ABSTRACT

Background

Arterial hypertension causes cardiovascular adverse events mainly through endothelial dysfunction, atherosclerosis, and inflammation. Carotid intima-media thickness (CIMT) is a marker of subclinical atherosclerosis and endothelial dysfunction. Systemic immune-inflammation index (SII) reflects systemic inflammatory and immunity status. This index has strong prognostic value in malignancy and recently was demonstrated to be associated with adverse events in cardiovascular diseases. We aimed to interrogate the relationship between SII and CIMT in patients with hypertension.

Methods

A total of 215 consecutive hypertensive patients were included in the study. CIMT of all patients was obtained by B-mode arterial doppler ultrasound. SII was obtained by the following formula: (platelet × neutrophil/lymphocyte ratio) from admission complete blood count. Patients were divided into two groups by means of CIMT is above or below the value of 0.9 mm. SII and demographic characteristics of patients were compared between groups.

Results

Increased CIMT was detected in 55 (25.6%) of hypertensive patients. The patients with increased CIMT were older and had higher neutrophil count (p < .001), neutrophil to lymphocyte ratio (NLR) (p < .001), C-reactive protein (CRP) (p = .047), CRP to albumin ratio (CAR) (p = .044) and SII (p < .001) Advanced age (OR: 1.054; 95% CI: 1.015–1.095; p = .006), NLR (OR: 3.213; 95% CI: 1.577–6.546; p = .001), and SII (OR: 3.906; 95% CI: 1.887–8.086; p < .001) were independent predictors of increased CIMT in multivariable logistic regression analysis.

Conclusion

SII was an independent predictor of elevated CIMT in hypertensive patients. Preventive approaches for future atherosclerotic cardiovascular diseases can be developed in those with higher SII level.

中文翻译：

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全身免疫炎症指数与高血压患者颈动脉内膜中层厚度增加有关

摘要

背景

动脉高血压主要通过内皮功能障碍、动脉粥样硬化和炎症引起心血管不良事件。颈动脉内膜中层厚度 (CIMT) 是亚临床动脉粥样硬化和内皮功能障碍的标志物。全身免疫炎症指数（SII）反映全身炎症和免疫状态。该指数在恶性肿瘤中具有很强的预后价值，最近被证明与心血管疾病的不良事件有关。我们旨在探讨高血压患者 SII 和 CIMT 之间的关系。

方法

共有 215 名连续的高血压患者被纳入研究。所有患者的CIMT均通过B型动脉多普勒超声获得。SII通过以下公式获得：（血小板×中性粒细胞/淋巴细胞比率）从入院全血细胞计数。患者通过CIMT高于或低于0.9 mm的值分为两组。比较两组患者的 SII 和人口统计学特征。

结果

在 55 名（25.6%）高血压患者中检测到 CIMT 增加。CIMT 增加的患者年龄较大，中性粒细胞计数 ( p < .001)、中性粒细胞与淋巴细胞的比率 (NLR) ( p < .001)、C 反应蛋白 (CRP) ( p = .047)、CRP 与白蛋白的比例较高比率 (CAR) ( p = .044) 和 SII ( p < .001) 高龄 (OR: 1.054; 95% CI: 1.015–1.095; p = .006), NLR (OR: 3.213; 95% CI: 1.577 –6.546；p = .001）和 SII（OR：3.906；95% CI：1.887–8.086；p < .001）是多变量逻辑回归分析中 CIMT 增加的独立预测因子。

结论

SII 是高血压患者 CIMT 升高的独立预测因子。可以在 SII 水平较高的人群中开发未来动脉粥样硬化性心血管疾病的预防方法。