Correlation analysis of carotid plaque in young patients with newly diagnosed type 2 diabetes and platelet-to-lymphocyte ratio and neutrophil–lymphocyte ratio
Restricted accessResearch articleFirst published online February, 2023
Correlation analysis of carotid plaque in young patients with newly diagnosed type 2 diabetes and platelet-to-lymphocyte ratio and neutrophil–lymphocyte ratio
Platelet-to-lymphocyte ratio (PLR) and neutrophil–lymphocyte ratio (NLR) have been reported to be related to atherosclerosis. The relationship between PLR, NLR, and carotid atherosclerotic plaque in young patients with newly diagnosed type 2 diabetes has not been clinically reported. This study aimed to analyze the relationship between PLR, NLR, and carotid plaques in young patients with newly diagnosed type 2 diabetes.
Method
The total 268 patients were divided into the intima-media–thickening (IMT) group (116 cases) and plaque group (152 cases). The plaque group was divided into grade I (62 cases), grade II (47 cases), and grade III groups (43 cases). The counts of platelets, neutrophils, and lymphocytes were determined.
Results
The diagnostic effect of PLR and NLR was evaluated by the receiver-operating characteristic curve (ROC) and areas under the curve (AUC). The PLR and NLR values in the observation group were higher than those in the control group; these two values in the plaque group were also higher than those in the IMT group. The two values in the grade III plaque group were higher than those in grade II. The values in the grade II plaque group were also higher than those in the grade I plaque group. The ROC of PLR and NLR were 0.722 and 0.653, and the AUC of PLR and NLR were 111.086 and 2.240. PLR yielded a sensitivity of 0.789 and a specificity of 0.612. Neutrophil–lymphocyte ratio yielded a sensitivity of 0.809 and a specificity of 0.511.
Conclusion
The PLR and NLR may be related to carotid inflammation in patients and positively correlated with carotid plaque.
AngeloAMattiaALisaM, et al.Endothelial dysfunction in diabetes. Diabetes Care2011; 34: S285–S290.
2.
DuksalTTiftikciogluBIBilginS, et al.Role of inflammation in sensory neuropathy in prediabetes or diabetes. Acta Neurol Scand2016; 133: 384–390.
3.
ZhaoLHuFX. α-Lipoic acid treatment of aged type 2 diabetes mellitus complicated with acute cerebral infarction. Eur Review Medical Pharmacological Sciences2014; 18: 3715–3719.
4.
Santl LetonjaMLetonjaMIkolajević-StarcevićJN, et al.Association of manganese superoxide dismutase and glutathione S-transferases genotypes with carotid atherosclerosis in patients with diabetes mellitus type 2. Int J Angiolo2012; 31: 33–41.
5.
KimEYLeeJWYooHM, et al.The platelet-to-lymphocyte ratio versus neutrophil-to-lymphocyte ratio: which is better as a prognostic factor in gastric cancer?Ann Surg Oncol2015; 22: 4363–4370.
6.
YildizAYukselMOylumluM, et al.The utility of the Platelet-Lymphocyte Ratio for predicting no reflow in patients with ST-segment elevation myocardial infarction. Clin Appl Thrombosis/Hemostasis2015; 21: 223–228.
7.
SariISunbulMMammadovC, et al.Relation of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio with coronary artery disease severity in patients undergoing coronary angiography. Kardiologia Polska2015; 73: 1310–1316.
8.
CorriereTDi MarcaSCataudellaE, et al.Neutrophil-to-Lymphocyte Ratio is a strong predictor of atherosclerotic carotid plaques in older adults. Nutr Metab Cardiovasc Dis2018; 28: 23–27.
9.
HyunSKwonSChoS, et al.Can the Neutrophil-to-Lymphocyte Ratio appropriately predict carotid artery stenosis in patients with Ischemic stroke?—A retrospective study. J Stroke Cerebrovasc Dis2015; 24: 2646–2651.
10.
AltintasO.AltintasM. O.TasalA., et al.The relationship of platelet-to-lymphocyte ratio with clinical outcome and final infarct core in acute ischemic stroke patients who have undergone endovascular therapy. Neurol Res2016; 38: 759–765.
11.
WangRTZhangJRLiY, et al.Neutrophil-Lymphocyte ratio is associated with arterial stiffness in diabetic retinopathy in type 2 diabetes. J Diabetes Complications2015; 29: 245–249.
