The roles of total cholesterol, the neutrophil-to- high-density-lipoprotein ratio and the lymphocyte-to-high-density-lipoprotein ratio in the diagnosis and progression of Parkinson's disease

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Abstract Background Parkinson’s disease (PD), is the second most prevalent neurodegenerative disease after Alzheimer’s disease. Inflammation, immunity dysregulation and other pathological processes play pivotal roles in the pathogenesis and progression of PD. Nevertheless, the role of peripheral inflammatory markers in diagnosing and monitoring the progression of PD remains to be fully elucidated. Patients and Methods 192 patients with PD were selected, and sex- and age-matched healthy individuals (n = 190) were included in the control group. Then, the persons’ basic information was collected, such as gender, age, smoking, blood lipids, and so on. Then, the neutrophil-to-high-density-lipoprotein ratio (NHR) and the lymphocyte -to-high-density-lipoprotein ratio (LHR), etc. were calculated. Then, the indicators were contrasted in the two groups, and, univariate and multivariate logistic regression were conducted. Pearson and Spearman correlation analyses were utilized to determine the correlation between total cholesterol (TC), the NHR, the LHR, the neutrophil-to-lymphocyte ratio (NLR), the lymphocyte-to-monocyte ratio (LMR), and the progression of PD. The nomogram was drawn using R language. Results TC, triglyceride (TG), neutrophils, monocytes, lymphocytes, serum albumin, the high-to-low-density-lipoprotein ratio (HLR), the monocyte-to-high-density-lipoprotein ratio (MHR), the NHR and the LHR in the PD group were significantly different from those in the control group (p  0.05). Univariate and multivariate logistic regression analyses showed that TC, the LHR, and the NHR were independent influencing factors for PD. Pearson and Spearman correlation analyses indicated a negative correlation between TC, the NHR, the LHR and the UPDRS scores in patients with PD. And it showed a negative correlation between the LHR and the Hoehn and Yahr (H&Y) staging system. Moreover, it showed significant correlations between the LHR, the NLR, the LMR, and the duration of patients with PD. Furthermore, an accuracy model of the nomogram was structured for the indicators of PD, which showed adequately sensitivity and specificity using receiver operating characteristic (ROC) curve to evaluate the diagnostic performance of TC, the LHR, and the NHR for PD. Conclusions The findings indicate that lower levels of TC, the NHR, and the LHR may be relevant for diagnosing and assessing the progression of PD, and they appear to be candidate biomarkers for PD.

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