Diego Martínez-Urbistondo1, Almudena Beltrán1, Oscar Beloqui1, Ana Huerta2. 1. Departamento de Medicina Interna, Clínica Universidad de Navarra, Pamplona, Navarra, España. 2. Departamento de Medicina Interna, Clínica Universidad de Navarra, Pamplona, Navarra, España. Electronic address: ahuerta@unav.es.
Abstract
BACKGROUND AND OBJECTIVE: The neutrophil-to-lymphocyte ratio has demonstrated to be a prognostic inflammatory marker in cardiovascular disease. The objective of this study is to evaluate the association between neutrophil-to-lymphocyte ratio and pathologic urinary albumin/creatinine ratio as an early marker of cardiovascular risk and systemic endothelial dysfunction, associated with microvascular disease, in asymptomatic subjects. MATERIALS AND METHODS: A unicenter cross-sectional study was conducted, including 1816 asymptomatic subjects. Patients with previous cardiovascular disease, those who were treated with ACE inhibitors and/or angiotensin II receptor blockers and patients with albumin/creatinine ratio over 300mg/g were excluded. The outcome of the study was the presence of a pathologic urinary albumin/creatinine ratio. RESULTS: The neutrophil-to-lymphocyte ratio was significantly associated with altered urinary albumin/creatinine ratio in the univariate analysis and after adjustment for other known endothelial and cardiovascular risk factors (age, hypertension, dyslipidaemia, diabetes or altered glomerular filtration rate). Based on the sensitivity and specificity of different neutrophil-to-lymphocyte ratio thresholds, 3 risk groups were created for altered urinary albumin/creatinine ratio: low risk in those with neutrophil-to-lymphocyte ratio < 1.5, intermediate risk in patients between 1.5 and 3, and high risk in those with neutrophil-to-lymphocyte ratio > 3. These groups were found to have a statistically significant and independent prognostic power for altered urinary albumin/creatinine ratio in asymptomatic patients. CONCLUSIONS: The neutrophil-to-lymphocyte ratio appears to be a cost-efficient, non-invasive and independent potential marker of systemic endothelial dysfunction in asymptomatic subjects.
BACKGROUND AND OBJECTIVE: The neutrophil-to-lymphocyte ratio has demonstrated to be a prognostic inflammatory marker in cardiovascular disease. The objective of this study is to evaluate the association between neutrophil-to-lymphocyte ratio and pathologic urinary albumin/creatinine ratio as an early marker of cardiovascular risk and systemic endothelial dysfunction, associated with microvascular disease, in asymptomatic subjects. MATERIALS AND METHODS: A unicenter cross-sectional study was conducted, including 1816 asymptomatic subjects. Patients with previous cardiovascular disease, those who were treated with ACE inhibitors and/or angiotensin II receptor blockers and patients with albumin/creatinine ratio over 300mg/g were excluded. The outcome of the study was the presence of a pathologic urinary albumin/creatinine ratio. RESULTS: The neutrophil-to-lymphocyte ratio was significantly associated with altered urinary albumin/creatinine ratio in the univariate analysis and after adjustment for other known endothelial and cardiovascular risk factors (age, hypertension, dyslipidaemia, diabetes or altered glomerular filtration rate). Based on the sensitivity and specificity of different neutrophil-to-lymphocyte ratio thresholds, 3 risk groups were created for altered urinary albumin/creatinine ratio: low risk in those with neutrophil-to-lymphocyte ratio < 1.5, intermediate risk in patients between 1.5 and 3, and high risk in those with neutrophil-to-lymphocyte ratio > 3. These groups were found to have a statistically significant and independent prognostic power for altered urinary albumin/creatinine ratio in asymptomatic patients. CONCLUSIONS: The neutrophil-to-lymphocyte ratio appears to be a cost-efficient, non-invasive and independent potential marker of systemic endothelial dysfunction in asymptomatic subjects.
Authors: Diego Martínez-Urbistondo; RodrigoSan San Cristóbal; Paula Villares; Miguel Ángel Martínez-González; Nancy Babio; Dolores Corella; José Luis Del Val; José M Ordovás; Ángel M Alonso-Gómez; Julia Wärnberg; Jesús Vioque; Dora Romaguera; José López-Miranda; Ramon Estruch; Francisco J Tinahones; José Lapetra; J Luís Serra-Majem; Aurora Bueno-Cavanillas; Josep A Tur; Alba Marcos; Xavier Pintó; Miguel Delgado-Rodríguez; Pilar Matía-Martín; Josep Vidal; Clotilde Vázquez; Emilio Ros; María Vanessa Bullón Vela; Antoni Palau; Marta Masagué; Itziar Abete; Anai Moreno-Rodríguez; Inma Candela-García; Jadwiga Konieczna; Antonio García-Ríos; Oscar Lecea Juárez; Paco Martín; Albert Goday; M Ángeles Zulet; Jessica Vaquero-Luna; María Del Carmen Sayón Orea; Isabel Megías; Enric Baltasar; J Alfredo Martínez; Lidia Daimiel Journal: Front Endocrinol (Lausanne) Date: 2022-06-29 Impact factor: 6.055
Authors: José C De La Flor; Francisco Valga; Alexander Marschall; Tania Monzon; Cristina Albarracín; Elisa Ruiz; Miguel Rodeles Journal: Case Rep Nephrol Date: 2021-03-12