Article(id=1324078127965675961, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078037817504735, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202502373, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1740067200000, receivedDateStr=2025-02-21, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614425888, onlineDateStr=2026-11-02, pubDate=1770652800000, pubDateStr=2026-02-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614425888, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614425888, creator=13701087609, updateTime=1793614425888, updator=13701087609, issue=Issue{id=1324078037817504735, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='3', pageStart='385', pageEnd='576', issueExtLink='null', onlineDate='null', pubDate='1770652800000', pubDateStr='2026-02-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614404396, creator='13701087609', updateTime=1793614474144, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324078330420527919, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078037817504735, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324078330420527920, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078037817504735, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=435, endPage=441, ext={EN=ArticleExt(id=1324078128171196858, articleId=1324078127965675961, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Association between peripheral blood inflammatory markers and carotid atherosclerotic plaques in an elderly population, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the association between peripheral blood inflammatory markers and carotid atherosclerotic plaque in an elderly population.

Methods

A cross-sectional study was conducted, including 6 569 participants from the West China Elderly Cohort who met inclusion criteria between May 2022 and November 2023. Unconditional Logistic regression was used to examine the relationship between inflammatory markers and carotid atherosclerotic plaque, with stratified and interaction analyses conducted for further insights. Multinomial Logistic regression was applied to explore the associations between inflammatory markers and the severity of carotid atherosclerotic plaques (single/multiple).

Results

Unconditional Logistic regression revealed significant associations between plaque formation risk and white blood cell count (OR=1.06, 95% CI: 1.03-1.10, P<0.001), neutrophils count (OR=1.06, 95% CI: 1.02-1.11, P=0.002), monocytes (OR=2.95, 95% CI: 2.02-4.32, P<0.001), and SIRI (OR=1.13, 95% CI: 1.05-1.22, P<0.001). Stratified analysis identified platelets as significantly associated with plaque formation in elderly individuals with diabetes, with a multiplicative interaction observed (P=0.023).Multinomial Logistic regression revealed that monocytes were specifically associated with the risk of single plaques (OR=2.14,95% CI: 1.33-3.43, P=0.002), whereas white blood cells, neutrophils, monocytes, platelets, neutrophil-lymphocyte ratio (NLR),systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI) were linked to the risk of multiple plaques (P<0.05).

Conclusion

Peripheral blood inflammatory markers are closely related to the formation and severity of carotid atherosclerotic plaques in the elderly, providing valuable insights for assessing carotid atherosclerosis risk.

, authors=Ye LI, Ting YU, Ting LIU, Bo-wen LEI, Lin CHEN, Jia-yuan LI, Xia JIANG, authorsList=Ye LI, Ting YU, Ting LIU, Bo-wen LEI, Lin CHEN, Jia-yuan LI, Xia JIANG, authorCompany=null, correspAuthors=Xia JIANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324078128984891841, articleId=1324078127965675961, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=外周血炎症指标与老年人群颈动脉粥样硬化斑块的关联性研究, columnId=1228016567632462653, journalTitle=现代预防医学, columnName=流行病与统计方法, runingTitle=null, highlight=null, articleAbstract=
目的

探讨老年人群中外周血炎症指标与颈动脉粥样硬化斑块的关联。

方法

采用横断面研究方法,本研究纳入华西老年人群队列于2022年5月—2023年11月招募的符合纳入标准的6 569名研究对象。采用非条件logistic回归探索外周血炎症指标与颈动脉粥样硬化斑块的关联,并进行分层分析和交互作用分析;采用多项式logistic回归探索外周血炎症指标与颈动脉粥样硬化斑块严重程度(单发/多发)的关联。

结果

非条件logistic回归显示,白细胞计数(OR=1.06, 95% CI:1.03~1.10, P<0.001)、中性粒细胞(OR=1.06, 95% CI:1.02~1.11, P=0.002)、单核细胞(OR=2.95, 95% CI:2.02~4.32, P<0.001)和SIRI (OR=1.13, 95% CI:1.05~1.22, P<0.001)与颈动脉粥样硬化斑块形成风险有关。分层分析结果显示,血小板与老年糖尿病人群的颈动脉粥样硬化斑块形成风险有关,且存在相乘交互作用(P=0.023)。进一步多项式logistic回归发现,仅单核细胞水平可影响单发颈动脉粥样硬化斑块的形成(OR=2.14, 95% CI:1.33~3.43, P=0.002),而血小板、白细胞、中性粒细胞、单核细胞、中性粒细胞/淋巴细胞比值(neutrophil-lymphocyte ratio, NLR)、全身免疫炎症指数(systemic immune-inflammation index, SII)和全身炎症反应指数(systemic inflammatory response index, SIRI)均与多发颈动脉粥样硬化斑块形成风险有关(P<0.05)。

