Associations of neutrophil-to-lymphocyte ratio with intracranial and extracranial atherosclerotic stenosis

Yu Xie; Zhenxing Liu; Bitang Dan; Li Zou; Lei Zhang; Renwei Zhang; Huagang Li; Qi Cai; Nadire Aiziretiaili; Shanling Ren; Yumin Liu

doi:10.3389/fneur.2022.966022

Associations of neutrophil-to-lymphocyte ratio with intracranial and extracranial atherosclerotic stenosis

Front Neurol. 2022 Sep 20:13:966022. doi: 10.3389/fneur.2022.966022. eCollection 2022.

Authors

Yu Xie¹, Zhenxing Liu¹, Bitang Dan¹, Li Zou¹, Lei Zhang¹, Renwei Zhang¹, Huagang Li¹, Qi Cai¹, Nadire Aiziretiaili², Shanling Ren¹, Yumin Liu¹

Affiliations

¹ Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China.
² Department of Neurology, The First People's Hospital of Kashi Prefecture, Kashi, China.

Abstract

Background: Neutrophil-to-lymphocyte ratio (NLR) has been shown to be an important inflammatory maker. This study aims to investigate the association of NLR with intracranial and extracranial atherosclerotic stenosis.

Methods: We retrospectively recruited patients who underwent digital subtraction angiography (DSA) for evaluating intracranial/extracranial stenosis in the Zhongnan Hospital of Wuhan University from January 2017 to October 2021. Clinical characteristics, DSA data, blood routine, and lipid profile were recorded. Logistic regression was used to evaluate the association of NLR and intercranial/extracranial atherosclerotic stenosis in three aspects: distribution of stenosis, whether the stenosis is symptomatic, and degree of stenosis.

Results: A total of 1,129 patients were included in our analysis, with a median age of 62 y (interquartile range 55-68), and a median admission NLR of 2.39 (interquartile range 1.84-3.42). A total of 986 patients presented intracranial and/or extracranial atherosclerotic stenosis. Increased NLR were associated with intracranial stenosis [odds ratio (OR), 1.54; 95% CI, 1.27-1.85; p < 0.001], extracranial stenosis (OR, 1.56; 95% CI, 1.25-1.96; p < 0.001), and combined intracranial/extracranial stenosis (OR, 1.61; 95% CI, 1.28-2.03; p < 0.001). After adjustment of potential factors, higher NLR were independently associated with symptomatic stenosis (OR, 1.16; 95% CI, 1.05-1.27; p = 0.003) and degree of stenosis (OR, 1.32; 95% CI, 1.17-1.49; p < 0.001). Compared with the first quartile NLR, the second, third, and fourth quartiles NLR were independent risk factors for symptomatic stenosis and stenosis degree (both p for trend <0.001).

Conclusion: Increased NLR is an important factor associated with both intracranial and extracranial atherosclerotic stenosis. Patients with symptomatic intracranial/extracranial atherosclerotic stenosis or a more severe degree of stenosis presented elevated NLR levels.

Keywords: atherosclerosis; digital subtraction angiography; extracranial stenosis; intracranial stenosis; neutrophil-to-lymphocyte ratio.