Comparison of the Value of Neutrophil to High-Density Lipoprotein Cholesterol Ratio and Lymphocyte to High-Density Lipoprotein Cholesterol Ratio for Predicting Metabolic Syndrome Among a Population in the Southern Coast of China

Figures & data

Table 1 Basic Characteristics of the Study Subjects

Parameter	Men (n=483)			Women (n=918)
	MetS(−) (n=343)	MetS(+) (n=140)	p	MetS(−) (n=641)	MetS(+) (n=277)	p
Age (years)	54.8±13.5	57.2±10.5	0.057	52.6 ±12.7	60.7±10.0	<0.001
Education (high school or above), n (%)	162 (47.2)	68 (48.6)	0.79	238 (37.1)	60 (21.7)	<0.001
History of hypertension, n (%)	84 (24.5)	56 (40.0)	<0.001	104 (16.2)	128 (46.2)	<0.001
History of diabetes, n (%)	12 (3.5)	25 (17.9)	<0.001	17 (2.7)	54 (19.5)	<0.001
Physical activity, n (%)	216 (63.0)	92 (65.7)	0.57	392 (61.2)	184 (66.4)	0.13
Current smoking, n (%)	114 (33.2)	46 (32.9)	0.94	5 (0.8)	3 (1.1)	0.65
Current alcohol use, n (%)	167 (48.7)	66 (47.1)	0.76	77 (12.0)	25 (9.0)	0.19
Waist circumference (cm)	85.45±8.40	97.38±6.22	<0.001	79.58±8.46	89.77±6.88	<0.001
Systolic blood pressure (mmHg)	133.33±17.91	140.88±14.29	<0.001	128.22±18.64	144.73±18.47	<0.001
Diastolic blood pressure (mmHg)	83.71±10.47	89.16±9.04	<0.001	79.38±9.89	85.52±9.15	<0.001
Red blood cell count (10^12/L)	5.12±0.62	5.20±0.43	0.20	4.64±0.48	4.78±0.53	<0.001
Hemoglobin (g/L)	150.70±13.76	155.32±9.47	<0.001	133.65±11.15	137.21±11.54	<0.001
Platelet count, (10^9/L)	242 (209–274)	246 (218–289)	0.21	261 (223–302)	268 (238–311)	0.023
White blood cell count (10^9/L)	6.87±1.59	7.24±1.66	0.019	6.10±1.53	6.69±1.67	<0.001
Neutrophil count (10^9/L)	3.45 (2.81–4.22)	3.66 (3.05–4.61)	0.015	4.64±0.48	4.78±0.53	<0.001
Lymphocyte count (10^9/L)	2.33 (1.94–2.77)	2.41 (2.03–2.95)	0.20	2.14 (1.77–2.58)	2.34 (1.99–2.85)	<0.001
Monocyte count (10^9/L)	0.53 (0.42–0.67)	0.56 (0.46–0.72)	0.011	0.43 (0.34–0.53)	0.46 (0.36–0.54)	0.048
Total cholesterol (mmol/L)	5.25±0.93	5.51±1.10	0.008	5.50±1.07	5.80±1.18	<0.001
HDL-C (mmol/L)	1.41±0.31	1.20±0.25	<0.001	1.69±0.31	1.37±0.30	<0.001
LDL-C (mmol/L)	3.17±0.84	3.19±0.94	0.80	3.19 (2.64–3.80)	3.40 (2.61–4.11)	0.12
Triglyceride(mmol/L)	1.26 (0.92–1.63)	2.10 (1.70–2.65)	<0.001	1.10 (0.85–1.39)	2.02 (1.61–2.70)	<0.001
Fasting plasma glucose (mmol/L)	4.86 (4.60–5.20)	5.58 (4.97–6.30)	<0.001	4.86 (4.57–5.19)	5.63 (4.99–6.36)	<0.001
Hypersensitive C-reactive protein (mmol/L)	1.24 (0.54–2.44)	1.87 (1.24–3.03)	<0.001	1.08 (0.00–1.93)	1.99 (1.23, 3.41)	<0.001
Serum creatinine (μmol/L)	89.86±11.37	88.35±11.36	0.184	66.43±8.71	67.15±8.40	0.247

