ABSTRACT

Background

Residual inflammation is thought to promote endothelial dysfunction and cardiovascular disease risk among people living with HIV (PLWH) receiving antiretroviral therapy (ART). Whether the neutrophil-to-lymphocyte ratio (NLR), a putative marker of systemic inflammation, may be associated with endothelial dysfunction has not been investigated in PLWH on stable ART.

Research design and methods

In this cross-sectional study, 210 PLWH (mean age 49 years, 79% males, 88/7/5% Caucasians/Africans/Hispanics) on long-term ART (median ART duration 8 years) were enrolled among those who were afferent to an Infectious Diseases outpatient clinic. The association between NLR and brachial flow-mediated dilation (bFMD) was analysed.

Results

A curvilinear association was observed between logarithmic-NLR and logarithmic-bFMD (R square = 0.034, p = 0.027), with logarithmic-bFMD decreasing significantly with increasing logarithmic-NLR only in PLWH with high NLR (≥1.47, median NLR) (r = −0.369, p < 0.001). However, NLR had a poor accuracy in the prediction of low bFMD (≤4.55, median bFMD) in PLWH with high NLR (55% sensitivity, 80% specificity, Youden index 0.35 for NLR 2.20).

Conclusions

Although there is an inverse association between NLR and bFMD among long-term ART-treated PLWH with high NLR, NLR has a low discriminatory ability toward endothelial dysfunction in this category of patients.

中文翻译：

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接受稳定抗逆转录病毒治疗的 HIV 感染者中性粒细胞与淋巴细胞比率与内皮功能障碍之间的关联

摘要

背景

残留炎症被认为会促进接受抗逆转录病毒治疗 (ART) 的 HIV 感染者 (PLWH) 的内皮功能障碍和心血管疾病风险。中性粒细胞与淋巴细胞的比率（NLR）是全身炎症的推定标志物，是否可能与内皮功能障碍有关，尚未在 PLWH 中进行稳定 ART 研究。

研究设计与方法

在这项横断面研究中，210 名接受长期 ART（中位 ART 持续时间 8 年）的 PLWH（平均年龄 49 岁，79% 男性，88/7/5% 高加索人/非洲人/西班牙裔）被纳入传入去传染病门诊。分析了 NLR 与肱动脉血流介导的扩张 (bFMD) 之间的关联。

结果

在对数-NLR 和对数-bFMD 之间观察到曲线关联（R 平方 = 0.034，p = 0.027），对数-bFMD 仅在具有高 NLR（≥1.47，中位数 NLR）的 PLWH 中随着对数-NLR 的增加而显着降低（r = -0.369，p < 0.001）。然而，NLR 在预测具有高 NLR 的 PLWH 中的低 bFMD（≤4.55，中位 bFMD）方面的准确性较差（55% 的敏感性，80% 的特异性，对于 NLR 2.20 的约登指数 0.35）。

结论

尽管在长期接受 ART 治疗且 NLR 较高的 PLWH 中，NLR 和 bFMD 之间存在负相关，但 NLR 在此类患者中对内皮功能障碍的区分能力较低。