Neutrophil-to-lymphocyte ratio: an inflammation marker related to cardiovascular risk in children

Anna Prats-Puig; Montserrat Gispert-Saüch; Ferran Díaz-Roldán; Gemma Carreras-Badosa; Inés Osiniri; Montserrat Planella-Colomer; Lluís Mayol; Francis de Zegher; Lourdes Ibánez; Judit Bassols; Abel López-Bermejo

doi:10.1160/TH15-01-0037

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2015; 114(04): 727-734
DOI: 10.1160/TH15-01-0037

Blood Cells, Inflammation and Infection

Schattauer GmbH

Neutrophil-to-lymphocyte ratio: an inflammation marker related to cardiovascular risk in children

Authors

Anna Prats-Puig

¹Girona Institute for Biomedical Research, Girona, Spain;

²Department of Physical Therapy, EUSES University School, University of Girona, Girona, Spain

³Pediatrics, Dr. Josep Trueta Hospital, Girona, Spain
Montserrat Gispert-Saüch

³Pediatrics, Dr. Josep Trueta Hospital, Girona, Spain
Ferran Díaz-Roldán

¹Girona Institute for Biomedical Research, Girona, Spain;

³Pediatrics, Dr. Josep Trueta Hospital, Girona, Spain
Gemma Carreras-Badosa

¹Girona Institute for Biomedical Research, Girona, Spain;

³Pediatrics, Dr. Josep Trueta Hospital, Girona, Spain
Inés Osiniri

⁴Pediatrics, Salut Empordà Foundation, Figueres, Spain
Montserrat Planella-Colomer

³Pediatrics, Dr. Josep Trueta Hospital, Girona, Spain
Lluís Mayol

³Pediatrics, Dr. Josep Trueta Hospital, Girona, Spain
Francis de Zegher

⁵Department of Development & Regeneration, University of Leuven, Leuven, Belgium
Lourdes Ibánez

⁶Pediatric Endocrinology, Sant Joan de Déu Children’s Hospital, Esplugues, Barcelona and CIBERDEM (Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders), Barcelona, Spain
Judit Bassols

¹Girona Institute for Biomedical Research, Girona, Spain;

³Pediatrics, Dr. Josep Trueta Hospital, Girona, Spain
Abel López-Bermejo

¹Girona Institute for Biomedical Research, Girona, Spain;

³Pediatrics, Dr. Josep Trueta Hospital, Girona, Spain

⁷TransLab Research Group, Department of Medical Sciences, Faculty of Medicine, University of Girona, Girona, Spain

Abstract

Summary

Low-grade chronic inflammation plays a pathogenic role in cardiovascular disease. An increase in the ratio of circulating neutrophils to lymphocytes (N/L ratio) may serve as a marker of cardiovascular risk in adults. It was the study objective to study whether N/L ratio associates with vascular parameters in children. Subjects were 501 prepubertal and early pubertal Caucasian children (mean age 8.0 years; mean body mass index (BMI) Z-score 0.2 ± 0.9; 266 boys and 235 girls) recruited within an ongoing population-based study. The subjects were stratified into three groups according to age. Neutrophil, lymphocyte, BMI, waist circumference, systolic blood pressure (SBP) and carotid intima-media thickness (cIMT), assessed in all children. The N/L ratio, derived from the absolute neutrophil and lymphocyte counts. In children aged < 7 years (n=190, all prepubertal), no associations were observed between N/L ratio and either anthropometric or cardiovascular parameters. In children aged 7–9 years (n=171, 1.7 % early pubertal), higher N/L ratio associated with higher BMI Z-score and waist circumference (p=0.008 to p< 0.0001). In children aged > 9 years (n=140, 29.2 % early pubertal), N/L ratio associated again with BMI Z-score and waist circumference and also positively with SBP and cIMT (all p=0.008 to p< 0.0001). These associations remained significant in linear regression models following adjustment for possible confounding variables such as age, gender, fasting triglycerides, C-reactive protein and puberty (and for SBP and cIMT, adjustment also for BMI). In conclusion, our results provide the first evidence that a higher N/L ratio is associated with a less favourable cardiovascular profile in children and delineate the development of these associations from late childhood onwards.

Keywords

Body mass index - cardiovascular risk - children - intima-media thickness - neutrophils to lymphocytes ratio

Full Text

References

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