ABSTRACT
Objective To explore how neutrophil-lymphocyte ratio (NLR) is related with inflammation and atherosclerosis,and the role of NLR in hospitalization in maintenance hemodialysis (MHD) patients.Methods MHD patients treated in hemodialysis center of Sichuan Provincial People's Hospital from June till November 2013 were enrolled.Patients with severe infection,cardiovascular events and malignant carcinoma were excluded.NLR was determined from complete blood count differential.Clinical parameters such as serum albumin,lipids,intact parathormone,ferritin,C-reactive protein (CRP),25-(OH) vitamin D,interleukin-6 (IL-6) and alkaline phosphatase (ALP) were collected.Pulse wave velocity (PWV) and ankle-brachial index (ABI) were used to evaluate the arterial stiffness.Spearman analysis was used to evaluate the relationship between NLR and these parameters.All patients were divided into low NLR group (NLR≤3.25) and high NLR group (NLR ＞3.25) on the median NLR,and their differences in these indexes were analyzed.During the one-year follow-up,the reasons and rates of hospitalization and survival were analyzed.Results One hundred and thirteen MHD patients including 58 males and 55 females were enrolled with (69±49) dialysis age and (54± 15) average age.(1) The NLR was significantly correlated with whole blood count (WBC,r=0.538,P＜ 0.001),ABIL (r=0.201,P=0.033),ABIR (r=0.235,P=0.012) and total cholesterol (TC,r=-0.414,P＜ 0.001) and low-density lipoprotein cholesterol (LDL-C,r=-0.378,P ＜ 0.001).(2) Low NLR patients had increased TC,LDL-C and IL-6 as compare with high NLR patients,however decreased ABIL and ABIR (all P ＜ 0.05).(3) Forty one patients were hospitalized 63 times during the follow-up period.Annual hospitalization rate was 558/1000 and the mortality rate was 17.7/1000.(4)NLR in patients at least hospitalized once a year was significantly lower than in patients without hospitalization,while ALP was higher (all P ＜ 0.05).Compared with those in other patients,NLR and hemoglobin (Hb) were significantly lower in patients with hospitalization due to infection,while ALP was higher (all P ＜ 0.05).Conclusions NLR is related with WBC,ABI,TC and LDL-C in MHDpatients.Lower NLR may indicate high risk for cardiovascular,atherosclerosis and hospitalization,probably different form non-MHD patients,which needs more studies to verify.
ABSTRACT
Objective To explore the role of liver X receptor (LXR) agonist T0901317 on thrombomodulin (TM) expression in human glomerular endothelial cells and the possible mechanisms.Methods Different concentrations of T0901317 were used to stimulate human glomerular endothelial cells for different time,then LXRα,LXRβ expression were detected by using Western blotting analysis;the roles of T0901317 on TM mRNA and TM protein expression were observed by using real-time PCR,Western blotting and immunofluorescence assay.LXRα,LXRβ gene interference segment Si-hLXRα,Si -hLXRβ were transfected into human glomerular endothelial cells with the concentration of 100 nmol/L respectively,then the roles of Si-hLXRα,Si-hLXRβ on the TM protein and TM mRNA expression were assayed by Western blotting and real time PCR.Results Human glomerular endothelial cells expressed LXRα and LXRβ.Compared to the normal cells and DMSO group,T0901317 could significantly promote TM expression in human glomerular endothelial cells (P ＜ 0.05) and showed a time -and dose-dependent manner.TM expression in Si-hLXRα transfected group was significantly lower than that in the control group (P ＜ 0.05),while TM expression in Si-hLXRβ transfected group had no significant difference compared to the control group.Conclusions Human glomerular endothelial cells express LXRα and LXRβ.LXR agonist T0901317 promotes TM expression in human glomerular endothelial cells,which may be mainly through activating LXRa.