compared with NHR alone or in combination with NLR and NHR. These findings underscore the complex interplay between inflammation and lipid metabolism in the pathogenesis of CVD. While NHR shows promise as a cost-effective tool for CVD risk assessment, NLR emerges potential as a prognostic marker for mortality. Further research is warranted to explore the dynamic changes in these markers and their implications for clinical practice.

Neutrophil-to-HDL-C Ratio as an inflammatory biomarker in patients with anxiety and obstructive coronary artery disease: A retrospective study

Background

Anxiety is a common comorbidity with coronary artery disease (CAD). The neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-high-density lipoprotein cholesterol (HDL-C) ratio (NHR), lymphocyte-to-HDL-C ratio (LHR), and monocytes-to-lymphocyte ratio (MLR) can predict the severity of CAD. This retrospective study aimed to explore the relationship between NLR, NHR, LHR, and MLR and the presence of obstructive or severe CAD (OCAD, SCAD) in patients with comorbid anxiety and chest pain.

Methods

A total of 1063 patients with anxiety and chest pain were divided into an NOCAD group and OCAD group according to computed topography angiography (CCTA). The 455 patients in the OCAD group were further divided into the NSCAD group (n = 216) and SCAD group (n = 239) according to coronary angiography (CAG) results, and the Gensini score (GS) was calculated. Demographic and laboratory data were collected.

Results

Multiple regression analysis showed that higher NLR, NHR, and LHR served as independent risk factors for OCAD in patients with anxiety and chest pain (OR 1.37, 95%CI: 1.13-1.65, p = 0.001; OR 2.24, 95%CI: 1.89-2.65, p < 0.001; OR 2.47, 95%CI: 1.87-3.62, p < 0.001), and both were significantly associated with SCAD (OR 1.93, 95%CI: 1.44-2.59, p < 0.001; OR 4.45, 95%CI: 3.28-6.31, p < 0.001; OR 2.86, 95%CI: 1.93-4.25, p < 0.001). Area under the receiver operating characteristic curve analysis showed that NHR had the highest predictive value for OCAD and SCAD compared with NLR and LHR (AUC 0.71, sensitivity 57.14 %, specificity 68.20 %; AUC 0.86, sensitivity 83.68 %, specificity 74.54 %, respectively). When NHR and GS were combined, the predictive value for SCAD further increased compared to other parameters (AUC 0.94, sensitivity 92.05 %, specificity 87.05 %).

Conclusion

NLR, NHR, and LHR were associated with severity of coronary stenosis in patients with comorbid anxiety and chest pain. Among these systemic inflammatory markers, NHR served as a more effective independent predictor of OCAD and SCAD in these patients.

Analysis of the Clinical Predictive Value of the Novel Inflammatory Indices SII, SIRI, MHR and NHR in Patients with Acute Myocardial Infarction and Their Extent of Coronary Artery Disease

Background

This study aims to observe the relationship between novel inflammatory markers and AMI, and analyze its correlation with the degree of coronary artery disease.

Methods

Clinical data were collected from the control (510 cases) and AMI (406 cases) groups. The AMI group was classified into mild, moderate and severe according to the Gensini score. Correlation of SII, SIRI, MHR and NHR with Gensini score in AMI patients was analysed using Spearman rank correlation analysis. Factors influencing the degree of coronary lesion in AMI were analysed by multi-factor ordinal logistic regression. The predictive value of the novel inflammatory markers for AMI and its coronary severity was assessed using ROC curves. Risk prediction of the extent of coronary artery disease in AMI using the Nomogram for novel inflammatory indices.

Results

The levels of SII, SIRI, MHR and NHR were significantly higher in the AMI group than in the control group. With increasing Gensini score, all four novel inflammatory indices showed an increasing trend. And four novel inflammatory indices were positively correlated with Gensini scores. Meanwhile, SII, SIRI and MHR were independent risk factors for the extent of coronary artery disease in AMI. SII, SIRI, MHR and NHR have good predictive value for AMI, and have predictive value for mild and severe AMI, but have no predictive value for moderate AMI. The nomogram results showed that SII, SIRI and MHR had some predictive value for the degree of coronary artery disease in AMI. The nomogram results showed that SII, SIRI and MHR had some predictive value for the degree of coronary artery disease in AMI.

