The Association Between Neutrophil-to-Lymphocyte Ratio, Atherogenic Index of Plasma, and Cardiovascular Disease

Hongxin Cheng1,2, Wen Zhong1,2, Hanbin Li1,2

  • 1Department of Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Mediators of Inflammation
|September 2, 2025
PubMed

Insights

Higher levels of neutrophil-to-lymphocyte ratio (NLR) and atherogenic index of plasma (AIP) are linked to cardiovascular disease (CVD). Combining NLR and AIP offers better prediction of CVD incidence, suggesting combined monitoring for prevention.

Area of Science:

  • Cardiovascular Medicine
  • Inflammation Biomarkers
  • Lipid Metabolism

Background:

  • Cardiovascular disease (CVD) incidence is rising globally.
  • Inflammatory markers like neutrophil-to-lymphocyte ratio (NLR) and lipid indices such as atherogenic index of plasma (AIP) are implicated in CVD.
  • Understanding the distinct and combined roles of NLR and AIP in CVD is crucial.

Purpose of the Study:

  • To investigate the independent and combined associations of NLR and AIP with the incidence of CVD.
  • To evaluate the predictive efficacy of NLR and AIP, individually and in combination, for CVD.

Main Methods:

  • Utilized data from 13,184 individuals, employing complex survey designs and sample weights.
  • Neutrophil-to-lymphocyte ratio (NLR) calculated from peripheral blood counts.
  • Atherogenic index of plasma (AIP) calculated using log-transformed triglyceride and HDL-C levels.

Main Results:

  • Both elevated NLR and AIP were independently associated with increased CVD risk.
  • The highest quartile of AIP and NLR showed significantly higher odds ratios for CVD compared to the lowest quartile.
  • The combination of high NLR and AIP demonstrated a synergistic effect, with a higher odds ratio for CVD and improved predictive accuracy (AUC: 0.629).

Conclusions:

  • This study suggests a combined impact of NLR and AIP on CVD development.
  • Monitoring and managing both NLR and AIP levels may offer clinical benefits for CVD prevention strategies.

Related Concept Videos

Inflammation01:38

Inflammation

Overview
Blood Studies for Cardiovascular System I: Cardiac Biomarkers01:20

Blood Studies for Cardiovascular System I: Cardiac Biomarkers

Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers01:19

Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers

Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
Blood Studies for Cardiovascular System III: Serum Lipid Profile01:25

Blood Studies for Cardiovascular System III: Serum Lipid Profile

Understanding serum lipids is crucial for maintaining cardiovascular health and preventing heart disease and stroke.
Serum lipids are fats and fatty substances in the blood and are crucial for various bodily functions, including energy storage, cellular structure, and hormone production. Serum lipids consist of cholesterol, triglycerides, and phospholipids.
Cholesterol is a soft, fat-like substance found in all body cells. It is crucial for producing hormones, vitamin D, and substances that aid...
Coronary Artery Disease I: Introduction01:30

Coronary Artery Disease I: Introduction

Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
Psychoneuroimmunology: Cardiovascular Disease01:27

Psychoneuroimmunology: Cardiovascular Disease

Psychoneuroimmunology (PNI) is a multidisciplinary field that examines how psychological factors, particularly stress, interact with the immune system and impact physical health. Research in PNI has shown that chronic or traumatic stress can disrupt both the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system. These disruptions contribute to serious health conditions, including cardiovascular diseases.
A key area of focus in PNI is the relationship between stress and coronary...