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. 2022 Jun 20:9:927768.
doi: 10.3389/fcvm.2022.927768. eCollection 2022.

Predictive Value of Non-high-Density Lipoprotein Cholesterol and Neutrophil-Lymphocyte Ratio for Coronary Artery Vulnerable Plaques in Type 2 Diabetes Mellitus

Xiyi Huang  1 , Shaomin Yang  2 , Qiang Zhao  3 , Xinjie Chen  4 , Jialing Pan  4 , Shaofen Lai  1 , Fusheng Ouyang  4 , Lingda Deng  4 , Yongxing Du  4 , Xiaohong Li  4 , Qiugen Hu  4 , Baoliang Guo  4 , Jiemei Liu  5
Affiliations

Predictive Value of Non-high-Density Lipoprotein Cholesterol and Neutrophil-Lymphocyte Ratio for Coronary Artery Vulnerable Plaques in Type 2 Diabetes Mellitus

Xiyi Huang et al. Front Cardiovasc Med. .

Abstract

Background: Patients with diabetes have an increased risk of developing vulnerable plaques (VPs), in which dyslipidemia and chronic inflammation play important roles. Non-high-density lipoprotein cholesterol (non-HDL-C) and neutrophil-lymphocyte ratio (NLR) have emerged as potential markers of both coronary artery VPs and cardiovascular prognosis. This study aimed to investigate the predictive value of non-HDL-C and NLR for coronary artery VPs in patients with type 2 diabetes mellitus (T2DM).

Methods: We retrospectively enrolled 204 patients with T2DM who underwent coronary computed tomography angiography between January 2018 and June 2020. Clinical data including age, sex, hypertension, smoking, total cholesterol, low-density lipoprotein cholesterol, HDL-C, triglyceride, non-HDL-C, glycated hemoglobin, neutrophil count, lymphocyte count, NLR, and platelet count were analyzed. Multivariate logistic regression was used to estimate the association between non-HDL-C, NLR, and coronary artery VPs. Receiver operating curve analysis was performed to evaluate the value of non-HDL-C, NLR, and their combination in predicting coronary artery VPs.

Results: In our study, 67 patients (32.84%) were diagnosed with VPs, 75 (36.77%) with non-VP, and 62 (30.39%) with no plaque. Non-HDL-C and NLR were independent risk factors for coronary artery VPs in patients with T2DM. The areas under the ROC curve of non-HDL-C, NLR, and their combination were 0.748 [95% confidence interval (CI): 0.676-0.818], 0.729 (95% CI: 0.650-0.800), and 0.825 (95% CI: 0.757-0.887), respectively.

Conclusion: Either non-HDL-C or NLR could be used as a predictor of coronary artery VPs in patients with T2DM, but the predictive efficiency and sensitivity of their combination would be better.

Keywords: coronary computed tomography angiography; coronary heart disease; neutrophil-lymphocyte ratio; non-high-density lipoprotein cholesterol; type 2 diabetes mellitus; vulnerable plaque.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Forest plots show the comparison of risk factors for coronary artery vulnerable plaques in T2DM patients. Non-HDL-C (OR 2.500, 95%CI: 1.32–4.735) and NLR (OR 1.998, 95%CI: 1.373–2.907) were independent risk factors for coronary artery vulnerable plaques.
FIGURE 2
FIGURE 2
Receiver operating characteristic curves for predicting coronary artery vulnerable plaques using baseline Non-HDL-C, NLR, and their combination in T2DM patients. The AUC of Non-HDL-C, NLR, and their combination were 0.748 (95% CI: 0.676–0.818), 0.729 (95% CI: 0.650–0.800), and 0.825 (95% CI: 0.757–0.887), respectively.
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