101
|
Otal Y, Avcıoglu G, Haydar FG. A new biomarker in severe pneumonia associated with coronavirus disease 2019: hypoalbuminemia. A prospective study. SAO PAULO MED J 2022; 140:378-383. [PMID: 35507997 PMCID: PMC9671240 DOI: 10.1590/1516-3180.2021.0066.r2.16082021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 08/16/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Effective triage and early detection are very important for controlling and treating coronavirus disease 2019 (COVID-19). Thus, the relationships between hypoalbuminemia and other acute-phase reactants in such cases need to be evaluated. OBJECTIVES To investigate the importance of albumin levels in cases of severe pneumonia due to COVID-19. DESIGN AND SETTING Prospective study conducted in Ankara City Hospital (a stage 3 hospital), Turkey. METHODS Data from 122 patients diagnosed with pneumonia due to COVID-19 who were admitted to this hospital were analyzed statistically in comparison with date from 60 healthy controls. Three groups were established: healthy controls, intubated patients and non-intubated patients. Lung tomography scans from the patients were examined one-by-one. Real-time polymerase chain reaction (RT-PCR) test results were recorded. RESULTS Albumin levels were statistically significantly lower in the intubated and non-intubated groups than in the control group, in comparing the three groups (P < 0.01). The other acute-phase reactants, i.e. neutrophil-to-lymphocyte ratio and C-reactive protein levels, were significantly higher in the intubated and non-intubated groups than in the control group (P < 0.05). Albumin levels were also significantly lower in the intubated group than in the non-intubated group (P = 0.02). No differences were detected with regard to other parameters (P > 0.05). CONCLUSIONS Hypoalbuminemia may constitute a biomarker indicating the severity of pneumonia due to COVID-19.
Collapse
Affiliation(s)
- Yavuz Otal
- MD. Physician, Department of Emergency Medicine, Ankara City Hospital, Ankara, Turkey.
| | - Gamze Avcıoglu
- MD. Physician, Department of Medical Biochemistry, Karadeniz Ereğli State Hospital, Zonguldak, Turkey.
| | - Fadime Gullu Haydar
- MD. Physician, Department of General Surgery, Ankara City Hospital, Ankara, Turkey.
| |
Collapse
|
102
|
Liu Z, Perry LA, Penny‐Dimri JC, Raveendran D, Hu ML, Arslan J, Britten‐Jones AC, O’Hare F, Ayton LN, Edwards TL. The association of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio with retinal vein occlusion: a systematic review and meta-analysis. Acta Ophthalmol 2022; 100:e635-e647. [PMID: 34219390 DOI: 10.1111/aos.14955] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/17/2021] [Indexed: 12/17/2022]
Abstract
The neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are emerging haematological inflammatory biomarkers. However, their significance in retinal vein occlusion (RVO) and its subtypes, branch and central RVO (BRVO and CRVO, respectively), is uncertain. This systematic review and meta-analysis aimed to clarify the association of NLR and PLR with RVO. We searched MEDLINE (Ovid), EMBASE (Ovid) and the Cochrane Library for studies investigating the association of NLR and PLR with RVO from inception to 2 December 2020. We used random-effects inverse-variance modelling to generate pooled effect measures. We used bivariate Bayesian modelling to meta-analyse the ability of NLR and PLR to differ between individuals with and without RVO and performed meta-regression and sensitivity analyses to explore inter-study heterogeneity. Eight studies published encompassing 1059 patients were included for analysis. Both NLR and PLR were significantly elevated in RVO, with pooled mean differences of 0.63 (95% confidence interval (CI) 0.31-0.95) and 21.49 (95% CI 10.03-32.95), respectively. The pooled sensitivity, specificity and area under the Bayesian summary receiver operating characteristic curve were, respectively, 0.629 (95% credible interval (CrI) 0.284-0.872), 0.731 (95% CrI 0.373-0.934) and 0.688 (95% CrI 0.358-0.872) for NLR; and 0.645 (95% CrI 0.456-0.779), 0.616 (95% CrI 0.428-0.761) and 0.621 (95% CrI 0.452-0.741) for PLR. Mean and variability of age and diabetes mellitus prevalence partially explained between-study heterogeneity. NLR and PLR are significantly elevated in RVO. Future research is needed to investigate the potential prognostic value and independence of these findings.
