Blood Neutrophil/Lymphocyte Ratio Is Associated With Cerebral Large-Artery Atherosclerosis but Not With Cerebral Small-Vessel Disease

Darda Chung; Kee Ook Lee; Jung-Won Choi; Nam Keun Kim; Ok-Joon Kim; Sang-Heum Kim; Seung-Hun Oh; Won Chan Kim

doi:10.3389/fneur.2020.01022

Blood Neutrophil/Lymphocyte Ratio Is Associated With Cerebral Large-Artery Atherosclerosis but Not With Cerebral Small-Vessel Disease

Front Neurol. 2020 Sep 9:11:1022. doi: 10.3389/fneur.2020.01022. eCollection 2020.

Authors

Darda Chung¹, Kee Ook Lee¹, Jung-Won Choi¹, Nam Keun Kim², Ok-Joon Kim¹, Sang-Heum Kim³, Seung-Hun Oh¹, Won Chan Kim¹

Affiliations

¹ Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
² Institute for Clinical Research, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
³ Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.

Abstract

Background and Objective: The blood neutrophil/lymphocyte ratio (NLR) is a marker of peripheral inflammation, with a high NLR associated with an increased risk of cardiovascular events and poor prognosis in ischemic stroke. However, few data are available on the differential impact of the blood NLR on different silent cerebral vascular pathologies, including cerebral large-artery atherosclerosis (LAA) and cerebral small-vessel disease (CSVD), in neurologically healthy individuals. Methods: We evaluated cardiovascular risk factors, brain magnetic resonance imaging (MRI), and MR angiography of 950 individuals without any neurological diseases. The study participants were divided into three groups according to NLR tertile (low, middle, and high). The presences of extracranial (EC) and intracranial (IC) atherosclerosis were considered to indicate LAA on brain MR angiography. The presences of silent lacunar infarction (SLI) and cerebral white matter hyperintensities (WMHs) were analyzed as indices of CSVD on brain MRI. Results: In univariate analysis, the high NLR tertile group showed a high prevalence of old age, hyperlipidemia, and renal dysfunction and higher fasting glucose. Multivariable logistic regression analysis revealed that indices of LAA (EC atherosclerosis [odds ratio: 1.88; 95% confidence interval: 1.14-3.09; p = 0.01] and IC atherosclerosis [odds ratio: 1.87; 95% confidence interval: 1.15-3.06; p = 0.01]) were more prevalent in the highest NLR tertile group than in the lowest NLR tertile group after adjustment for cardiovascular risk factors. However, no significant differences were found in the prevalence of CSVD indices (SLI and WMHs) among the three NLR tertile groups. Conclusions: A high NLR is associated with the development of cerebral LAA but not CSVD.

Keywords: cardiovascular risk factors; ischemic stroke; large-artery atherosclerosis; neutrophil-lymphocyte ratio; small-vessel disease.