结论

老年人群外周血炎症指标与颈动脉粥样硬化斑块形成及严重程度关系密切,对评估颈动脉粥样硬化有一定价值。

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李叶(1990—),女,本科,中级,研究方向:医学影像

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姜侠,E-mail:
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(In Chinese), articleTitle=Correlation analysis between peripheral blood leukocyte differential count and incidence of dyslipidemia, refAbstract=null), Reference(id=1324078138745037337, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078127965675961, doi=null, pmid=null, pmcid=null, year=2024, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[24], rfOrder=27, authorNames=曹可馨, journalName=null, refType=null, unstructuredReference=曹可馨.新型炎症标志物与多囊卵巢综合征患者糖脂代谢异常的相关性研究[D].扬州:扬州大学,2024., articleTitle=新型炎症标志物与多囊卵巢综合征患者糖脂代谢异常的相关性研究, refAbstract=null), Reference(id=1324078138820534810, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078127965675961, doi=null, pmid=null, pmcid=null, year=2024, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[24], rfOrder=28, authorNames=Cao KX, journalName=null, refType=null, unstructuredReference=Cao KX. Correlation between novel inflammatory markers and disorders of glucose and lipid metabolism in patients with polycystic ovary syndrome[D]. Yangzhou: Yangzhou University, 2024. (In Chinese), articleTitle=Correlation between novel inflammatory markers and disorders of glucose and lipid metabolism in patients with polycystic ovary syndrome, refAbstract=null), Reference(id=1324078138896032283, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078127965675961, doi=null, pmid=null, pmcid=null, year=2023, volume=21, issue=11, pageStart=1845, pageEnd=1848, 1940, url=null, language=null, rfNumber=[25], rfOrder=29, authorNames=邢本远, 戴昕妤, 丁红, journalName=中华全科医学, refType=null, unstructuredReference=邢本远,戴昕妤,丁红,等.人颈动脉粥样硬化斑块炎性反应与外周血血小板、淋巴细胞计数比值及玻璃样变性的相关性研究[J].中华全科医学,2023,21(11):1845-1848, 1940., articleTitle=人颈动脉粥样硬化斑块炎性反应与外周血血小板、淋巴细胞计数比值及玻璃样变性的相关性研究, refAbstract=null), Reference(id=1324078138967335452, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078127965675961, doi=null, pmid=null, pmcid=null, year=2023, volume=21, issue=11, pageStart=1845, pageEnd=1848, 1940, url=null, language=null, rfNumber=[25], rfOrder=30, authorNames=Xing BY, Dai XY, Ding H, journalName=Chinese Journal of General Practice, refType=null, unstructuredReference=Xing BY, Dai XY, Ding H, et al. Correlation between inflammatory response and peripheral blood platelet-lymphocyte ratio and vitelliform degeneration in human carotid atherosclerotic plaques[J]. Chinese Journal of General Practice, 2023, 21(11): 1845-1848, 1940. (In Chinese), articleTitle=Correlation between inflammatory response and peripheral blood platelet-lymphocyte ratio and vitelliform degeneration in human carotid atherosclerotic plaques, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1324078129186218434, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078127965675961, xref=null, ext=[AuthorCompanyExt(id=1324078129194607043, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078127965675961, companyId=1324078129186218434, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China), AuthorCompanyExt(id=1324078129202995652, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078127965675961, companyId=1324078129186218434, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=四川大学华西公共卫生学院/华西第四医院,四川 成都 610041)])], figs=[ArticleFig(id=1324078133397299696, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078127965675961, language=EN, label=Figure 1, caption=Flowchart of study participant selection, figureFileSmall=P8Nf/0ZDZBl9X6Xwb3UCog==, figureFileBig=Z26FJa4j1TjnajI/OXPwvA==, tableContent=null), ArticleFig(id=1324078133460214257, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078127965675961, language=CN, label=图1, caption=研究对象筛选流程图, figureFileSmall=P8Nf/0ZDZBl9X6Xwb3UCog==, figureFileBig=Z26FJa4j1TjnajI/OXPwvA==, tableContent=null), ArticleFig(id=1324078133661540850, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078127965675961, language=EN, label=Figure 2, caption=Analysis of correlations among different inflammatory indicators, figureFileSmall=mZCsVVm0fcAf6uk/bSkhdw==, figureFileBig=YXeQ0t5oZImeY0wdd+wY0Q==, tableContent=null), ArticleFig(id=1324078133770592755, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078127965675961, language=CN, label=图2, caption=不同炎症指标的相关性分析, figureFileSmall=mZCsVVm0fcAf6uk/bSkhdw==, figureFileBig=YXeQ0t5oZImeY0wdd+wY0Q==, tableContent=null), ArticleFig(id=1324078133850284532, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078127965675961, language=EN, label=Figure 3, caption=Association between inflammatory indicators and carotid atherosclerotic plaque, figureFileSmall=5HDESuq1ELxPfpr2kHONJA==, figureFileBig=rakdZqum+E0wBatpfp7w4w==, tableContent=null), ArticleFig(id=1324078133938364917, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078127965675961, language=CN, label=图3, caption=炎症指标与颈动脉粥样硬化斑块的关联, figureFileSmall=5HDESuq1ELxPfpr2kHONJA==, figureFileBig=rakdZqum+E0wBatpfp7w4w==, tableContent=null), ArticleFig(id=1324078134001279478, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078127965675961, language=EN, label=Table 1, caption=

