Correlation of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio with vascular endothelial function and left ventricular hypertrophy in patients undergoing hemodialysis

Objective To explore the correlation between neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (NLR) with vascular endothelial function and left ventricular hypertrophy (LVH) in patients undergoing hemodialysis (HD). Methods A total of 107 patients with maintenance HD were enrolled. According to left ventricular mass index (LVMI), they were divided into two groups:a LVH group and a non-LVH group. The flow-mediated dilation (FMD) of the brachial artery was measured by color ultrasound. According to the value of FMD, they were divided into three groups:a good endothelial function group, a common endothelial function group and an endothelial dysfunction group. Their clinical data and biochemical indexes were collected. The influencing factors of FMD were analyzed. The presence of LVH in HD patients was used as the dependent variable for binary logistic regression analysis.Results For HD patients, the LVH group showed significantly lower FMD, but higher systolic blood pressure, diastolic blood pressure and NLR than the non-LVH group (P<0.05). There were statistical differences in NLR and PLR among the three groups with various vascular endothelial function (P<0.05). Spearman correlation analysis showed that FMD was negatively correlated with LVMI, glycosylated hemoglobin, NLR and PLR (P<0.05). With the vascular endothelial dysfunction as a dependent variable, binary logistic regression analysis was conducted, which indicated that age, glycosylated hemoglobin and NLR were the independent risk factors. According to ROC curve analysis, the AUC values of ROC curves for age, glycosylated hemoglobin and NLR in predicting vascular endothelial dysfunction in HD patients were 0.605 (95%CI:0.488-0.722), 0.619 (95%CI:0.504-0.734) and 0.794 (95%CI:0.706-0.883). The optimal cut-off values were 64.00 years old, 5.85%, and 3.42, with a sensitivity of 38.2%, 58.8%, 94.1%, respectively and a specificity of 17.8%, 63.0%, 69.9%, respectively. With the LVH as a dependent variable, binary logistic regression analysis showed that NLR was an independent risk factor. According to ROC curve analysis, the AUC value of ROC curve for predicting LVH in HD patients by NLR was 0.671 (95%CI:0.567-0.774), where the optimal cut-off value was 3.49, with a sensitivity of 61.7% and a specificity of 72.3%.Conclusions FMD is significantly correlated with LVMI in HD patients. Age, HbA1c and NLR are the independent risk factors for vascular endothelial dysfunction, while NLR is the independent risk factors for LVH.