Predictive Value of Non-high-Density Lipoprotein Cholesterol and Neutrophil-Lymphocyte Ratio for Coronary Artery Vulnerable Plaques in Type 2 Diabetes Mellitus

Xiyi Huang; Shaomin Yang; Qiang Zhao; Xinjie Chen; Jialing Pan; Shaofen Lai; Fusheng Ouyang; Lingda Deng; Yongxing Du; Xiaohong Li; Qiugen Hu; Baoliang Guo; Jiemei Liu

doi:10.3389/fcvm.2022.927768

Predictive Value of Non-high-Density Lipoprotein Cholesterol and Neutrophil-Lymphocyte Ratio for Coronary Artery Vulnerable Plaques in Type 2 Diabetes Mellitus

Front Cardiovasc Med. 2022 Jun 20:9:927768. doi: 10.3389/fcvm.2022.927768. eCollection 2022.

Authors

Xiyi Huang¹, Shaomin Yang², Qiang Zhao³, Xinjie Chen⁴, Jialing Pan⁴, Shaofen Lai¹, Fusheng Ouyang⁴, Lingda Deng⁴, Yongxing Du⁴, Xiaohong Li⁴, Qiugen Hu⁴, Baoliang Guo⁴, Jiemei Liu⁵

Affiliations

¹ Department of Clinical Laboratory, The Affiliated Shunde Hospital of Guangzhou Medical University, Foshan, China.
² Department of Radiology, The Affiliated Shunde Hospital of Guangzhou Medical University, Foshan, China.
³ Department of Cardiovascular Medicine, The Affiliated Shunde Hospital of Guangzhou Medical University, Foshan, China.
⁴ Department of Radiology, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, China.
⁵ Department of Rehabilitation Medicine, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, China.

Abstract

Background: Patients with diabetes have an increased risk of developing vulnerable plaques (VPs), in which dyslipidemia and chronic inflammation play important roles. Non-high-density lipoprotein cholesterol (non-HDL-C) and neutrophil-lymphocyte ratio (NLR) have emerged as potential markers of both coronary artery VPs and cardiovascular prognosis. This study aimed to investigate the predictive value of non-HDL-C and NLR for coronary artery VPs in patients with type 2 diabetes mellitus (T2DM).

Methods: We retrospectively enrolled 204 patients with T2DM who underwent coronary computed tomography angiography between January 2018 and June 2020. Clinical data including age, sex, hypertension, smoking, total cholesterol, low-density lipoprotein cholesterol, HDL-C, triglyceride, non-HDL-C, glycated hemoglobin, neutrophil count, lymphocyte count, NLR, and platelet count were analyzed. Multivariate logistic regression was used to estimate the association between non-HDL-C, NLR, and coronary artery VPs. Receiver operating curve analysis was performed to evaluate the value of non-HDL-C, NLR, and their combination in predicting coronary artery VPs.

Results: In our study, 67 patients (32.84%) were diagnosed with VPs, 75 (36.77%) with non-VP, and 62 (30.39%) with no plaque. Non-HDL-C and NLR were independent risk factors for coronary artery VPs in patients with T2DM. The areas under the ROC curve of non-HDL-C, NLR, and their combination were 0.748 [95% confidence interval (CI): 0.676-0.818], 0.729 (95% CI: 0.650-0.800), and 0.825 (95% CI: 0.757-0.887), respectively.

Conclusion: Either non-HDL-C or NLR could be used as a predictor of coronary artery VPs in patients with T2DM, but the predictive efficiency and sensitivity of their combination would be better.

Keywords: coronary computed tomography angiography; coronary heart disease; neutrophil-lymphocyte ratio; non-high-density lipoprotein cholesterol; type 2 diabetes mellitus; vulnerable plaque.