Baseline characteristics of the study participants [M(P25,P75), n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总人群(n=6 569)非斑块组(n=3 188)斑块组(n=3 381)P值
年龄 (年)69(65,73)68(65,71)70(66,74)<0.001
性别<0.001
男2 957(45.0)1 329(41.7)1 628(48.2)
女3 612(55.0)1 859(58.3)1 753(51.8)
受教育年限 (年)<0.001
02 206(33.6)715(22.4)614(18.2)
1~93 034(46.2)1 002(31.4)1 204(35.6)
≥101 329(20.2)1 471(46.1)1 563(46.2)
收入水平0.163
较低1 888(28.7)935(29.3)953(28.2)
低1 074(16.3)513(16.1)595(17.6)
中等2 499(38.0)543(17.0)531(15.7)
高1 108(16.9)1 197(37.5)1 302(38.5)
BMI(kg/m2)0.003
<18.5160(2.4)1 272(39.9)1 448(42.8)
18.5~23.92 720(41.4)63(2.0)97(2.9)
24.0~27.92 806(42.7)458(14.4)425(12.6)
≥28.0883(13.4)1 395(43.8)1 411(41.7)
吸烟<0.001
无4 888(74.4)2 443(76.6)2 445(72.3)
有1 681(25.6)745(23.4)936(27.7)
饮酒0.024
无5 638(85.8)2 768(86.8)2 870(84.9)
有931(14.2)420(13.2)511(15.1)
糖尿病<0.001
无4 929(75.0)2 497(78.3)2 432(71.9)
有1 640(25.0)691(21.7)949(28.1)
高血压<0.001
无1 692(25.8)937(29.4)755(22.3)
有4 877(74.2)2 251(70.6)2 626(77.7)
血脂异常0.033
无4 107(62.5)2 035(63.8)2 072(61.3)
有2 462(37.5)1 153(36.2)1 309(38.7)
), ArticleFig(id=1324078134076776951, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078127965675961, language=CN, label=表1, caption=

研究对象的基线特征[M(P25,P75), n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总人群(n=6 569)非斑块组(n=3 188)斑块组(n=3 381)P值
年龄 (年)69(65,73)68(65,71)70(66,74)<0.001
性别<0.001
男2 957(45.0)1 329(41.7)1 628(48.2)
女3 612(55.0)1 859(58.3)1 753(51.8)
受教育年限 (年)<0.001
02 206(33.6)715(22.4)614(18.2)
1~93 034(46.2)1 002(31.4)1 204(35.6)
≥101 329(20.2)1 471(46.1)1 563(46.2)
收入水平0.163
较低1 888(28.7)935(29.3)953(28.2)
低1 074(16.3)513(16.1)595(17.6)
中等2 499(38.0)543(17.0)531(15.7)
高1 108(16.9)1 197(37.5)1 302(38.5)
BMI(kg/m2)0.003
<18.5160(2.4)1 272(39.9)1 448(42.8)
18.5~23.92 720(41.4)63(2.0)97(2.9)
24.0~27.92 806(42.7)458(14.4)425(12.6)
≥28.0883(13.4)1 395(43.8)1 411(41.7)
吸烟<0.001
无4 888(74.4)2 443(76.6)2 445(72.3)
有1 681(25.6)745(23.4)936(27.7)
饮酒0.024
无5 638(85.8)2 768(86.8)2 870(84.9)
有931(14.2)420(13.2)511(15.1)
糖尿病<0.001
无4 929(75.0)2 497(78.3)2 432(71.9)
有1 640(25.0)691(21.7)949(28.1)
高血压<0.001
无1 692(25.8)937(29.4)755(22.3)
有4 877(74.2)2 251(70.6)2 626(77.7)
血脂异常0.033
无4 107(62.5)2 035(63.8)2 072(61.3)
有2 462(37.5)1 153(36.2)1 309(38.7)
), ArticleFig(id=1324078134148080120, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078127965675961, language=EN, label=Table 2, caption=

Unconditional logistic regression analysis of the risk for carotid atherosclerotic plaque

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2模型3AIC
OR (95%CI)P值OR (95%CI)P值OR (95%CI)P值
血小板(109/L)1.00 (1.00~1.00)0.0271.00 (1.00~1.00)0.0271.00 (1.00~1.00)0.1158 743.8
白细胞(109/L)1.08 (1.05~1.12)<0.0011.09 (1.05~1.12)<0.0011.06 (1.03~1.10)<0.0018 732.1
淋巴细胞(109/L)1.08 (0.99~1.18)0.0661.11 (1.02~1.21)0.0211.06 (0.97~1.16)0.1768 744.5
中性粒细胞(109/L)1.09 (1.05~1.13)<0.0011.09 (1.05~1.13)<0.0011.06 (1.02~1.11)0.0028 736.8
单核细胞(109/L)3.19 (2.19~4.65)<0.0013.30 (2.26~4.83)<0.0012.95 (2.02~4.32)<0.0018 714.8
NLR1.04 (1.00~1.09)0.0611.04 (0.99~1.08)0.0961.03 (0.99~1.08)0.1558 744.3
PLR1.00 (1.00~1.00)0.9191.00 (1.00~1.00)0.7991.00 (1.00~1.00)0.9688 746.3
SII1.00 (1.00~1.00)0.0361.00 (1.00~1.00)0.051.00 (1.00~1.00)0.1358 744.0
SIRI1.16 (1.07~1.25)<0.0011.15 (1.07~1.25)<0.0011.13 (1.05~1.22)0.0018 733.6
), ArticleFig(id=1324078134219383289, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078127965675961, language=CN, label=表2, caption=