12.
HuangWHuangJLiuQ, et al.Neutrophil-lymphocyte ratio is a reliable predictive marker for early-stage diabetic nephropathy. Clin Endocrinology2015; 82: 229–233.
13.
YangHJingHpXingY. Guideline for Chinese stroke vascular ultrasound examination. China J Ultrasound Medicine2015; 12: 599–610.
14.
Chinese Diabetes Society. Guidelines for the prevention and treatment of type 2 diabetes in China (2017 edition). Chin J Diabetes2018; 10: 4–67.
15.
ShinozakiNOgataNIkariY. Plaque protrusion detected by intravascular ultrasound during carotid artery stenting. J Stroke Cerebrovasc Dis2014; 23: 2622–2625.
16.
Revised committee of chinese guidelines for the prevention and treatment of hypertension. Chinese guidelines for the prevention and treatment of hypertension 2010. China hypertension prevention and treatment guidelines revision committeeChin J Hypertens2011; 8: 701–743.
17.
ZhuJGaoRZhaoS, et al.Guidelines for the prevention and treatment of dyslipidemia in Chinese adults (revised edition 2016). China Circ Mag2016; 31: 937–953.
18.
KimJMParkKYShinDW, et al.Relation of serum homocysteine levels to cerebral artery calcification and atherosclerosis. Atherosclerosis2016; 254: 200–204.
19.
KawleAPNayakARLandeNH, et al.Comparative evaluation of risk factors, outcome and biomarker levels in young and old acute ischemic stroke patients. Ann Neurosci2015; 22: 70–77.
20.
RennaRPilatoFProficeP, et al.Risk factor and etiology analysis of ischemic stroke in young adult patients. J Stroke Cerebrovasc Dis2014; 23: e221–e227.
21.
González-GómezFJPérez-TorrePDeFelipeA, et al.Stroke in young adults: incidence rate, risk factors, treatment and prognosis. Rev Clin Esp2016; 216: 345–351.
22.
LiYCaiYZhaoM, et al.Risk factors between intracranial-extracranial atherosclerosis and anterior-posterior circulation stroke in ischaemic stroke. Neurol Res2017; 39: 30–35.
23.
von SarnowskiBSchminkeUGrittnerU, et al.Posterior versus anterior circulation stroke in young adults: a comparative study of stroke aetiologies and risk factors in stroke among young fabry patients (sifap1). Cerebrovasc Dis2017; 43: 152–160.
24.
HuCJiaW. Diabetes in China: epidemiology and genetic risk factors and their clinical utility in personalized medication. Diabetes2018; 67: 3–11.
25.
BraggFLiLBennettD, et al.Association of random plasma glucose levels with the risk for cardiovascular disease among Chinese adults without known diabetes. JAMA Cardiol2016; 1: 813–823.
26.
WilmotEIdrisI. Early onset type 2 diabetes: risk factors, clinical impact and management. Ther Adv Chronic Dis2014; 5: 234–244.
27.
BulutAAvciB. Carotid intima-media thickness values are significantly higher in patients with prediabetes compared to normal glucose metabolism. Medicine2019; 98: e17805.
28.
SłomkaTDrelich-ZbrojaAJarząbekM, et al.Intima-media complex thickness and carotid atherosclerotic plaque formation in Lublin’s population in the context of selected comorbidities. J Ultrason2018; 18: 133–139.
29.
LattanziSRinaldiCPulciniA, et al.Clinical phenotypes of embolic strokes of undetermined source. Neurol Sci2021; 42: 297–300.
30.
ManzoniGOltoliniAPerraS, et al.Resting whole body energy metabolism in class 3 obesity; from preserved insulin sensitivity to overt type 2 diabetes. Diabetes Metab Syndr Obes2020; 13: 489–497.
31.
SkiltonMRYeoSQNeJY, et al.Weight loss and carotid intima-media thickness-a meta-analysis. Obesity2017; 25: 357–362.
32.
HuoXGaoLGuoL, et al.Risk of non-fatal cardiovascular diseases in early-onset versus late-onset type 2 diabetes in China: a cross-sectional study. Lancet Diabetes Endocrinol2016; 4: 115–124.
33.
SeoDHKimSHSongJH, et al.Presence of carotid plaque is associated with rapid renal function decline in patients with type 2 diabetes mellitus and normal renal function. Diabetes Metab J2019; 43: 840–853.