Conclusion

The elevated levels of SIRI, SII, MHR, NHR in AMI patients are independent risk factors for the severity of coronary artery disease in AMI patients, and have predictive value to a certain extent.

Association between neutrophil-to-high-density lipoprotein cholesterol ratio and metabolic dysfunction-associated steatotic liver disease and liver fibrosis in the US population: a nationally representative cross-sectional study using NHANES data from 2017 to 2020

BACKGROUND

The neutrophil-to-high-density lipoprotein cholesterol ratio (NHR) has emerged as a promising biomarker for assessing inflammation and lipid dysregulation. Increasing evidence indicates that these metabolic disturbances play a crucial role in the development of metabolic dysfunction-associated steatotic liver disease(MASLD). This study aims to investigate the association between NHR, MASLD, and liver fibrosis.

METHODS

This cross-sectional study analyzed data from the 2017-2020 National Health and Nutrition Examination Survey (NHANES). Weighted multivariate logistic regression models were used to investigate the association between NHR and both MASLD and liver fibrosis. Smoothed curve fitting and threshold effect analysis were performed to detect potential nonlinear relationships. Subgroup analyses were conducted to assess the consistency of these associations across different groups.

RESULTS

The study involved 4,761 participants. We observed a significant positive association between NHR and MASLD (OR = 1.20, 95% CI: 1.09-1.31). However, there was no significant association between NHR and liver fibrosis (OR = 1.01; 95% CI: 0.94-1.09). The analysis of smoothed curve fitting and threshold effect revealed an inverted U-shaped relationship between NHR and MASLD, with a turning point at 5.63.

CONCLUSION

Our findings indicate a positive correlation between elevated NHR levels and MASLD prevalence. However, we did not observe a significant association between NHR and liver fibrosis prevalence. Further prospective research is needed to validate these findings in a longitudinal setting.

The relationship between NLR, LDL-C/HDL-C, NHR and coronary artery disease

OBJECTIVE

Chronic inflammation and dyslipidemia are key risk factors for atherosclerotic cardiovascular diseases. We retrospectively explored the association between the neutrophil to lymphocyte ratio (NLR), the ratio of low-density lipoprotein cholesterol (LDL-C) to high-density lipoprotein cholesterol (HDL-C), and the neutrophil to HDL-C ratio (NHR), and the severity of coronary lesions in patients with acute coronary syndrome (ACS).

METHOD

In June 2023, we selected 1210 patients who were diagnosed with ACS based on chest pain from January 2017 to December 2022. Of these, 1100 patients with abnormal coronary angiography were categorized into the experimental group, and 110 patients with normal coronary angiography were classified as the control group. We collected routine blood tests, lipid profiles, and coronary angiography results at admission (before coronary angiography). Patients were then stratified into a control group (Gensini score = 0) and an experimental group (Gensini score = 0) based on the Gensini score. The experimental group was further divided into a low score group (Gensini score < 69) and a high score group (Gensini score ≥ 69).

RESULT

1. Statistically significant differences were observed between the control and experimental groups in terms of gender, age, body mass index (BMI), hypertension, diabetes, smoking history, and counts of neutrophils (NEU), lymphocytes (LYM), monocytes (MON), eosinophils (EOS), red cell distribution width (RDW), total cholesterol (TC), HDL-C, LDL-C, NLR, LDL-C/HDL-C, and NHR (P<0.05). Furthermore, differences in BMI, hypertension, diabetes, smoking history, NEU, LYM, MON, TC, triglyceride (TG), HDL-C, LDL-C, NLR, LDL-C/HDL-C, and NHR were significant between the low and high score groups (P<0.05). 2. NEU, LYM, MON, TC, HDL-C, LDL-C, NLR, LDL-C/HDL-C, and NHR showed significant correlations with the Gensini score (r>0.2, P<0.05), with NLR and LDL-C/HDL-C showing the strongest correlations (r = 0.822, P = 0.000). 3. The Receiver Operating Characteristic (ROC) curve indicated that the combination of NLR and LDL-C/HDL-C had superior sensitivity and specificity in predicting the severity of coronary lesions, with a significant difference (P<0.05). The sensitivity was 87.1%, the specificity was 90.9%, and the cut-off point was 2.04. 4. A predictive model was developed based on the ratio of NLR and LDL-C/HDL-C to the Gensini score. The final model score was calculated as 6.803 + 7.029NLR + 13.079LDL-C/HDL-C (R2 = 0.708).