颈动脉粥样硬化斑块形成风险的非条件logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1模型2模型3AIC
OR (95%CI)P值OR (95%CI)P值OR (95%CI)P值
血小板(109/L)1.00 (1.00~1.00)0.0271.00 (1.00~1.00)0.0271.00 (1.00~1.00)0.1158 743.8
白细胞(109/L)1.08 (1.05~1.12)<0.0011.09 (1.05~1.12)<0.0011.06 (1.03~1.10)<0.0018 732.1
淋巴细胞(109/L)1.08 (0.99~1.18)0.0661.11 (1.02~1.21)0.0211.06 (0.97~1.16)0.1768 744.5
中性粒细胞(109/L)1.09 (1.05~1.13)<0.0011.09 (1.05~1.13)<0.0011.06 (1.02~1.11)0.0028 736.8
单核细胞(109/L)3.19 (2.19~4.65)<0.0013.30 (2.26~4.83)<0.0012.95 (2.02~4.32)<0.0018 714.8
NLR1.04 (1.00~1.09)0.0611.04 (0.99~1.08)0.0961.03 (0.99~1.08)0.1558 744.3
PLR1.00 (1.00~1.00)0.9191.00 (1.00~1.00)0.7991.00 (1.00~1.00)0.9688 746.3
SII1.00 (1.00~1.00)0.0361.00 (1.00~1.00)0.051.00 (1.00~1.00)0.1358 744.0
SIRI1.16 (1.07~1.25)<0.0011.15 (1.07~1.25)<0.0011.13 (1.05~1.22)0.0018 733.6
), ArticleFig(id=1324078134387155450, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078127965675961, language=EN, label=Table 3, caption=

Stratified and interaction analysis of the effects of diabetes, hypertension, and dyslipidemia on carotid atherosclerotic plaque risk

, figureFileSmall=null, figureFileBig=null, tableContent=
变量糖尿病高血压血脂异常
无有无有无有
OR (95%CI)P值OR (95%CI)P值OR (95%CI)P值OR (95%CI)P值OR (95%CI)P值OR (95%CI)P值
血小板
(109/L)
1.00 (1.00~1.00)0.8481.00 (1.00~1.00)0.0061.00 (1.00~1.00)0.2911.00 (1.00~1.00)0.2231.00 (1.00~1.00)0.0871.00 (1.00~1.00)0.721
P-交互0.0230.7880.454
白细胞
(109/L)
1.06 (1.02~1.10)0.0021.08 (1.01~1.15)0.0231.05 (0.98~1.12)0.1471.07 (1.03~1.11)<0.0011.07 (1.03~1.12)<0.0011.05 (0.99~1.11)0.097
P-交互0.7030.6060.448
淋巴细胞
(109/L)
1.09 (0.99~1.22)0.0920.99 (0.84~1.17)0.9061.00 (0.83~1.19)0.9641.09 (0.98~1.20)0.1121.08 (0.96~1.21)0.191.04 (0.90~1.20)0.593
P-交互0.310.40.7
中性粒细胞
(109/L)
1.05 (1.01~1.10)0.0261.10(1.01~1.18)0.0241.06 (0.98~1.15)0.1671.07 (1.02~1.12)0.0061.08 (1.02~1.13)0.0031.04 (0.97~1.12)0.226
P-交互0.4110.8810.45
单核细胞
(109/L)
2.70 (1.76~4.16)<0.0013.90 (1.82~8.33)<0.0013.49 (1.67~7.29)0.0012.79 (1.80~4.31)<0.0013.04 (1.90~4.87)<0.0012.80 (1.52~5.17)0.001
P-交互0.4030.6010.833
NLR1.02 (0.98~1.07)0.3521.06 (0.97~1.16)0.1891.02 (0.93~1.11)0.6691.03 (0.99~1.08)0.1651.04 (0.99~1.09)0.131.01 (0.93~1.10)0.806
P-交互0.4580.7770.563
PLR1.00 (1.00~1.00)0.4511.00 (1.00~1.00)0.2041.00 (1.00~1.00)0.5711.00 (1.00~1.00)0.6911.00 (1.00~1.00)0.8731.00 (1.00~1.00)0.763
P-交互0.1370.4890.734
SII1.00 (1.00~1.00)0.4041.00 (1.00~1.00)0.1161.00 (1.00~1.00)0.3011.00 (1.00~1.00)0.2461.00 (1.00~1.00)0.1321.00 (1.00~1.00)0.716
P-交互0.3070.680.664
SIRI1.10 (1.02~1.20)0.0171.24 (1.06~1.45)0.0081.09 (0.95~1.24)0.2221.15 (1.05~1.26)0.0021.13 (1.04~1.23)0.0061.14 (0.99~1.32)0.067
P-交互0.2010.4730.895
), ArticleFig(id=1324078134475235835, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078127965675961, language=CN, label=表3, caption=

