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High neutrophil to lymphocyte ratios predict intracranial atherosclerosis in a healthy population

  • Ki-Woong Nam
    Affiliations
    Department of Neurology, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, South Korea
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  • Hyung-Min Kwon
    Correspondence
    Corresponding author. Department of Neurology, Seoul National University College of Medicine and Seoul Metropolitan Government-Seoul National University Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-Gu, Seoul 07061, South Korea.
    Affiliations
    Department of Neurology, Seoul National University College of Medicine and Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
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  • Han-Yeong Jeong
    Affiliations
    Department of Neurology, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, South Korea
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  • Jin-Ho Park
    Correspondence
    Corresponding author. Department of Family Medicine, Seoul National University College of Medicine and Seoul National University Hospital, 101 Daehakno, Jongno-Gu, Seoul 03080, South Korea.
    Affiliations
    Department of Family Medicine, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, South Korea
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  • Sang Hyuck Kim
    Affiliations
    Department of Family Medicine, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, South Korea
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  • Su-Min Jeong
    Affiliations
    Department of Family Medicine, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, South Korea
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      Highlights

      • Intracranial atherosclerosis (ICAS) is associated with neutrophil to lymphocyte ratio (NLR) in a healthy population.
      • Locations of ICAS seem to be not significantly related to the NLR.
      • The number of ICAS lesions and degree of stenosis were associated with NLR values with a dose response manner.

      Abstract

      Background and aims

      Although atherosclerosis has been shown to be an inflammatory disease, intracranial atherosclerosis (ICAS) has not been well addressed. The purpose of this study was to evaluate the relationship between the neutrophil to lymphocyte ratio (NLR) and the presence of ICAS lesions in a generally healthy population.

      Methods

      A consecutive series of subjects, who voluntarily visited for health check-ups between January 2006 and December 2013, were selected. Brain magnetic resonance imaging, brain magnetic angiography (MRA), and blood cell count data were assessed. ICAS was defined as an occlusion or more than 50% stenosis of intracranial vessels, as observed on brain MRA images. NLR was calculated based on absolute neutrophil and lymphocyte counts.

      Results

      A total of 2842 subjects were evaluated, and 76 ICAS cases were found. The median NLR was 1.52 [1.17–2.01]. In multivariate analysis, NLR remained an independent predictor of ICAS [adjusted OR (aOR) = 1.72, 95% confidence interval (CI) = 1.01–2.95, p = 0.048]. Age (aOR = 1.08, 95% CI = 1.05–1.11, p < 0.001) and hypertension (aOR = 1.81, 95% CI = 1.11–2.94, p = 0.017) were also significant factors for ICAS independent of NLR. Regarding ICAS burdens, NLR was significantly higher when the number of ICAS lesions (p = 0.017) or occlusive ICAS lesions (p = 0.005) was increased in a dose-response manner.

      Conclusions

      A high NLR was associated with both prevalence and burdens of ICAS in a healthy population.

      Keywords

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