The associations between neutrophil-to-lymphocyte ratio and the Chinese Visceral Adiposity Index, and carotid atherosclerosis and atherosclerotic cardiovascular disease risk.

ABSTRACT

BACKGROUND: Inflammation and obesity are the main risk factors for the development of carotid atherosclerosis and atherosclerotic cardiovascular disease (ASCVD). The neutrophil-to-lymphocyte ratio (NLR) is a recently developed indicator of inflammation that can be easily calculated from blood cell counts. The Chinese Visceral Adiposity Index (CVAI) was used to assess visceral obesity in the Chinese population. AIMS: To explore the associations between both NLR and CVAI, and carotid atherosclerosis and ASCVD risk in elderly Chinese. METHODS: A total of 4437 participants aged ≥55 years and with no history of cardiovascular disease, were enrolled in this retrospective study. Anthropometric measurements, laboratory results, and carotid ultrasonography results were extracted from a database. We used established formulas to calculate NLR and CVAI, and the Pooled Cohort Equations to generate the 10-year ASCVD risk score. Participants were divided into two groups according to their 10-year ASCVD scores <7.5% and ≥7.5%. RESULTS: NLR and CVAI were significantly higher in patients with carotid atherosclerosis. Regression analysis showed that NLR (OR 1.23, 95% CI 1.05-1.43, p = 0.01) and CVAI (OR 1.39, 95% CI 1.21-1.61, p = 0.001) were independent risk factors for carotid atherosclerosis. A combination of NLR and CVAI improved the goodness-of-fit (p < 0.001) and discriminability of the model (p = 0.0013). NLR, CVAI and carotid plaques showed positive associations with the 10-year ASCVD risk score (all p < 0.001). CONCLUSIONS: NLR and CVAI are positively associated with the prevalence of carotid atherosclerosis and high risk of ASCVD in elderly adults and could be useful in the identification of a high risk of atherosclerosis.