糖尿病、高血压、血脂异常和颈动脉粥样硬化斑块发生风险的分层分析与交互作用分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量糖尿病高血压血脂异常
无有无有无有
OR (95%CI)P值OR (95%CI)P值OR (95%CI)P值OR (95%CI)P值OR (95%CI)P值OR (95%CI)P值
血小板
(109/L)
1.00 (1.00~1.00)0.8481.00 (1.00~1.00)0.0061.00 (1.00~1.00)0.2911.00 (1.00~1.00)0.2231.00 (1.00~1.00)0.0871.00 (1.00~1.00)0.721
P-交互0.0230.7880.454
白细胞
(109/L)
1.06 (1.02~1.10)0.0021.08 (1.01~1.15)0.0231.05 (0.98~1.12)0.1471.07 (1.03~1.11)<0.0011.07 (1.03~1.12)<0.0011.05 (0.99~1.11)0.097
P-交互0.7030.6060.448
淋巴细胞
(109/L)
1.09 (0.99~1.22)0.0920.99 (0.84~1.17)0.9061.00 (0.83~1.19)0.9641.09 (0.98~1.20)0.1121.08 (0.96~1.21)0.191.04 (0.90~1.20)0.593
P-交互0.310.40.7
中性粒细胞
(109/L)
1.05 (1.01~1.10)0.0261.10(1.01~1.18)0.0241.06 (0.98~1.15)0.1671.07 (1.02~1.12)0.0061.08 (1.02~1.13)0.0031.04 (0.97~1.12)0.226
P-交互0.4110.8810.45
单核细胞
(109/L)
2.70 (1.76~4.16)<0.0013.90 (1.82~8.33)<0.0013.49 (1.67~7.29)0.0012.79 (1.80~4.31)<0.0013.04 (1.90~4.87)<0.0012.80 (1.52~5.17)0.001
P-交互0.4030.6010.833
NLR1.02 (0.98~1.07)0.3521.06 (0.97~1.16)0.1891.02 (0.93~1.11)0.6691.03 (0.99~1.08)0.1651.04 (0.99~1.09)0.131.01 (0.93~1.10)0.806
P-交互0.4580.7770.563
PLR1.00 (1.00~1.00)0.4511.00 (1.00~1.00)0.2041.00 (1.00~1.00)0.5711.00 (1.00~1.00)0.6911.00 (1.00~1.00)0.8731.00 (1.00~1.00)0.763
P-交互0.1370.4890.734
SII1.00 (1.00~1.00)0.4041.00 (1.00~1.00)0.1161.00 (1.00~1.00)0.3011.00 (1.00~1.00)0.2461.00 (1.00~1.00)0.1321.00 (1.00~1.00)0.716
P-交互0.3070.680.664
SIRI1.10 (1.02~1.20)0.0171.24 (1.06~1.45)0.0081.09 (0.95~1.24)0.2221.15 (1.05~1.26)0.0021.13 (1.04~1.23)0.0061.14 (0.99~1.32)0.067
P-交互0.2010.4730.895
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Logistic regression analysis of inflammatory indicators and the number of carotid atherosclerotic plaques

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变量单发颈动脉粥样硬化斑块多发颈动脉粥样硬化斑块
OR (95%CI)P值OR (95%CI)P值
血小板(109/L)1.00 (1.00~1.00)0.5041.00 (1.00~1.00)0.002
白细胞(109/L)1.03 (0.99~1.07)0.1541.09 (1.05~1.14)<0.001
淋巴细胞(109/L)1.08 (0.96~1.20)0.1911.05 (0.95~1.17)0.348
中性粒细胞(109/L)1.02 (0.97~1.07)0.5341.10 (1.05~1.16)<0.001
单核细胞(109/L)2.14 (1.33~3.43)0.0023.81 (2.46~5.92)<0.001
NLR1.00 (0.95~1.05)0.9731.06 (1.01~1.11)0.027
PLR1.00 (1.00~1.00)0.0531.00 (1.00~1.00)0.106
SII1.00 (1.00~1.00)0.5311.00 (1.00~1.00)0.007
SIRI1.09 (1.00~1.19)0.0611.17 (1.07~1.27)<0.001
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炎症指标与颈动脉粥样硬化斑块数量的logistic回归分析

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变量单发颈动脉粥样硬化斑块多发颈动脉粥样硬化斑块
OR (95%CI)P值OR (95%CI)P值
血小板(109/L)1.00 (1.00~1.00)0.5041.00 (1.00~1.00)0.002
白细胞(109/L)1.03 (0.99~1.07)0.1541.09 (1.05~1.14)<0.001
淋巴细胞(109/L)1.08 (0.96~1.20)0.1911.05 (0.95~1.17)0.348
中性粒细胞(109/L)1.02 (0.97~1.07)0.5341.10 (1.05~1.16)<0.001
单核细胞(109/L)2.14 (1.33~3.43)0.0023.81 (2.46~5.92)<0.001
NLR1.00 (0.95~1.05)0.9731.06 (1.01~1.11)0.027
PLR1.00 (1.00~1.00)0.0531.00 (1.00~1.00)0.106
SII1.00 (1.00~1.00)0.5311.00 (1.00~1.00)0.007
SIRI1.09 (1.00~1.19)0.0611.17 (1.07~1.27)<0.001
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外周血炎症指标与老年人群颈动脉粥样硬化斑块的关联性研究
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李叶 , 于婷 , 刘婷 , 雷博文 , 陈林 , 李佳圆 , 姜侠
现代预防医学 | 流行病与统计方法 2026,53(3): 435-441
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现代预防医学 |流行病与统计方法 2026 , 53 (3) : 435 -441
外周血炎症指标与老年人群颈动脉粥样硬化斑块的关联性研究
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李叶, 于婷, 刘婷, 雷博文, 陈林, 李佳圆, 姜侠
作者信息
  • 四川大学华西公共卫生学院/华西第四医院,四川 成都 610041
通讯作者:
姜侠,E-mail:
作者简介:

李叶(1990—),女,本科,中级,研究方向:医学影像

Association between peripheral blood inflammatory markers and carotid atherosclerotic plaques in an elderly population
Ye LI, Ting YU, Ting LIU, Bo-wen LEI, Lin CHEN, Jia-yuan LI, Xia JIANG
Affiliations
  • West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China
出版时间: 2026-02-10 doi: 10.20043/j.cnki.MPM.202502373
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目的

探讨老年人群中外周血炎症指标与颈动脉粥样硬化斑块的关联。

方法

采用横断面研究方法,本研究纳入华西老年人群队列于2022年5月—2023年11月招募的符合纳入标准的6 569名研究对象。采用非条件logistic回归探索外周血炎症指标与颈动脉粥样硬化斑块的关联,并进行分层分析和交互作用分析;采用多项式logistic回归探索外周血炎症指标与颈动脉粥样硬化斑块严重程度(单发/多发)的关联。