Collapse
Affiliation(s)
- Zhengyang Liu
- Department of Anaesthesia The Royal Melbourne Hospital Melbourne VIC Australia
- Royal Victorian Eye and Ear Hospital East Melbourne VIC Australia
- Centre for Eye Research Australia East Melbourne VIC Australia
- Department of Surgery (Ophthalmology) The University of Melbourne East Melbourne VIC Australia
| | - Luke A. Perry
- Department of Anaesthesia The Royal Melbourne Hospital Melbourne VIC Australia
| | | | - Dev Raveendran
- Department of Anaesthesia The Royal Melbourne Hospital Melbourne VIC Australia
| | - Monica L. Hu
- Royal Victorian Eye and Ear Hospital East Melbourne VIC Australia
- Centre for Eye Research Australia East Melbourne VIC Australia
- Department of Surgery (Ophthalmology) The University of Melbourne East Melbourne VIC Australia
| | - Janan Arslan
- Centre for Eye Research Australia East Melbourne VIC Australia
- Department of Surgery (Ophthalmology) The University of Melbourne East Melbourne VIC Australia
| | - Alexis Ceecee Britten‐Jones
- Centre for Eye Research Australia East Melbourne VIC Australia
- Department of Surgery (Ophthalmology) The University of Melbourne East Melbourne VIC Australia
- Department of Optometry and Vision Sciences The University of Melbourne Melbourne VIC Australia
| | - Fleur O’Hare
- Centre for Eye Research Australia East Melbourne VIC Australia
- Department of Surgery (Ophthalmology) The University of Melbourne East Melbourne VIC Australia
- Department of Optometry and Vision Sciences The University of Melbourne Melbourne VIC Australia
| | - Lauren N. Ayton
- Centre for Eye Research Australia East Melbourne VIC Australia
- Department of Surgery (Ophthalmology) The University of Melbourne East Melbourne VIC Australia
- Department of Optometry and Vision Sciences The University of Melbourne Melbourne VIC Australia
| | - Thomas L. Edwards
- Royal Victorian Eye and Ear Hospital East Melbourne VIC Australia
- Centre for Eye Research Australia East Melbourne VIC Australia
- Department of Surgery (Ophthalmology) The University of Melbourne East Melbourne VIC Australia
| |
Collapse
|
103
|
Azzouz M, Xu Y, Barregard L, Fagerberg B, Zöller B, Molnár P, Oudin A, Spanne M, Engström G, Stockfelt L. Air pollution and biomarkers of cardiovascular disease and inflammation in the Malmö Diet and Cancer cohort. Environ Health 2022; 21:39. [PMID: 35413834 PMCID: PMC9004064 DOI: 10.1186/s12940-022-00851-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 03/31/2022] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Air pollution is associated with increased risk of cardiovascular disease, possibly through chronic systemic inflammation that promotes the progression of atherosclerosis and the risk of cardiovascular events. This study aimed to investigate the associations between air pollution and established biomarkers of inflammation and cardiovascular disease. METHODS The Cardiovascular Subcohort of the Malmö Diet and Cancer cohort includes 6103 participants from the general population of Malmö, Sweden. The participants were recruited 1991-1994. Annual mean residential exposure to particulate matter < 2.5 and < 10 μm (PM2.5 and PM10), and nitrogen oxides (NOx) at year of recruitment were assigned from dispersion models. Blood samples collected at recruitment, including blood cell counts, and biomarkers (lymphocyte- and neutrophil counts, C-reactive protein (CRP), soluble urokinase-type plasminogen activator receptor (suPAR), lipoprotein-associated phospholipase A2 (Lp-PLA2), ceruloplasmin, orosomucoid, haptoglobin, complement-C3, and alpha-1-antitrypsin) were analyzed. Multiple linear regression models were used to investigate the cross-sectional associations between air pollutants and biomarkers. RESULTS The mean annual exposure levels in the cohort were only slightly or moderately above the new WHO guidelines of 5 μg/m3 PM2.5 (10.5 μg/m3 PM2.5). Residential PM2.5 exposure was associated with increased levels of ceruloplasmin, orosomucoid, C3, alpha-1-antitrypsin, haptoglobin, Lp-PLA2 and the neutrophil-lymphocyte ratio. Ceruloplasmin, orosomucoid, C3 and alpha-1-antitrypsin were also positively associated with PM10. There were no associations between air pollutants and suPAR, leukocyte counts or CRP. The associations between particles and biomarkers were still significant after removing outliers and adjustment for CRP levels. The associations were more prominent in smokers. CONCLUSION Long-term residential exposure to moderate levels of particulate air pollution was associated with several biomarkers of inflammation and cardiovascular disease. This supports inflammation as a mechanism behind the association between air pollution and cardiovascular disease.
