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中性粒细胞–淋巴细胞比值在中国成年人中的分布及其影响因素
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Abstract:
目的：本研究通过分析常规体检人群中临床检查结果，旨在评估中性粒细胞–淋巴细胞比值(neutrophil- to-lymphocyte ratio, NLR)在中国成年人中的分布及其与之相关的影响因素。方法：我们分析了2020年12月至2021年6月在武汉协和医院进行全面健康体检的1463名成年人的临床检查结果，其中，1120人的检查结果被纳入最终的研究分析中。临床检查结果包括实验室检验结果(如血常规、肝功能和肾功能)、体格检查结果(如脉率和血压)以及个人信息(如年龄、身高、体重和体重指数(BMI))。由于数据的非正态性，我们在分析前对所有连续变量进行了标准正态转换(零均值正态化)。独立样本t检验或单因素方差分析用以确定不同组间差异。Pearson相关系数被用来评估正态转换后的变量之间的相关性。用逐步线性回归分析评估NLR的独立影响因素。P < 0.05被认为有统计学意义。结果：NLR的中位数为1.636 (95%医学参考值范围：0.808~3.277)。NLR与年龄(r = 0.151, p < 0.001)、脉率(r = 0.088, p < 0.05)、碱性磷酸酶(ALP, r = 0.085, p < 0.05)、BMI (r = 0.073, p < 0.05)、收缩压(systolic pressure, SP, r = 0.066, p < 0.05)之间存在正相关性，NLR与总蛋白(total protein, TP)呈负相关关系(r = ？0.069, p < 0.05)。年龄、脉率、TP和ALP是NLR的独立影响因素。在不同性别之间没有观察到NLR值的统计学差异。结论：年龄、脉率、ALP、血压、BMI和TP与NLR独立相关，其中年龄、脉率、TP和ALP是NLR的独立影响因素。性别不是影响NLR的因素。因此，在临床实践中当我们使用NLR作为炎症的标志物评估炎症时，应将更多相关因素纳入考虑当中，而不是单一的数值。
Objective: This study aimed to assess the value of the neutrophil-to-lymphocyte ratio (NLR) and its affecting factors in Chinese adults by analyzing clinical results in a routine physical examination population. Methods: We analyzed the clinical examination data of 1463 adults who took a com-prehensive physical examination in Wuhan Union Hospital from December 2020 to June 2021, and 1120 remained in the final analysis. Clinical data included laboratory records (e.g., blood routine, hepatic and renal functions), physical examination results (e.g., pulse rate and blood pressure), and personal demographic information (e.g., age, height, weight, and body mass index (BMI)). A stand-ard normal transformation (zero-mean normalization) was applied to all continuous variables be-fore our analyses due to non-normality. The independent sample t-test or one-way ANOVA was per-formed to determine the difference between groups. Pearson correlation coefficients were used to assess the association between variables after normal transformation. Stepwise linear regression analysis was conducted to evaluate the independent determinants of NLR. Statistical significance was set at p-value < 0.05. Results: The median NLR is 1.636 (95% medical reference range: 0.808~3.277). There were positive associations between NLR and age (r = 0.151, p < 0.001), pulse rate (r = 0.088, p < 0.05), alkaline phosphatase (ALP, r = 0.085, p < 0.05), BMI (r = 0.073, p < 0.05), systolic pressure (SP, r = 0.066, p < 0.05). NLR was negatively correlated with total protein (TP, r = ？0.069, p < 0.05). No statistical difference was observed in NLR value between genders. Age, pulse rate, TP, and ALP were the independent determinants of NLR.
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