结果

非条件logistic回归显示,白细胞计数(OR=1.06, 95% CI:1.03~1.10, P<0.001)、中性粒细胞(OR=1.06, 95% CI:1.02~1.11, P=0.002)、单核细胞(OR=2.95, 95% CI:2.02~4.32, P<0.001)和SIRI (OR=1.13, 95% CI:1.05~1.22, P<0.001)与颈动脉粥样硬化斑块形成风险有关。分层分析结果显示,血小板与老年糖尿病人群的颈动脉粥样硬化斑块形成风险有关,且存在相乘交互作用(P=0.023)。进一步多项式logistic回归发现,仅单核细胞水平可影响单发颈动脉粥样硬化斑块的形成(OR=2.14, 95% CI:1.33~3.43, P=0.002),而血小板、白细胞、中性粒细胞、单核细胞、中性粒细胞/淋巴细胞比值(neutrophil-lymphocyte ratio, NLR)、全身免疫炎症指数(systemic immune-inflammation index, SII)和全身炎症反应指数(systemic inflammatory response index, SIRI)均与多发颈动脉粥样硬化斑块形成风险有关(P<0.05)。

结论

老年人群外周血炎症指标与颈动脉粥样硬化斑块形成及严重程度关系密切,对评估颈动脉粥样硬化有一定价值。

炎症  /  颈动脉粥样硬化斑块  /  横断面研究  /  Logistic回归分析
Objective

To investigate the association between peripheral blood inflammatory markers and carotid atherosclerotic plaque in an elderly population.

Methods

A cross-sectional study was conducted, including 6 569 participants from the West China Elderly Cohort who met inclusion criteria between May 2022 and November 2023. Unconditional Logistic regression was used to examine the relationship between inflammatory markers and carotid atherosclerotic plaque, with stratified and interaction analyses conducted for further insights. Multinomial Logistic regression was applied to explore the associations between inflammatory markers and the severity of carotid atherosclerotic plaques (single/multiple).

Results

Unconditional Logistic regression revealed significant associations between plaque formation risk and white blood cell count (OR=1.06, 95% CI: 1.03-1.10, P<0.001), neutrophils count (OR=1.06, 95% CI: 1.02-1.11, P=0.002), monocytes (OR=2.95, 95% CI: 2.02-4.32, P<0.001), and SIRI (OR=1.13, 95% CI: 1.05-1.22, P<0.001). Stratified analysis identified platelets as significantly associated with plaque formation in elderly individuals with diabetes, with a multiplicative interaction observed (P=0.023).Multinomial Logistic regression revealed that monocytes were specifically associated with the risk of single plaques (OR=2.14,95% CI: 1.33-3.43, P=0.002), whereas white blood cells, neutrophils, monocytes, platelets, neutrophil-lymphocyte ratio (NLR),systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI) were linked to the risk of multiple plaques (P<0.05).

Conclusion

Peripheral blood inflammatory markers are closely related to the formation and severity of carotid atherosclerotic plaques in the elderly, providing valuable insights for assessing carotid atherosclerosis risk.