Collapse
Affiliation(s)
- Mehjar Azzouz
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Yiyi Xu
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lars Barregard
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Björn Fagerberg
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Bengt Zöller
- Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden
| | - Peter Molnár
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anna Oudin
- Occupational and Environmental Medicine, Department for Laboratory Medicine, Lund University, Lund, Sweden
- Division of Sustainable Health, Umeå University, Umeå, Sweden
| | - Mårten Spanne
- Environment Department, City of Malmö, Malmö, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences in Malmö, CRC, Lund University, Lund, Sweden
| | - Leo Stockfelt
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| |
Collapse
|
104
|
Estella Á, Garcia Garmendia JL, de la Fuente C, Machado Casas JF, Yuste ME, Amaya Villar R, Estecha MA, Yaguez Mateos L, Cantón Bulnes ML, Loza A, Mora J, Fernández Ruiz L, Díez Del Corral Fernández B, Rojas Amezcua M, Rodriguez Higueras MI, Díaz Torres I, Recuerda Núñez M, Zaheri Beryanaki M, Rivera Espinar F, Matallana Zapata DF, Moreno Cano SG, Gimenez Beltrán B, Muñoz N, Sainz de Baranda Piñero A, Bustelo Bueno P, Moreno Barriga E, Rios Toro JJ, Pérez Ruiz M, Gómez González C, Breval Flores A, de San José Bermejo Gómez A, Ruiz Cabello Jimenez MA, Guerrero Marín M, Ortega Ordiales A, Tejero-Aranguren J, Rodriguez Mejías C, Gomez de Oña J, de la Hoz C, Ocaña Fernández D, Ibañez Cuadros S, Garnacho Montero J. Predictive factors of six-week mortality in critically ill patients with SARS-CoV-2: A multicenter prospective study. Med Intensiva 2022; 46:179-191. [PMID: 35461665 PMCID: PMC9020190 DOI: 10.1016/j.medine.2021.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/22/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The objective of the study is to identify the risk factors associated with mortality at six weeks, especially by analyzing the role of antivirals and munomodulators. DESIGN Prospective descriptive multicenter cohort study. SETTING 26 Intensive care units (ICU) from Andalusian region in Spain. PATIENTS OR PARTICIPANTS Consecutive critically ill patients with confirmed SARS-CoV-2 infection were included from March 8 to May 30. INTERVENTIONS None. VARIABLES Variables analyzed were demographic, severity scores and clinical condition. Support therapy, drug and mortality were analyzed. An univariate followed by multivariate Cox regression with propensity score analysis was applied. RESULTS 495 patients were enrolled, but 73 of them were excluded for incomplete data. Thus, 422 patients were included in the final analysis. Median age was 63 years and 305 (72.3%) were men. ICU mortality: 144/422 34%; 14 days mortality: 81/422 (19.2%); 28 days mortality: 121/422 (28.7%); 6-week mortality 152/422 36.5%. By multivariable Cox proportional analysis, factors independently associated with 42-day mortality were age, APACHE II score, SOFA score at ICU admission >6, Lactate dehydrogenase at ICU admission >470U/L, Use of vasopressors, extrarenal depuration, %lymphocytes 72h post-ICU admission <6.5%, and thrombocytopenia whereas the use of lopinavir/ritonavir was a protective factor. CONCLUSION Age, APACHE II, SOFA>value of 6 points, along with vasopressor requirements or renal replacement therapy have been identified as predictor factors of mortality at six weeks. Administration of corticosteroids showed no benefits in mortality, as did treatment with tocilizumab. Lopinavir/ritonavir administration is identified as a protective factor.
