中性粒细胞淋巴细胞比率在衡量肥胖病人炎症状态的初步探讨

Preliminary Study on Neutrophil-Lymphocyte Ratio as an Indicator of Inflammatory State in Obese Patients

目的：观察中性粒细胞淋巴细胞比率（neutrophil-lymphocyte ratio，NLR）作为炎症标志物在患有肥胖和代谢综合征的病人中的诊断价值。方法根据肥胖程度和代谢综合征的发展状态选取253个受试对象，根据 WHO推荐诊断标准， BMI＜25 kg／m2，25 kg／m2＜BMI＜30 kg／m2，BMI＞30分别为健康组、超重组和肥胖组，比较各组间的代谢和炎症标志物，并进行相关分析。结果各组间白细胞计数和C反应蛋白（CRP）有显著差异（P＜0.01），随着肥胖程度的发展，淋巴细胞和中性粒细胞计数显著增加，NLR在各组间无显著性差异（P＜0.05）。白细胞总数、中性粒细胞、淋巴细胞和 CRP与身高体重指数（BMI）呈显著相关性，但是NLR和BMI无显著相关性。结论对评价肥胖伴代谢综合征病人的炎症状态， NLR不是一个好的衡量炎症指标，白细胞计数和CRP是比较有用的衡量炎症指标。

Objective To investigate the usage of the neutrophil-lymphocyte ratio （NLR）as an inflammatory marker in obese patients with and without metabolic syndrome（MetS）.Methods Individuals whose BMI was 〉30 and 25kg/m2 were ac-cepted as obese and overweight according to WHO recommendations.253 subjects were selected according to degree of obe-sity and status of Mets and assigned groups as obese overweight and control group respectively.Metabolic and inflammatory markers were compared between groups and correlation analysis was performed.Results Leukocyte count and CRP were significantly different （P〈0.001）between groups,both lymphocyte and neutrophil counts were significantly increased with increased degree of obesity （P〈0.05）,but NLR was not different between body mass index （BMI）groups （P=0.228）. Leukocyte,neutrophil,and lymphocyte counts and CRP level showed a significant correlation with BMI （P〈0.001）,where-as NLR was not correlated with BMI （P=0.667）.Conclusion NLR would not be a good indicator of inflammation while leukocyte count and CRP are more useful biomarkers to indicate inflammation in obese patients with and without MetS.