Inflammation  /  Carotid atherosclerotic plaque  /  Cross-sectional study  /  Logistic regression analysis
李叶, 于婷, 刘婷, 雷博文, 陈林, 李佳圆, 姜侠. 外周血炎症指标与老年人群颈动脉粥样硬化斑块的关联性研究. 现代预防医学, 2026 , 53 (3) : 435 -441 . DOI: 10.20043/j.cnki.MPM.202502373
Ye LI, Ting YU, Ting LIU, Bo-wen LEI, Lin CHEN, Jia-yuan LI, Xia JIANG. Association between peripheral blood inflammatory markers and carotid atherosclerotic plaques in an elderly population[J]. Modern Preventive Medicine, 2026 , 53 (3) : 435 -441 . DOI: 10.20043/j.cnki.MPM.202502373
随着经济和社会的快速发展,中国正面临显著的人口老龄化进程。老年人群中,动脉粥样硬化已被确立为脑血管事件的主要病因之一,严重影响健康和生活质量。作为动脉粥样硬化的典型病理表现之一[1],颈动脉粥样硬化斑块的形成和发展与多种复杂的炎症过程密切相关[2-3]。Gasbarrino等[4]的横断面研究显示,在男性中,低白细胞计数及高单核细胞/白细胞比值与较大的斑块不稳定性存在显著关联;而在女性中,高嗜碱性粒细胞/白细胞比值不仅与斑块不稳定性相关,还与斑块内出血和血栓形成有关。同样,Erkan等人[5]的研究发现,血小板在颈动脉粥样硬化斑块破裂过程中发挥了重要作用。此外,一系列复合炎症指标如中性粒细胞/淋巴细胞比值(neutrophil-lymphocyte ratio, NLR)、血小板/淋巴细胞比值(platelet-lymphocyte ratio, PLR)、全身免疫炎症指数(systemic immune-inflammation index, SII)以及全身炎症反应指数(systemic inflammatory response index, SIRI)也被报道与颈动脉粥样硬化斑块的进展密切相关[6-9]。尽管上述研究为我们揭示了外周血炎症指标与颈动脉粥样硬化的潜在关联,但目前针对中国老年人群的相关数据仍然匮乏。此外,既往研究主要集中于斑块的存在与否,而对斑块严重程度(单发与多发)及其可能的非线性关联鲜有深入探讨。基于此,本研究依托华西老年人群队列,系统探讨外周血炎症指标与颈动脉粥样硬化斑块的关联,进一步分析这些指标对斑块严重程度的影响。通过本研究,旨在为动脉粥样硬化的预防、筛查及干预策略提供科学依据,从而减少心脑血管疾病对老年人群健康的威胁,助力健康老龄化目标的实现。
本研究人群来源于华西老年人群队列。华西老年人群队列是一项由四川大学华西公共卫生学院/华西第四医院组织开展的聚焦中国60岁及以上老年人重大慢病发病及演进规律的流行病学前瞻性队列。本研究纳入标准:(1)研究对象年龄在60岁及以上;(2)研究对象在调查地区居住满3个月及以上;(3)研究对象同意参加本队列研究。排除标准:(1)研究对象发生严重的慢性病事件(如三期高血压),或出现严重失能;(2)研究对象表达或理解能力异常;(3)暴露因素测量或协变量数据缺失者。2022年5月—2023年11月进行的基线调查期间,该队列招募了10 627名年龄在60岁以上的参与者,在排除未完成暴露测量973人,协变量缺失者3 085人,最终共纳入6 569名研究对象,见图1。所有研究对象均签署了知情同意书,本研究通过了伦理委员会的批准(审批号:HXSY-EC-2022034)。其中,非颈动脉粥样硬化斑块组3 188名(48.53%),颈动脉粥样硬化斑块组3 381名(51.47%)。
(1)问卷调查:采用统一编制的调查问卷,调查员经统一培训通过面访形式收集病例资料。进行健康体检、生活行为方式调查和神经精神问卷调查。(2)样本收集:采集血液、尿液、粪便、唾液等多种生物样本。本研究收集研究对象的空腹外周血用于炎症指标的检测,包括:血小板计数、白细胞计数、中性粒细胞计数、单核细胞计数、淋巴细胞计数、PLR、NLR、SII和SIRI。所有血样均在当天采集后采用冷链运输至项目组生物样本库,并按照统一规范的实验室标准流程进行检测。
颈动脉粥样硬化斑块由一名训练有素的超声医师使用日立超声系统(HV VISION Preirus)评估,遵循Mannheim颈动脉内膜-中膜厚度和斑块共识。
按照是否存在颈动脉粥样硬化斑块将人群分为非斑块组与斑块组,运用χ2检验或t检验对两组人群的人口统计学、生活方式和代谢特征进行均衡性检验;采用 Spearman 相关系数对不同炎症指标间的相关性进行衡量;运用非条件logistic回归分析探讨外周血炎症指标与颈动脉粥样硬化斑块的关联并计算比值比(odds ratio, OR)和95%置信区间(confidence interval, CI),并进一步按高血压、糖尿病、血脂异常进行分层分析及交互作用分析;采用限制性立方样条拟合外周血炎症指标与颈动脉粥样硬化斑块之间的非线性关联;采用多项式logistic回归探索外周血炎症指标与颈动脉粥样硬化斑块严重程度(单发/多发)的关联。以上所有统计分析均由R 4.2.2软件完成。双侧检验,检验水准α=0.05。
非颈动脉粥样硬化斑块组与颈动脉粥样硬化斑块组的基线特征如表1所示,年龄、性别、受教育年限、身体质量指数(body mass index,BMI)、吸烟、饮酒、糖尿病、高血压、血脂异常在两组人群中分布存在统计学差异(P<0.05),与非斑块组相比,有颈动脉粥样硬化斑块者更有可能是年龄较大、男性、吸烟、饮酒、高血压、糖尿病、血脂异常人群;而收入水平在两组人群的分布差异无统计学意义。
如图2所示,各项炎症指标之间均存在显著的统计学相关性,尽管其相关程度有所不同。因此,在接下来的非条件logistic回归分析和多项式logistic回归分析中,应分别对其进行独立探讨。
