Sex-specific differences in the effect of lymphocyte-to-C-reactive protein ratio on subclinical myocardial injury in the general population free from cardiovascular disease

Abstract

Background and aimThe Lymphocyte-to-C-reactive protein ratio (LCR) combines information on immune and inflammatory status. Lymphocytes reflect immune health, while C-reactive protein (CRP) signals systemic inflammation. Some studies have linked LCR with cardiovascular outcomes, suggesting it could help identify at-risk individuals. However, its clinical utility needs further research validation. To investigate the association between lymphocyte-to-C-reactive protein ratio (LCR) and subclinical myocardial injury (SC-MI) in individuals who are free from cardiovascular disease (CVD) within the general population. Methods and resultsThe study included individuals in the National Health and Nutrition Examination Survey (NHANES) III. SC-MI was defined as having a Cardiac Infarction Injury Score (CIIS) greater than 10 units on a 12-lead electrocardiogram. Logistic regression models were employed to investigate the association between LCR and SC-MI. In total, 5870 individuals were included in the study, among whom 3266 had a history of SC-MI. Compared with the lowest quartile (Q1) in male, the odds ratios (OR) of SC-MI in Q2, Q3, and Q4 were 0.67 (95%CI: 0.53–0.86), 0.66 (95%CI: 0.51–0.84), and 0.70 (95%CI: 0.55–0.89), respectively. The data shows a trend where the OR of SC-MI are lower in higher quartiles of LCR, compared to the lowest quartile, in the male population (P for trend = 0.006). In other words, the likelihood of SC-MI tends to be lower among males with higher LCR values. However, after adjusting for potential confounding variables, the relationship between LCR and SC-MI displays a pattern of an initial decline, followed by a minor upward shift. ConclusionLCR is independently and inversely associated with SC-MI risk in the general population free from CVD. Furthermore, the observed association is exclusive to males, indicating a need for further randomized controlled trials to substantiate the efficacy of implementing LCR reduction as a means of CVD prevention in the male population.