34.
BaberUMehranRSartoriS, et al.Prevalence, impact, and predictive value of detecting subclinical coronary and carotid atherosclerosis in asymptomatic adults: the BioImage study. J Am Coll Cardiol2015; 65: 1065–1074.
35.
LiuMLiuSWWangLJ, et al.Burden of diabetes, hyperglycaemia in China from to 2016: findings from the 1990 to 2016, global burden of disease study. Diabetes Metab2019; 45: 286–293.
36.
ShahASUrbinaEM. Vascular and endothelial function in youth with type 2 diabetes mellitus. Curr Diab Rep2017; 17: 36.
OzgonulCSertogluE. Accurate use of Neutrophil/Lymphocyte ratio in patients with age-related macular degeneration. Ocul Immunol Inflamm2016; 24: 359–360.
39.
OzgonulCSertogluEAyyildizO, et al.Novel biomarkers for patients with idiopathic acute anterior uveitis: neutrophil to lymphocyte ratio and platelet to lymphocyte ratio. Int J Ophthalmol2017; 10: 262–266.
40.
GucluHOzalSAPelitli GurluV, et al.Elevated Neutrophil Lymphocyte Ratio in recurrent optic neuritis. J Ophthalmol2015; 2015: 758687.
41.
FengJFHuangYChenQX. Preoperative platelet lymphocyte ratio (PLR) is superior to neutrophil lymphocyte ratio (NLR) as a predictive factor in patients with esophageal squamous cell carcinoma. World J Surg Oncol2014; 12: 58.
42.
AteşAHAytemirKKoçyiğitD, et al.Association of Neutrophil-to-Lymphocyte Ratio with the severity and morphology of coronary atherosclerotic plaques detected by multidetector computerized tomography. Acta Cardiol Sin2016; 32: 676–683.
43.
YükselMYıldızAOylumluM, et al.The association between platelet/lymphocyte ratio and coronary artery disease severity. Anatol J Cardiol2015; 15: 640–647.
44.
BaltaSCelikTMikhailidisDP, et al.The relation between atherosclerosis and the Neutrophil-Lymphocyte Ratio. Clin Appl Thromb Hemost2016; 22: 405–411.
45.
İdil SoyluAArıkan CortcuSUzunkayaF, et al.The correlation of the platelet-to-lymphocyte ratio with the severity of stenosis and stroke in patients with carotid arterial disease. Vascular2017; 25: 299–306.
46.
SefilFUlutasKTDokuyucuR, et al.Investigation of neutrophil lymphocyte ratio and blood glucose regulation in patients with type 2 diabetes mellitus. J Int Med Res2014; 42: 581–588.
47.
XuRYinXXuW, et al.Assessment of carotid plaque neovascularization by contrast-enhanced ultrasound and high sensitivity C-reactive protein test in patients with acute cerebral infarction: a comparative study. Neurol Sci2016; 37: 1107–1112.
48.
BaettaRCorsiniA. Role of polymorphonuclear neutrophils in atherosclerosis: current state and future perspectives. Atherosclerosis2010; 210: 1–13.
49.
LangerHFBigalkeBSeizerP, et al.Interaction of platelets and inflammatory endothelium in the development and progression of coronary artery disease. Semin Thromb Hemost2010; 36: 131–138.
50.
LievensDZerneckeASeijkensT, et al.Platelet CD40L mediates thrombotic and inflammatory processes in atherosclerosis. Blood2010; 116: 4317–4327.
51.
KaplanZSJacksonSP. The role of platelets in atherothrombosis. Hematology2011; 2011: 51–61.
52.
MoraisJ. [Residual platelet activity in patients managed with clopidogrel: clinical implications for the management of patients with acute coronary syndrome]. Rev Port Cardiol2012; 31: 555–557.
53.
SunbulMGerinFDurmusE, et al.Neutrophil to lymphocyte and platelet to lymphocyte ratio in patients with dipper versus non-dipper hypertension. Clin Exp Hypertens2014; 36: 217–221.
54.
EkeløfSJensenSERosenbergJ, et al.Reduced oxidative stress in STEMI patients treated by primary percutaneous coronary intervention and with antioxidant therapy: a systematic review. Cardiovasc Drugs Ther2014; 28: 173–181.
