High neutrophil-to-lymphocyte ratio predicts short survival in multiple system atrophy

LingYu Zhang; Bei Cao; Yanbing Hou; Qianqian Wei; RuWei Ou; Bi Zhao; Huifang Shang

doi:10.1038/s41531-021-00267-7

High neutrophil-to-lymphocyte ratio predicts short survival in multiple system atrophy

NPJ Parkinsons Dis. 2022 Jan 20;8(1):11. doi: 10.1038/s41531-021-00267-7.

Authors

LingYu Zhang¹, Bei Cao¹, Yanbing Hou¹, Qianqian Wei¹, RuWei Ou¹, Bi Zhao¹, Huifang Shang²

Affiliations

¹ Department of Neurology, Laboratory of Neurodegenerative Disorders, Rare Diseases Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
² Department of Neurology, Laboratory of Neurodegenerative Disorders, Rare Diseases Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China. hfshang2002@126.com.

Abstract

The neutrophil-to-lymphocyte ratio (NLR), an inflammatory marker, can predict the prognosis of neurodegenerative diseases. However, the significance of NLR for the prognosis of multiple system atrophy (MSA) has not been reported. We aimed to examine the prognostic significance of NLR in MSA. A total of 169 MSA patients and 163 matched healthy controls (HCs) were enrolled. MSA patients were divided into three groups according to the tertiles of their NLR. Kaplan-Meier survival analysis and Cox regression model were used to assessing the effect of NLR on survival. An independent validation cohort of 56 consecutive patients with probable MSA who met the inclusion criteria was included. The NLR was significantly higher in patients with MSA than that in HCs. The survival duration in patients with MSA in group 3 was shorter than that in patients in the other two groups (P = 0.013). In the multivariable Cox regression model, a higher NLR increased the risk of mortality in patients with MSA after adjusting for confounding factors (HR = 1.922, P = 0.035). Additionally, a higher NLR increased the risk of mortality in MSA with predominant cerebellar ataxia (MSA-C) (HR = 2.398, P = 0.033) and in men (HR = 3.483, P = 0.027). The concordance index for the multivariate Cox regression model was more than 0.7 both in the primary cohort and external validation cohort. Patients with MSA had a higher NLR than did HCs. A high NLR increased the risk of mortality with MSA, especially in MSA-C and in men.