Abstract
BACKGROUND: Lowering lipid variability may be a potential strategy for improving the inflammatory state in patients with coronary heart disease (CHD). This study investigated the association between the variability of non-high-density lipoprotein cholesterol (non-HDL-C) and the neutrophil-to-lymphocyte ratio (NLR). METHODS: This study enrolled 2,711 CHD patients subjected to percutaneous coronary intervention (PCI). During the 1-year follow-up period after PCI, the variability of non-HDL-C was assessed using standard deviation (SD), coefficient of variation (CV), and variability independent of mean (VIM). NLR was calculated as the ratio of absolute neutrophil count to absolute lymphocyte count. The relationship between the non-HDL-C variability and the average NLR level during follow-ups was examined using a linear regression analysis. RESULTS: The mean age of the patients was 64.4 ± 10.8 years, with 72.4% being male. The average NLR level was 2.98 (2.26-4.14) during the follow-up (1 year after PCI). The variability of non-HDL-C was 0.42 (0.26-0.67) for SD, 0.17 (0.11-0.25) for CV, and 0.02 (0.01-0.03) for VIM. A locally weighted scatterplot smoothing curve indicates that the average levels of NLR increased with increasing variability of non-HDL-C. Regardless of the variability assessment method used, non-HDL-C variability was significantly positively associated with the average NLR level during follow-ups: SD [β (95% CI) = 0.681 (0.366-0.996)], CV [β (95% CI) = 2.328 (1.458-3.197)], and VIM [β (95% CI) = 17.124 (10.532-23.715)]. This association remained consistent across subgroups stratified by age, gender, diabetes, and hypertension. CONCLUSION: The variability of non-HDL-C was positively associated with NLR in patients with CHD, suggesting that reducing non-HDL-C variability may improve the low-grade inflammatory state in CHD patients.