CONCLUSION

Compared to NLR, LDL-C/HDL-C, and NHR, the combined NLR and LDL-C/HDL-C ratio is a more accurate marker for assessing the severity of coronary artery disease in ACS patients. Its convenience and effectiveness make it a promising tool for early assessment, timely risk stratification, and appropriate clinical intervention, ultimately improving clinical outcomes for ACS patients.

The Association Between Neutrophil/High-Density Lipoprotein Cholesterol Ratio and Non-Alcoholic Fatty Liver Disease in a Healthy Population

Objective

Non-alcoholic fatty liver disease (NAFLD) is characterized by abnormal lipid metabolism and inflammation. This study aimed to investigate the relationship between neutrophil-HDL cholesterol ratio (NHR) and NAFLD in a healthy population.

Methods

1881 healthy people who underwent a physical examination from August to December 2023 at the Hebei General Hospital were chosen for this cross-sectional study. 936 individuals were ultimately included thanks to propensity matching and exclusion criteria. Ultrasound was used to diagnose fatty liver and a t-test or Mann-Whitney test was used to compare the clinical characteristics of participants between groups with and without fatty liver. Logistic regression was used to construct a new model that included NHR. The predictive value of NHR as well as the new model for NAFLD in a healthy population was assessed using logistic regression and subject work characteristic curves.

Results

NHR levels were higher among participants in the NAFLD group than those without NAFLD(P<0.05). NHR is a risk factor for NAFLD in a healthy population(P<0.05). The odds ratios (ORs) of NHR for predicting NAFLD in Model I (adjusted for sex, age, and BMI) and Model II (adjusted for sex, age, BMI, HbA1c, TC, TG, and ALT) were 1.166 (1.022, 1.331) and 1.248 (1.110, 1.402)(P<0.05). The new model created by logistic regression predicted NAFLD with an area under the curve of 0.676 (0.645, 0.706). Compared to participants in the low NHR group, the high NHR group exhibited a higher prevalence of NAFLD(p<0.05).

Conclusion

NHR is associated with NAFLD, which is a good predictor of NAFLD in a healthy population.

Predictive value of the neutrophil percentage-to-albumin ratio for coronary atherosclerosis severity in patients with CKD

BACKGROUND

The neutrophil percentage-to-albumin ratio (NPAR), which is defined as the percentage of neutrophils divided by the concentration of albumin, is a cost-effective and readily available biomarker of inflammation. This study aimed to evaluate the association between the NPAR and the severity of coronary atherosclerosis in patients with chronic kidney disease (CKD).

METHODS

A total of 280 CKD patients who underwent coronary angiography were retrospectively enrolled in this study. The severity of coronary atherosclerosis was evaluated using the Gensini score (GS). Patients were divided into low-, medium- and high-NPAR groups according to the tertiles of the NPAR values. Logistic regression analysis was conducted to analyze the relationship between the NPAR and the GS. The cutoff points for the sensitivity and specificity of the NPAR in predicting the GS were estimated via receiver operating characteristic (ROC) analysis.

RESULTS

There was a higher prevalence of coronary artery disease (CAD) among CKD patients with higher NPARs (P =0.041). More patients in the high-NPAR group had complex CAD (triple-vessel disease and/or left main coronary artery stenosis) and chronic total occlusion lesions, and more of these patients required revascularization therapy (P<0.05). Multivariate logistic regression analysis revealed a significant positive correlation between the NPAR and the severity of coronary stenosis (adjusted OR 2.68, 95% CI 1.25-5.76, p=0.012), particularly among female and older (age ≥65) patients. The ROC analysis indicated that the optimal cutoff value for the NPAR in predicting severe coronary artery stenosis (GS>60) in CKD patients was 1.91 (sensitivity 0.495, specificity 0.749), with an area under the curve (AUC) of 0.650 (95% CI 0.581-0.719, P<0.001). A subgroup analysis according to sex revealed that the NPAR exhibited stronger predictive value in female patients (AUC 0.730, 95% CI 0.643-0.817) than in male patients (AUC 0.565, 95% CI 0.460-0.670) (P<0.001), and the optimal cutoff value for the NPAR in female patients was 1.80 (sensitivity 0.667, specificity 0.705).