Collapse
Affiliation(s)
- Á Estella
- Intensive Care Unit, Hospital Universitario de Jerez, Jerez, Spain.
| | - J L Garcia Garmendia
- Intensive Care Unit, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, Spain
| | - C de la Fuente
- Intensive Care Unit, Hospital Universitario Reina Sofía de Córdoba, Córdoba, Spain
| | - J F Machado Casas
- Intensive Care Unit, Hospital Universitario Virgen de las Nieves de Granada, Granada, Spain
| | - M E Yuste
- Intensive Care Unit, Hospital Universitario Clínico San Cecilio de Granada, Granada, Spain
| | - R Amaya Villar
- Intensive Care Unit, Hospital Universitario Virgen del Rocio de Sevilla, Sevilla, Spain
| | - M A Estecha
- Intensive Care Unit, Hospital Universitario Virgen de la Victoria de Málaga, Málaga, Spain
| | - L Yaguez Mateos
- Intensive Care Unit, Hospital Universitario de Jaén, Jaén, Spain
| | - M L Cantón Bulnes
- Intensive Care Unit, Hospital Universitario Virgen Macarena de Sevilla, Sevilla, Spain
| | - A Loza
- Intensive Care Unit, Hospital Universitario Virgen de Valme, Sevilla, Spain
| | - J Mora
- Intensive Care Unit, Hospital Universitario Regional de Málaga, Málaga, Spain
| | - L Fernández Ruiz
- Intensive Care Unit, Hospital San Juan de la Cruz Úbeda, Úbeda, Jaén, Spain
| | | | - M Rojas Amezcua
- Intensive Care Unit, Hospital Infanta Margarita de Cabra, Cabra, Spain
| | | | - I Díaz Torres
- Intensive Care Unit, Hospital Universitario de Puerto Real, Puerto Real, Spain
| | - M Recuerda Núñez
- Intensive Care Unit, Hospital Universitario de Puerto Real, Puerto Real, Spain
| | | | - F Rivera Espinar
- Intensive Care Unit, Hospital de Montilla, Montilla, Córdoba, Spain
| | - D F Matallana Zapata
- Intensive Care Unit, Hospital Infanta Elena de Huelva, Hospital Quirón Huelva, Huelva, Spain
| | - S G Moreno Cano
- Intensive Care Unit, Hospital Universitario de Jerez, Jerez, Spain
| | | | - N Muñoz
- Intensive Care Unit, Hospital de la Cruz Roja de Córdoba, Córdoba, Spain
| | | | - P Bustelo Bueno
- Intensive Care Unit, Hospital HLA Puerta del Sur de Jerez, Jerez, Spain
| | - E Moreno Barriga
- Intensive Care Unit, Hospital Universitario de Puerto Real, Puerto Real, Spain
| | - J J Rios Toro
- Intensive Care Unit, Hospital de Ronda, Ronda, Spain
| | - M Pérez Ruiz
- Intensive Care Unit, Hospital Universitario de Jerez, Jerez, Spain
| | - C Gómez González
- Intensive Care Unit, Hospital Universitario Virgen del Rocio de Sevilla, Sevilla, Spain
| | - A Breval Flores
- Intensive Care Unit, Hospital de la Cruz Roja de Córdoba, Córdoba, Spain
| | | | | | - M Guerrero Marín
- Intensive Care Unit, Hospital Universitario de Jaén, Jaén, Spain
| | - A Ortega Ordiales
- Intensive Care Unit, Hospital Universitario Regional de Málaga, Málaga, Spain
| | - J Tejero-Aranguren
- Intensive Care Unit, Hospital Universitario Clínico San Cecilio de Granada, Granada, Spain
| | - C Rodriguez Mejías
- Intensive Care Unit, Hospital Universitario Virgen de las Nieves de Granada, Granada, Spain
| | - J Gomez de Oña
- Intensive Care Unit, Hospital de Poniente, Almería, Spain
| | - C de la Hoz
- Intensive Care Unit, Hospital de Poniente, Almería, Spain
| | - D Ocaña Fernández
- Intensive Care Unit, Hospital La Inmaculada Huercal-Overa de Almería, Almería, Spain
| | - S Ibañez Cuadros
- Intensive Care Unit, Hospital Universitario de Puerto Real, Puerto Real, Spain
| | - J Garnacho Montero
- Intensive Care Unit, Hospital Universitario Virgen de la Macarena Sevilla, Sevilla, Spain
| |
Collapse
|
105
|
Majmundar M, Kansara T, Park H, Ibarra G, Marta Lenik J, Shah P, Kumar A, Doshi R, Zala H, Chaudhari S, Kalra A. Absolute lymphocyte count as a predictor of mortality and readmission in heart failure hospitalization. IJC HEART & VASCULATURE 2022; 39:100981. [PMID: 35281758 PMCID: PMC8904225 DOI: 10.1016/j.ijcha.2022.100981] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 12/15/2022]
Abstract
Lymphopenia (<1500/mm3) was associated with 82% higher mortality in heart failure patients irrespective of ejection fraction. Lymphopenia was a good predictor of all-cause readmission in heart failure patients with reduced ejection fraction. Due to cost-effectiveness, easy availability, and ability to predict outcomes in the short-term and medium-term, lymphopenia can be a valuable tool in the mortality, readmission prediction model of heart failure.
