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The association of neutrophil-to-lymphocyte ratio with all-cause mortality in Chinese patients with MPO-ANCA associated vasculitis

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Abstract

Neutrophil-to-lymphocyte ratio (NLR) has been recently reported to be a promising inflammatory marker to assess systemic inflammation in many disorders. However, there are only a few studies looking at NLR in patients with myeloperoxidase (MPO)-anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). This study was thus undertaken to explore the relationship between NLR at diagnosis with inflammatory response and disease activity among MPO-AAV patients in a single Chinese center. Furthermore, we evaluated whether NLR could predict the renal prognosis and patient outcome. 188 patients with MPO-AAV were included in this study. Baseline NLR was positively correlated with CRP (r = 0.404, P < 0.001) and negatively with serum levels of C3 (r =  − 0.163, P = 0.035), but it had no obvious correlation with Birmingham Vasculitis Activity Score (BVAS). Patients with MPO-AAV having NLR ≥ 9.53 exhibited higher risk for all-cause mortality than those having NLR < 9.53 (P < 0.0001). However, no significant difference was found in the kidney survival between patients having NLR ≥ 9.53 and those NLR < 9.53 at diagnosis. In multivariate analysis, NLR was positively associated with all-cause mortality (P = 0.037, HR = 1.98, 95% CI 1.04–3.78). There was no association between NLR with ESRD observed using univariate analysis or multivariate analysis. This large retrospective study of MPO-AAV patients in a single Chinese center demonstrates that NLR positively correlates with CRP and negatively correlates with serum levels of C3 in Chinese patients with MPO-AAV. Importantly, higher NLR predicts increased mortality and is, therefore, a useful independent prognostic in MPO-AAV.

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Funding

This work was supported by the National Natural Science Foundation of China (81800641), the Natural Science Foundation of Hunan Province (2018JJ3853; 2018JJ3818), the Project of Health Commission of Hunan province (C2019184), Chinese Society of Nephrology (18020010780), and the Elite Program of Xiangya hospital.

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Authors and Affiliations

  1. Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, Hunan Province, China

    Li Huang

  2. Department of Hematology, The Affiliated Zhuzhou Hospital Xiangya Medical College, Central South University, Zhuzhou, Hunan Province, China

    Chanjuan Shen

  3. Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China

    Yong Zhong, Ting Wu, Ting Meng, Zhou Xiao, Xiang Ao, Rong Tang, Xiangcheng Xiao, Qiaoling Zhou & Ping Xiao

  4. Centre for Inflammatory Diseases, Monash University, Clayton, VIC, 3168, Australia

    Joshua D. Ooi

  5. Department of Rheumatology and Immunology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China

    Ya-Ou Zhou

  6. Department of Medical Records and Information, Xiangya Hospital, Central South University, Changsha, Hunan Province, China

    Jin-Biao Chen

  7. Department of Pathology, Xiangya Hospital, Central South University, Changsha, Hunan Province, China

    Wei Lin

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  1. Li Huang
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Correspondence to Yong Zhong.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of Xiangya Hospital of Central South University (IRB approval number 200901008) and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Huang, L., Shen, C., Zhong, Y. et al. The association of neutrophil-to-lymphocyte ratio with all-cause mortality in Chinese patients with MPO-ANCA associated vasculitis. Clin Exp Med 20, 401–408 (2020). https://doi.org/10.1007/s10238-020-00629-0

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