CONCLUSIONS

Our study demonstrated that the NPAR is independently associated with the severity of coronary atherosclerosis in CKD patients, especially in female and elderly patients (≥65 years old). Moreover, the NPAR can effectively predict the severity of coronary atherosclerosis, exhibiting greater predictive value in females than in males.

Complete Blood Count-Derived Inflammation Indexes Are Useful in Predicting Metabolic Syndrome in Children and Adolescents with Severe Obesity

Background: Childhood obesity is a globally increasing pathological condition leading to long-term health issues such as cardiovascular diseases and metabolic syndrome (MetS). This study aimed to determine the clinical value of the Complete Blood Count-derived inflammation indexes Monocyte/HDL-C ratio (MHR), Lymphocyte/HDL-C ratio (LHR), Neutrophil/HDL-C ratio (NHR), and System Inflammation Response Index (SIRI) to predict the presence of metabolic syndrome and its association with cardiovascular risk markers (HOMA-IR, TG/HDL-C, and non-HDL-C) in children and adolescents with obesity. Methods: The study included a total of 552 children/adolescents with severe obesity (BMI: 36.4 [32.7-40.7] kg/m2; 219 males, 333 females; age: 14.8 [12.9-16.3] years), who were further subdivided based on the presence or absence of metabolic syndrome (MetS+ and MetS respectively). Results: The MHR, LHR, and NHR indexes (p < 0.0001), but not SIRI (p = 0.524), were significantly higher in the MetS+ compared to the MetS- subgroup, showing a positive correlation with the degree of MetS severity (p < 0.0001). Furthermore, MHR, LHR, and NHR were positively associated with cardiometabolic risk biomarkers (HOMA-IR: MHR p = 0.000, LHR p = 0.001, NHR p < 0.0001; TG/HDL-C: MHR, LHR, NHR p < 0.000; non-HDL-C: MHR, LHR p < 0.0001, NHR p = 0.000). Finally, the ROC curve analysis demonstrated that among the analyzed indexes, only MHR, LHR, and NHR had diagnostic value in distinguishing MetS patients among children and adolescents with obesity (MHR: AUC = 0.7045; LHR: AUC = 0.7205; NHR: AUC = 0.6934; p < 0.0001). Conclusions: In conclusion, the MHR, LHR, and NHR indexes, but not the SIRI index, can be considered useful tools for pediatricians to assess the risk of MetS and cardiometabolic diseases in children and adolescents with obesity and to develop multidisciplinary intervention strategies to counteract the widespread disease.

Effect of isotretinoin treatment on inflammatory and hematological parameters in patients with acne vulgaris

PURPOSE

Although the inflammatory and anti-inflammatory effects of isotretinoin (ISO) treatment in patients with acne vulgaris have been discussed in the literature in recent years, no sensitive and specific marker has been found in studies so far. Neutrophil/HDL (high-density lipoprotein) (NHR), lymphocyte/HD L(LHR), platelet/HDL (PHR), and lymphocyte/monocyte (LMR) are new biomarkers related to inflammation. Triglyceride/HDL (TG/HDL), LDL/HDL, and total cholesterol/HDL have been shown to be cardiometabolic risk factors predicting both cardiovascular disease risk and metabolic risk, rather than just a simple dyslipidemia scale. To our knowledge, the relationship between these parameters and ISO treatment has never been studied before. We aimed to evaluate the immuno-inflammatory response of ISO treatment in patients with acne vulgaris with NHR, LHR, PHR, LMR, TG/HDL, LDL/HDL, and total cholesterol/HDL parameters.

MATERIALS AND METHODS

In this study, 153 patients who received oral ISO treatment for at least 3 months with a diagnosis of moderate-severe acne vulgaris were evaluated retrospectively. Patients were given oral isotretinoin at a dose of 0.5-1 mg/kg. Pre and post-treatment leukocyte (WBC), neutrophil (NE), lymphocyte (LY), platelet (PLT), red cell distribution width (RDW), plateletcrit (PCT), neutrophil/lymphocyte (NLR), platelet/lymphocyte (PLR), mean platelet volume (MPV), monocyte/lymphocyte (MLR), LMR, total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride, MHR, NHR, LHR, PHR, TG/HDL, total cholesterol/HDL, LDL/HDL parameters were evaluated.

