解放军医学杂志2025，Vol.50Issue(12)：1508-1516,9.DOI:10.11855/j.issn.0577-7402.0494.2025.0730
全血细胞计数衍生炎性指标与年龄相关性黄斑变性的关系:一项基于NHANES数据库的横断面研究
Association between derived inflammatory indicators from complete blood count and age-related macular degeneration:a cross-sectional study based on NHANES database
摘要
Abstract
Objective To analyze the correlation between inflammatory indicators derived from complete blood count(CBC)and age-related macular degeneration(AMD)in the elderly population.Methods Clinical data were extracted from the National Health and Nutrition Examination Survey(NHANES)database,including 197 AMD patients and 956 non-AMD from the 2005-2006 and 2007-2008.Propensity score matching(PSM)was applied to match the baseline data of the two groups,and unmatched subjects were excluded.Relevant covariates were collated,and 6 CBC-derived inflammatory indicators were calculated,including neutrophil-to-lymphocyte ratio(NLR),derived neutrophil-to-lymphocyte ratio(dNLR),monocyte-to-lymphocyte ratio(MLR),neutrophil-and-monocyte-to-lymphocyte ratio(NMLR),systemic inflammatory response index(SIRI),and systemic immune inflammation index(SII).Extreme gradient boosting-Shapley Additive Explanations(XGBoost-SHAP)and multiple logistic regression models were performed to evaluate the correlation between CBC-derived inflammatory indicators and AMD.Sensitivity analysis was conducted to verify the robustness of the results,and restricted cubic spline(RCS)was utilized to test whether there was a nonlinear correlation between them.Results After PSM matching,197 AMD patients and 197 non-AMD patients were included,with no significant differences in age,race,marital status,hypertension,diabetes,or coronary heart disease between the two groups(P>0.05).Compared with non-AMD group,AMD group exhibited higher NLR,MLR,NMLR,SIRI,and SII(P<0.05).XGBoost-SHAP analysis was performed to calculate the average|SHAP|value of all indicators affecting AMD,identifying SII(0.0269),NLR(0.0140),and MLR(0.0138)as the most influential indicators.In multivariate logistic regression analysis,after adjusting for relevant covariates,the results of continuous variables showed that MLR(OR=16.721,95%CI 3.450-93.628),NLR(OR=1.205,95%CI 1.022-1.437),NMLR(OR=1.217,95%CI 1.042-1.439),SIRI(OR=1.432,95%CI 1.136-1.858),and SII(OR=1.001,95%CI 1.000-1.001)were positively correlated with AMD(P<0.05).The results of categorical variables indicated that only MLR(OR=2.543,95%CI 1.318-4.973)and SII(OR=1.694,95%CI 0.925-3.127)were positively correlated with AMD(P<0.05),and the overall trend showed a stable and significant correlation(Ptrend<0.05).Sensitivity analysis supported the positive correlation between MLR,SII,and AMD.The results of RCS test indicated a nonlinear positive correlation between NLR,MLR,NMLR,SIRI,SII and AMD(Pnonlinear<0.05).Conclusion With limits,the occurrence risk of AMD could increase by the rise of CBC-derived inflammatory indicators MLR and SII.关键词
全血细胞计数衍生炎性指标/年龄相关性黄斑变性/相关性/NHANES/横断面研究Key words
inflammatory indicators derived from complete blood count/age-related macular degeneration/correlation/NHANES/cross-sectional study分类
医药卫生引用本文复制引用
Shi Sui-Sui,Shi Xin-Yu,Zhang Hai-Peng,Feng Hui-Zi,Wu Yang,Yang Lei..全血细胞计数衍生炎性指标与年龄相关性黄斑变性的关系:一项基于NHANES数据库的横断面研究[J].解放军医学杂志,2025,50(12):1508-1516,9.基金项目
This work was supported by Xinjiang Uygur Autonomous Region 2+5 Key Talent Plan Project-Third Batch of"Tianchi Talents"Introduction Plan(BT-2025-TCYC-0131) 新疆维吾尔自治区2+5重点人才计划项目—第三批"天池英才"引进计划(BT-2025-TCYC-0131) （BT-2025-TCYC-0131）