模型1调整年龄、性别、受教育年限、收入水平后,血小板、白细胞、中性粒细胞、单核细胞、SII、SIRI是颈动脉粥样硬化斑块形成的危险因素;进一步调整BMI、吸烟、饮酒后,模型2提示血小板、白细胞、中性粒细胞、单核细胞、SIRI是发生颈动脉粥样硬化斑块的影响因素;纳入高血压、糖尿病、血脂异常等因素后,模型3结果显示,白细胞、中性粒细胞、单核细胞及SIRI均为颈动脉粥样硬化斑块形成的独立危险因素,可显著增加其发生风险。(P<0.05),AIC分别为8 732.1、8 736.8、8 714.8、8 733.6。见表2。
分层分析结果显示,无论有无糖尿病,白细胞、中性粒细胞、单核细胞、SIRI可能增加颈动脉粥样硬化斑块发生风险;白细胞、中性粒细胞、SIRI更有可能增加高血压人群颈动脉粥样硬化斑块的发生,OR(95% CI)为1.07 (1.03~1.11)、1.07(1.02~1.12)、1.15 (1.05~1.26);白细胞、中性粒细胞、单核细胞水平以及SIRI是影响无血脂异常人群颈动脉粥样硬化斑块的危险因素,OR(95% CI)为1.07 (1.03~1.12)、1.08 (1.02~1.13)、3.04(1.90~4.87)、1.13 (1.04~1.23),交互作用结果显示,血小板与糖尿病之间存在交互作用(P=0.023)。见表3。
为探索外周血炎症指标与颈动脉粥样硬化斑块的非线性关联,本研究进一步拟合限制性立方样条回归,结果显示仅PLR与颈动脉粥样硬化斑块存在非线性关联(P=0.046)。见图3。
如表4所示,进一步多项式logistic回归发现,仅单核细胞水平可影响单发颈动脉粥样硬化斑块的形成(OR=2.14, 95% CI:1.33~3.43, P=0.002),而血小板、白细胞、中性粒细胞、单核细胞、NLR、SII和SIRI均与多发颈动脉粥样硬化斑块形成风险有关(P<0.05)。
本研究依托华西老年人群队列,通过大规模社区老年人群横断面数据对外周血炎症指标与颈动脉粥样硬化斑块的关联进探究,调整年龄、性别、受教育年限、收入水平、BMI、吸烟、饮酒 、高血压、糖尿病、血脂异常后,非条件logistic回归分析显示,白细胞、中性粒细胞、单核细胞、SIRI与颈动脉粥样硬化斑块形成风险有关。有研究发现,当血管内皮受损时,内皮下的基底膜暴露,诱发血小板聚集或血脂沉积在受损处[10],随后白细胞通过束缚、粘附、爬行和迁移等过程对“填补物”进行吞噬形成泡沫细胞,最终形成了斑块[11]。此外,中性粒细胞通过释放髓过氧化物酶、NADPH氧化酶及脂肪氧化酶等活性物质,生成中性粒细胞胞外陷阱,诱导单核细胞向斑块处聚集,导致血管内皮细胞的功能障碍,同时触发氧化应激反应[12],这一连串过程不仅削弱了内皮细胞的屏障功能,还促进了炎症细胞与那些促进动脉粥样硬化的脂蛋白之间的相互作用[13]。这种相互作用为动脉粥样硬化血栓的形成创造了有利条件,从而加速了这一病理过程的发展。Liao等人[14]通过回顾性病例对照研究对10 015例患者队列中新型炎症标志物与颈动脉粥样硬化之间的关系进行探究,发现较高水平的SIRI与颈动脉粥样硬化显著相关,这与我们的研究结果一致。
在我们的研究中,分层分析结果显示,白细胞、中性粒细胞、SIRI更有可能增加高血压人群颈动脉粥样硬化斑块的发生。有研究发现,单核细胞和核苷酸结合寡聚结构域样受体蛋白3炎性小体可协调脂质驱动的血管炎症扩增,促进纤维帽的破坏,增加高血压患者颈动脉粥样硬化斑块的发生风险[15];Umesh等人[16]研究显示,中性粒细胞可释放大量生物活性物质,如花生四烯酸代谢物、血小板加重因子、细胞毒性氧源性自由基、髓过氧化物酶、弹性酶和酸性磷酸酶,这些生物活性物质可能与高血压人群体内的较高水平的CRP、TNF、CAM等炎性因子共同介导血管的炎性反应[17],导致斑块逐渐演变并增加其不稳定性[18]。研究表明,在血脂异常等病理状态下,脂肪细胞的功能会受到损害,进而引发胰岛素抵抗,这种损害一方面会导致肝脏内脂质合成增多而脂质清除减少,从而使得血液中甘油三酯水平上升,另一方面高密度脂蛋白胆固醇水平下降,导致血管黏附分子和胞间黏附分子异常增生,吸引外周血白细胞聚集,并使得新生单核细胞和淋巴细胞等细胞数量增多,加剧炎症反应,最终促使老年颈动脉粥样斑块患者颈动脉粥样硬化斑块的形成[19-23]。这与我们的研究结果不同,具体的机制有待进一步研究。此外,本研究发现,血小板与糖尿病之间存在交互作用,这可能与血小板可以增加对血管壁的黏附作用,而糖尿病患者体内的脂代谢异常,与血小板相互作用,共同促进了炎症与血栓形成,导致斑块的发生有关[24]。
一项横断面研究显示[3],PLR与≥2个股骨斑块的风险和狭窄发生率之间存在显著的线性剂量反应关系,然而其与颈动脉粥样硬化斑块严重程度的关系以及是否存在非线性关联却尚未可知。本研究发现,PLR与颈动脉粥样硬化斑块具有非线性关系,随着PLR的增加,颈动脉粥样硬化斑块发生风险呈上升趋势,这可能与活化的血小板促进基质蛋白酶的分泌,同时淋巴细胞分泌白细胞介素10,抑制单核细胞迁移从而共同发挥作用有关[25]。
综上所述,外周血多种炎症指标与颈动脉粥样硬化斑块形成风险有关,其中,白细胞、中性粒细胞、SIRI更有可能增加高血压人群颈动脉粥样硬化斑块的发生,PLR与颈动脉粥样硬化斑块的发生之间具有非线性关系。本研究不足之处,一是横断面研究,无法进行因果推断;二是,超声成像的评估依赖于医生的判断,因此可能存在错分偏倚。此外,本研究未完成暴露测量和协变量缺失的参与者比例较高,可能产生潜在的选择偏倚,因此仍需要进一步开展大样本队列研究及多中心研究对结果加以验证。

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2026年第53卷第3期
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doi: 10.20043/j.cnki.MPM.202502373
  • 接收时间:2025-02-21
  • 首发时间:2026-11-02
  • 出版时间:2026-02-10
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    四川大学华西公共卫生学院/华西第四医院,四川 成都 610041

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小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
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