Predictive value of neutrophil-to-lymphocyte ratio for atrial fibrillation and stroke in type 2 diabetes mellitus: The Hong Kong Diabetes Study
Carlin Chang, Jiandong Zhou, Oscar Hou In Chou, Justin Chan, Keith Sai Kit Leung, Teddy Tai Loy Lee, Wing Tak Wong, Abraham Ka Chung Wai, Tong Liu, Qingpeng Zhang, Sharen Lee and Tse, G. 2023. Predictive value of neutrophil-to-lymphocyte ratio for atrial fibrillation and stroke in type 2 diabetes mellitus: The Hong Kong Diabetes Study. Endocrinology, Diabetes & Metabolism. https://doi.org/10.1002/edm2.397
|Authors||Carlin Chang, Jiandong Zhou, Oscar Hou In Chou, Justin Chan, Keith Sai Kit Leung, Teddy Tai Loy Lee, Wing Tak Wong, Abraham Ka Chung Wai, Tong Liu, Qingpeng Zhang, Sharen Lee and Tse, G.|
Introduction: Neutrophil-to-lymphocyte ratio (NLR) is a routinely available biomarker that reflects systemic inflammation. The study evaluated the predictive value of NLR for ischemic stroke and atrial fibrillation (AF) in patients with type 2 diabetes mellitus.
Methods: This was a population-based cohort study of patients with type 2 diabetes mellitus and complete blood count tests at baseline between 1 January 1st, 2009, and 31 December, 2009, at government-funded hospitals/clinics in Hong Kong. Follow-up was until 31 December, 2019, or death.
Results: A total of 85,351 patients (age = 67.6 ± 13.2 years old, male = 48.8%, follow-up = 3101 ± 1441 days) were included. Univariable Cox regression found that increased NLR at quartiles 2, 3 and 4 was significantly associated with higher risks of new-onset ischemic stroke (hazard ratio [HR]: 1.28 [1.20-1.37], p < .001, HR: 1.41 [1.32-1.51], p < .001 and HR: 1.38 [1.29-1.47], p < .001) and AF (HR: 1.09 [1.02-1.17], p < .015; HR: 1.28 [1.20-1.37], p < .001; HR: 1.39 [1.31-1.49], p < .001) compared to quartile 1. On multivariable analysis, NLR remained a significant predictor of ischemic stroke risk for quartiles 2 and 3 (quartile 2: HR: 1.14 [1.05, 1.22], p = .001; quartile 3: HR: 1.14 [1.06, 1.23], p < .001) but not quartile 4 (HR: 1.08 [0.994, 1.17], p = .070). NLR was not predictive of AF after adjusting for confounders (quartile 2: HR: 0.966 [0.874, 1.07], p = .499; quartile 3: HR: 0.978 [0.884, 1.08], p = .661; quartile 4: HR: 1.05 [0.935, 1.16], p = .462).
Conclusion: NLR is a significant predictor of new-onset ischaemic stroke after adjusting for significant confounders in Chinese type 2 diabetes patients.
|Keywords||Atrial fibrillation;; Neutrophil-to-lymphocyte ratio; Stroke|
|Journal||Endocrinology, Diabetes & Metabolism|
|Digital Object Identifier (DOI)||https://doi.org/10.1002/edm2.397|
|Online||04 Dec 2022|
|Publication process dates|
|Accepted||23 Nov 2022|
|Deposited||12 May 2023|
Endocrino Diabet Metabol - 2022 - Chang - Predictive value of neutrophil‐to‐lymphocyte ratio for atrial fibrillation and.pdf
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