Background and Aims Several studies have supported the role of innate immune system as a key factor in the sterile inflammation underlying the pathophysiology of atherosclerosis in mice. However, its involvement in humans remains unclear. This study aimed to explore the association between neutrophil count, and the intima-media thickness of common carotid arteries (IMT-CC), as well as the potential impact of long-term dietary interventions on these associations. Methods A comprehensive analysis was conducted within the framework of the CORDIOPREV study, a long-term secondary prevention study involving dietary interventions with either a Mediterranean or a low-fat diet. The study evaluated the relationship between absolute neutrophil count and neutrophil-related ratios with IMT-CC at baseline and after 5 and 7 years of dietary intervention. Results At baseline, patients in the highest tertile of neutrophil count had a higher IMT-CC and number of carotid plaques, when compared to lowest tertile (P < .01 and P < .05, respectively). Logistic regression analyses supported this association. Elevated neutrophil count, neutrophil-to-erythrocyte ratio, and neutrophil-to-HDL ratio were associated with an increased likelihood of having an IMT-CC >.9 mm {odds ratio (OR) 1.17 [95% confidence interval (CI) 1.04–1.35], OR 2.21 (95% CI 1.24–4.12), and OR 1.96 (95% CI 1.09–3.55), respectively}, after adjustment for all variables, which was corroborated by linear regression. Furthermore, a linear mixed-effect model analysis from a longitudinal analysis spanning 5 and 7 years revealed an increase in 1 unit of neutrophils/μl at these time points was associated with a mean increase of .004 (.002) mm in the IMT-CC (P = .031) after adjustment for all variables. Interestingly, in patients exhibiting regression in IMT-CC after 7 years of follow-up, those following a Mediterranean diet showed a significant decrease in neutrophil count after 5 and 7 years (both with P < .05), compared to baseline. Conclusions These findings suggest that neutrophils may represent a promising target for preventing atherosclerosis. A Mediterranean diet could serve as an effective dietary strategy to reduce neutrophil levels and potentially slow the progression of atherosclerosis, offering a new neutrophil-reducing therapy concept. Further research is essential to gain deeper insights into the role of neutrophils in the pathophysiology of atherosclerotic cardiovascular disease in humans.

中文翻译：

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地中海饮食、中性粒细胞计数和颈动脉内膜中层厚度在二级预防中的研究：CORDIOPREV 研究


背景和目标 几项研究支持先天免疫系统是小鼠动脉粥样硬化病理生理学基础无菌炎症的关键因素。然而，它与人类的关系仍不清楚。本研究旨在探讨中性粒细胞计数与颈总动脉内膜中层厚度 （IMT-CC） 之间的关联，以及长期饮食干预对这些关联的潜在影响。方法 在 CORDIOPREV 研究的框架内进行了全面分析，这是一项长期的二级预防研究，涉及地中海或低脂饮食的饮食干预。该研究评估了基线时以及饮食干预 5 年和 7 年后中性粒细胞绝对计数和中性粒细胞相关比率与 IMT-CC 之间的关系。结果 在基线时，与最低三分位数相比，中性粒细胞计数最高三分位数的患者具有更高的 IMT-CC 和颈动脉斑块数量 （分别为 P < .01 和 P < .05）。Logistic 回归分析支持这种关联。中性粒细胞计数、中性粒细胞与红细胞比值和中性粒细胞与 HDL 比值升高与 IMT-CC >.9 mm 的可能性增加相关{比值比 （OR） 1.17 [95% 置信区间 （CI） 1.04-1.35]，OR 2.21 （95% CI 1.24-4.12），和 OR 1.96 （95% CI 1.09-3.55），在调整所有变量后，这通过线性回归证实。此外，来自跨越 5 年和 7 年的纵向分析的线性混合效应模型分析显示，在这些时间点增加 1 个单位的中性粒细胞/μl 与 IMT-CC 中平均增加 0.004 （.002） mm 相关 （P = .031） 调整所有变量后。 有趣的是，在随访 7 年后 IMT-CC 出现消退的患者中，与基线相比，遵循地中海饮食的患者在 5 年和 7 年后显示中性粒细胞计数显着降低 （均具有 P < .05）。结论 这些发现表明，中性粒细胞可能是预防动脉粥样硬化的一个有前途的靶点。地中海饮食可以作为一种有效的饮食策略，以降低中性粒细胞水平并可能减缓动脉粥样硬化的进展，从而提供一种新的中性粒细胞减少疗法概念。进一步的研究对于更深入地了解中性粒细胞在人类动脉粥样硬化性心血管疾病病理生理学中的作用至关重要。