Platelet‑to‑lymphocyte ratio, neutrophil‑to‑lymphocyte ratio and monocyte‑to‑HDL cholesterol ratio as markers of peripheral artery disease in elderly patients

Selvaggio,Stefano; Abate,Angela; Brugaletta,Giuseppe; Musso,Cinzia; Di Guardo,Mario; Di Guardo,Caterina; Vicari,Enzo Saretto Dante; Romano,Marcello; Luca,Salvatore; Signorelli,Salvatore Santo

doi:10.3892/ijmm.2020.4644

Platelet‑to‑lymphocyte ratio, neutrophil‑to‑lymphocyte ratio and monocyte‑to‑HDL cholesterol ratio as markers of peripheral artery disease in elderly patients

Authors:
- Stefano Selvaggio
- Angela Abate
- Giuseppe Brugaletta
- Cinzia Musso
- Mario Di Guardo
- Caterina Di Guardo
- Enzo Saretto Dante Vicari
- Marcello Romano
- Salvatore Luca
- Salvatore Santo Signorelli
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Affiliations: Geriatric Unit, ‘Maggiore’ Hospital, Modica, I‑97015 Ragusa, Italy, Villa Aurelia Hospital, 96100 Siracusa, Italy, Geriatric Unit, General Hospital ‘Garibaldi’ Nesima, I‑95122 Catania, Italy, Department of Agriculture, Food and Environment (Di3A), University of Catania, I‑95123 Catania, Italy, Geriatric Unit, General Hospital Cannizzaro, Department of Clinical and Experimental Medicine, University of Catania, I‑95123 Catania, Italy, Geriatric Unit, Department of General Surgery and Medical‑Surgical Specialties, University of Catania, I‑95123 Catania, Italy, Department of Clinical and Experimental Medicine, University of Catania, Internal Medicine Unit, University Hospital ‘G. Rodolico’, I‑95123 Catania, Italy
Published online on: June 16, 2020 https://doi.org/10.3892/ijmm.2020.4644
Pages: 1210-1216

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Abstract

Solid evidence underlines the pivotal role played by inflammation regarding atherosclerosis. Peripheral artery disease (PAD) is one of atherosclerotic cardiovascular diseases (CVDs), it is highly frequently diagnosed in older individuals. In the present study we carried out an investigation on the association between platelet‑to‑lymphocytes ratio (PLR), neutrophil‑to‑lymphocyte ratio (NLR), monocyte‑to‑HDL cholesterol ratio (MHR) with PAD as favourable markers. We identified 300 subjects aged over 70 years, without any concomitant CVDs. The PLR, NLR and MHR were assessed from peripheral venous blood routinely drawn in the ward during hospitalization. Patients were divided in groups according to ankle brachial index (ABI) value (>0.9; 0.9‑0.99; 1‑1.4; >1.4). Higher PLR (P=0.007), NLR (P=0.0001) and MHR (P=0.0001) were associated with <0.9 ABI. Patients with a >1.4 ABI showed NLR values higher compared to >0.9l ABI (P<0.01). Univariate linear regression analysis demonstrated the direct correlation between increase in PLR (P=0.0023)and MHR (P<0.0001) with the decrease in ABI value. In multivariate linear regression analysis including main cardiovascular risk factors we found that PLR, NLR and MHR were independently associated with lower ABI (P=0.0011). Results show and suggest that the elevated PLR, NLR and MHR are related to PAD evaluated with ABI measurement. PLR and MHR seem to be more reliable markers than NLR in PAD. NLR seems to be more related to incompressibility of arterial wall. It is hypothesized that these three indexes may play a role as simple and repetitive markers of PAD.

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