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High neutrophil to lymphocyte ratio is associated with white matter hyperintensity in a healthy population

  • Ki-Woong Nam
    Affiliations
    Department of Neurology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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  • Author Footnotes
    1 HM Kwon and JH Park contributed equally as corresponding author.
    Hyung-Min Kwon
    Correspondence
    Correspondence to: Hyung-Min Kwon, Department of Neurology, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-Gu, Seoul 07061, Republic of Korea.
    Footnotes
    1 HM Kwon and JH Park contributed equally as corresponding author.
    Affiliations
    Department of Neurology, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
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  • Han-Yeong Jeong
    Affiliations
    Department of Neurology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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  • Jin-Ho Park
    Correspondence
    Correspondence to: Jin-Ho Park, Department of Family Medicine, Seoul National University College of Medicine, and Seoul National University Hospital, 101 Daehakno, Jongno-Gu, Seoul 03080, Republic of Korea.
    Affiliations
    Family Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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  • Sang Hyuck Kim
    Affiliations
    Family Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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  • Su-Min Jeong
    Affiliations
    Family Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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  • Tae Gon Yoo
    Affiliations
    Family Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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  • Shinhye Kim
    Affiliations
    Family Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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  • Author Footnotes
    1 HM Kwon and JH Park contributed equally as corresponding author.

      Highlights

      • High neutrophil to lymphocyte ratio is associated with the burden of white matter hyperintensity in a healthy population
      • It may provide clues to the inflammatory pathophysiology of white matter hyperintensity development
      • Cerebral microbleeds, or silent brain infarcts did not seem to be related to NLR as white matter hyperintensity

      Abstract

      High neutrophil to lymphocyte ratio (NLR) is correlated with the occurrence, morbidity and mortality of cerebrovascular disease as a marker of systemic inflammation. However, its effect on cerebral white matter hyperintensity (WMH) is unclear. We investigated high NLR burden as a surrogate marker of WMH volume in a healthy population. Healthy subjects with voluntary health check-ups between January 2006 and December 2013, including brain MRI and laboratory examination, were collected. WMH volumes were rated quantitatively. A total of 2875 subjects were enrolled, and the mean volume of WMH was 2.63 ± 6.26 mL. In multivariate linear regression analysis, NLR [β = 0.191, 95% confidence interval (CI) = 0.104 to 0.279, P < 0.001] remained significant after adjusting for confounders. Age (β = 0.049, 95% CI = 0.045 to 0.054, P < 0.001), hypertension (β = 0.191, 95% CI = 0.101 to 0.281, P < 0.001), diabetes (β = 0.153, 95% CI = 0.045 to 0.261, P = 0.006), and extracranial atherosclerosis (β = 0.348, 95% CI = 0.007 to 0.688, P = 0.045) were also significant independently from NLR. Additionally, the high NLR group (NLR ≥ 1.52) was related to male sex, hypertension, diabetes, current smoking, extracranial atherosclerosis, silent brain infarct, and high WMH volumes. In conclusion, high NLR is associated with larger WMH volumes in a healthy population. Assessment of NLR may be helpful in detecting cerebral WMH burdens in high risk groups.

      Keywords

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