Background: The neutrophil-to-lymphocyte ratio (NLR) has been linked as a marker of systemic inflammation to adverse outcomes in various metabolic diseases. However, the association of the NLR with mortality risk among patients with hyperlipidemia remains inconclusive. Thus, this research aimed to investigate whether the NLR is associated with mortality risk among individuals with hyperlipidemia and to examine how glycemic status influences this relationship. Methods: Weighted Cox regression, restricted cubic splines (RCS), and subgroup analyses were employed to evaluate the association between the NLR and mortality risk in patients with hyperlipidemia. Time-dependent receiver operating characteristic (ROC) analysis was conducted to assess the predictive accuracy for mortality risk. Results: In Model 3, individuals in the highest NLR quartile had a 40% higher risk of all-cause mortality (95% confidence interval (CI): 1.19–1.65; p for trend <0.001) and an 86% higher risk of cardiovascular mortality (95% CI: 1.28–2.68; p for trend <0.001) compared with those in the lowest quartile. Time-dependent ROC analysis confirmed the superior performance of the NLR in predicting cardiovascular mortality risk. A significant interaction between the NLR and diabetes mellitus (DM) was observed for both all-cause and cardiovascular mortality in the subgroup analyses. Given this finding, we further examined the association between the NLR and mortality, stratified by glycemic status. The results indicated that the association between the NLR and mortality was stronger among individuals with DM. Conclusions: An elevated NLR is closely associated with an increased risk of mortality among individuals with hyperlipidemia, and the presence of DM significantly strengthens this association.
Zhou et al. (Mon,) studied this question.