title: Neutrophil-to-lymphocyte ratio: an inflammation marker related to cardiovascular risk in children.
abstract: 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.
authors.affiliation: Anna Prats-Puig, PhD, Girona Institute for Biomedical Research, Pediatric Endocrinology, Dr. Josep Trueta Hospital, Av. França s/n, Girona-17007, Spain, Tel.: +34 972 940200. Ext. 2810, Fax: +34 972 940270, E-mail: aprats@idibgi.org.
authors.forename: Anna
authors.initials: A
authors.lastname: Prats-Puig
authors.forename: Montserrat
authors.initials: M
authors.lastname: Gispert-Saüch
authors.forename: Ferran
authors.initials: F
authors.lastname: Díaz-Roldán
authors.forename: Gemma
authors.initials: G
authors.lastname: Carreras-Badosa
authors.forename: Inés
authors.initials: I
authors.lastname: Osiniri
authors.forename: Montserrat
authors.initials: M
authors.lastname: Planella-Colomer
authors.forename: Lluís
authors.initials: L
authors.lastname: Mayol
authors.forename: Francis
authors.initials: F
authors.lastname: de Zegher
authors.forename: Lourdes
authors.initials: L
authors.lastname: Ibánez
authors.forename: Judit
authors.initials: J
authors.lastname: Bassols
authors.forename: Abel
authors.initials: A
authors.lastname: López-Bermejo
mesh_terms: D000367:Age Factors; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000208:ethnology / Q000276:immunology* / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000175:diagnosis / Q000208:ethnology / Q000276:immunology* / Q000503:physiopathology; D016014:Linear Models; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000276:immunology*; D008297:Male; D015999:Multivariate Analysis; D009504:Neutrophils / Q000276:immunology*; D011237:Predictive Value of Tests; D011379:Prognosis; D011627:Puberty; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D055105:Waist Circumference; D044465:White People
keywords: Body mass index; cardiovascular risk; children; intima-media thickness; neutrophils to lymphocytes ratio