RESULTS

It was found that post-treatment WBC and MPV values increased statistically significantly; NLR, neutrophil, and PCT values, on the other hand, decreased significantly (p < 0.05). No statistically significant change was detected in PLR, MLR, LMR, MHR, NHR, LHR, PHR, lymphocyte, monocyte, platelet, and RDW parameters (p > 0.05). It was determined that post-treatment total cholesterol, triglyceride, VLDL, and LDL levels increased statistically significantly; however, the HDL level decreased significantly (p < 0.05). Levels of total cholesterol/HDL, TG/HDL, and LDL/HDL were also found to increase statistically significantly (p < 0.05).

CONCLUSION

Our study suggests that the MPV and NLR ratio as biomarkers can be used as indicators of atherosclerosis-related inflammation due to ISO treatment, but the MHR, NHR, LHR, PHR, MLR, LMR ratios cannot be used. Moreover, we believe that the ratios of TG/HDL, LDL/HDL, and total cholesterol/HDL offer a new contribution as indicators of cardiovascular risk and systemic inflammation related to ISO treatment.

Neutrophil/HDL-C, Lymphocyte/HDL-C and Monocyte/HDL-C in subjects with asymptomatic carotid atherosclerosis

BACKGROUND

Leukocyte count is a prognostic marker for cardiovascular diseases, with key role in atherosclerosis development. Specific number of neutrophils, lymphocytes and monocytes can predict cardiovascular risk, also in asymptomatic subjects. Among the lipoprotein fractions, HDL-C is a protective factor in the cardiovascular disorders. For the above reason, we have examined the peripheral count of leukocytes, neutrophils, lymphocytes and monocytes, and the ratios between neutrophils/HDL-cholesterol, lymphocytes/HDL-cholesterol, and monocytes/HDL-cholesterol, to evaluate the possible utility of the obtained values in progression of asymptomatic carotid atherosclerosis.

METHODS

We performed our analysis in a cohort of 100 subjects with asymptomatic carotid atherosclerosis, of which 43 men and 57 women. The data were expressed as medians and IQR. To analyse the differences in leukocyte, neutrophil, lymphocyte, monocytes count and their ratio with HDL-cholesterol the Mann-Whitney test was employed.

RESULTS

The peripheral count of leukocyte subtypes and the ratios, they change in relation to the number of cardiovascular risk factors and the degree of insulin resistance.

CONCLUSIONS

In this cohort of subjects, the percentage of observed cardiovascular risk factors significantly affect some leukocyte parameters. These results, allow us to underline the importance of the leukocyte indices in the evaluation of subjects with asymptomatic vascular atherosclerosis.

Changes in Lipids in Granulomatosis with Polyangiitis Relates to Glucocorticoids and History of Hypertension

Granulomatosis with polyangiitis (GPA) is an ANCA-associated small-vessel vasculitis. Vessel wall inflammation induces multiple vascular damages, leading to accelerated atherosclerosis. Metabolic profile and cardiovascular risk are somewhat understood in GPA patients. Cardiovascular atherosclerotic disease (ASCVD) may represent a risk for outcomes. Our purpose is to evaluate ASCVD risk in GPA patients. Thirty-six patients received GPA diagnosis (T0) and were evaluated after 1 (T1) and 2 (T2) years follow-up. All patients were treated with high-dose glucocorticoid, one-year tapered, along with immunosuppressants. Total cholesterol significantly increased in T1 vs. T0 and T2. LDL exhibited the same trend, while triglycerides increased in both T1 and T2 vs. T0. No difference was found in HDL. A significant hsCRP decrease was detected at T1 and T2 vs. T0, but not between T2 and T1. Moreover, we found a significant reduction in ESR at T2 compared with T1 and T0 and at T1 compared to T0. Hypertensive patients presented a pronounced increase in lipids, while inflammation reduced slowly compared to normotensives. Our data suggest that the increase in cholesterol and LDL in T1 is a consequence of glucocorticoids. These data can be useful in the evaluation of both CV diseases and lipid metabolism, which are closely related to vessel inflammation.