Table 2 Correlation Analysis Between Metabolic Syndrome Severity and LHR/NHR

Variable	Male		Female
	R	p	R	p
Red blood cell count	0.112	<0.05	0.155	<0.001
Hemoglobin	0.179	<0.001	0.146	<0.001
White blood cell count	0.109	<0.05	0.172	<0.001
Neutrophil count	0.111	<0.05	0.130	<0.001
Lymphocyte count	0.0578	0.205	0.174	<0.001
Mononuclear count	0.116	<0.05	0.065	<0.05
Lymphocyte to HDL-C ratio	0.245	<0.001	0.401	<0.001
Neutrophil to HDL-C ratio	0.260	<0.001	0.325	<0.001
hs-CRP	0.207	<0.001	0.297	<0.001

Abbreviation: hs-CRP, hypersensitive C-reactive protein.

Table 3 Binomial Logistic Regression Analysis Showing Independent Predictors of Metabolic Syndrome in Females

Variable	Model 1		Model 2		Model 3
	OR (95% CI)	p	OR (95% CI)	p	OR (95% CI)	p
LHR	3.877 (2.779–5.408)	<0.001	3.930 (2.767–5.583)	<0.001	3.671 (2.385–5.651)	<0.001
NHR	1.379 (1.145–1.660)	0.001	1.726 (1.403–2.125)	<0.001	1.728 (1.353–2.207)	<0.001
hs-CRP	1.021 (0.989–1.054)	0.191	1.004 (0.969–1.041)	0.826	–	–

Notes: Model 1 not adjusted; Model 2 adjusted for age, history, activity, smoking, drinking, waist circumference, systolic pressure, and diastolic pressure; Model 3 adjusted for Model 2 and fasting blood glucose.

Abbreviations: LHR, lymphocyte to high-density lipoprotein ratio; NHR, neutrophil to high-density lipoprotein ratio; hs-CRP, hypersensitive C-reactive protein.

Table 4 Binomial Logistic Regression Analysis Showing Independent Predictors of Metabolic Syndrome in Males

Variable	Model 1		Model 2		Model 3
	OR (95% CI)	p	OR (95% CI)	p	OR (95% CI)	p
LHR	1.458 (1.049–2.027)	0.025	1.571 (1.001–2.468)	0.05	1.406 (0.886–2.231)	0.148
NHR	1.360 (1.110–1.665)	0.003	1.163 (0.909–1.488)	0.003	1.147 (0.894–1.470)	0.281
hs-CRP	1.012 (0.987–1.038)	0.361	–	–	–	–

Notes: Model 1 not adjusted; Model 2 adjusted for age, history, activity, smoking, drinking, waist circumference, systolic pressure, and diastolic pressure; Model 3 adjusted for Model 2 and fasting blood glucose.

Abbreviations: LHR, lymphocyte to high-density lipoprotein ratio; NHR, neutrophil to high-density lipoprotein ratio; hs-CRP, hypersensitive C-reactive protein.

Table 5 Areas Under the ROC Curve (AUC), Sensitivity and Specificity by the Optimized Cutoff Points for LHR and NHR in Predicting Metabolic Syndrome

Risk Factor	AUC (95% CI)	Cutoff According to Youden’s Index	Sensitivity (%)	Specificity (%)
Males (n=483)
LHR	0.656 (0.603–0.710)	1.96	58.6	67.1
NHR	0.665 (0.613–0.718)	3.38	50.0	73.6
Females (n=918)
LHR	0.752 (0.719–0.785)	1.36	80.9	56.5
NHR	0.704 (0.667–0.741)	2.31	59.9	71.8

Abbreviations: LHR, lymphocyte to high-density lipoprotein ratio; NHR, neutrophil to high-density lipoprotein ratio.

Figure 1 ROC curve analysis of the value of lymphocyte to high-density lipoprotein ratio (LHR), and neutrophil to high-density lipoprotein ratio (NHR) for predicting metabolic syndrome in females.

Figure 2 ROC curve analysis of the value of lymphocyte to high-density lipoprotein ratio (LHR), and neutrophil to high-density lipoprotein ratio (NHR) for predicting metabolic syndrome in males.