Background There is renewed interest in pursuing frugal and readily available laboratory markers to predict mortality and readmission in heart failure. We aim to determine the relationship between absolute lymphocyte count (ALC) and clinical outcomes in patients with heart failure hospitalization. Methods This was a retrospective cohort study of patients with heart failure. Patients were divided into two groups based on ALC, less than or equal to 1500 cells/mm3 and > 1500 cells/ mm3. The primary outcome was all-cause mortality. We did subgroup analysis based on ejection fraction and studied the association between ALC categories and clinical outcomes. Both ALC groups are matched by propensity score, outcomes were analyzed by Cox regression, and estimates are presented in hazard ratios (HR) and 95% confidence intervals (CI). Results We included 1029 patients in the pre-matched cohort and 766 patients in the propensity-score matched cohort. The median age was 64 years (IQR, 54–75), and 60.78% were male. In the matched cohort, ALC less than or equal to 1500 cells/mm3 had a higher risk of mortality compared with ALC > 1500 cells/mm3 (HR 1.51, 95% CI: 1.17–1.95; P = 0.002). These results were reproducible in subgroups of heart failure. When ALC was divided into four groups based on their levels, the lowest group of ALC had the highest risk of mortality. Conclusions In patients with heart failure and both subgroups, ALC less than or equal to 1500 cells/mm3 had a higher risk of mortality. Patients in lower groups of the ALC categories had a higher risk of mortality.
Collapse
Affiliation(s)
- Monil Majmundar
- Department of Cardiology, Maimonides Medical Center, Brooklyn, NY, USA
| | - Tikal Kansara
- Department of Internal Medicine, Cleveland Clinic Union Hospital, OH, USA
| | - Hansang Park
- Department of Internal Medicine, New York Medical College/Metropolitan Hospital, NY, USA
| | - Gabriel Ibarra
- Department of Internal Medicine, New York Medical College/Metropolitan Hospital, NY, USA
| | - Joanna Marta Lenik
- Department of Internal Medicine, New York Medical College/Metropolitan Hospital, NY, USA
| | - Palak Shah
- Department of Internal Medicine, New York Medical College/Metropolitan Hospital, NY, USA
| | - Ashish Kumar
- Department of Internal Medicine, Cleveland Clinic Akron General, Akron, OH, USA
| | - Rajkumar Doshi
- Department of Cardiology, St. Joseph's Medical Center, NJ, USA
| | - Harshvardhan Zala
- Department of Clinical Research, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Shobhana Chaudhari
- Department of Internal Medicine, New York Medical College/Metropolitan Hospital, NY, USA
| | - Ankur Kalra
- Division of Cardiovascular Medicine, Krannert Cardiovascular Research Center, Indiana University School of Medicine, Indianapolis, IN, USA
| |
Collapse
|
106
|
Luo Y, Tan N, Zhao J, Li Y. A Nomogram for Predicting In-Stent Restenosis Risk in Patients Undergoing Percutaneous Coronary Intervention: A Population-Based Analysis. Int J Gen Med 2022; 15:2451-2461. [PMID: 35264881 PMCID: PMC8901259 DOI: 10.2147/ijgm.s357250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 02/16/2022] [Indexed: 12/13/2022] Open
Abstract
Objective In-stent restenosis (ISR) is a fatal complication of percutaneous coronary intervention (PCI). An early predictive model with the medical history of patients, angiographic characteristics, inflammatory indicators and blood biochemical index is urgently needed to predict ISR events. We aim to establish a risk prediction model for ISR in CAD patients undergoing PCI. Methods A total of 477 CAD patients who underwent PCI with DES (drug-eluting stents) between January 2017 and December 2020 were retrospectively enrolled. And the preoperative factors were compared between the non-ISR and ISR groups. The least absolute shrinkage and selection operator (LASSO) and multi-factor logistic regression were used for statistical analysis. The prediction model was evaluated using receiver operator characteristic (ROC) analysis, the Hosmer–Lemeshow 2 statistic, and the calibration curve. Results In this study, 94 patients developed ISR after PCI. Univariate analysis showed that post-PCI ISR was associated with the underlying disease (COPD), higher Gensini score (GS score), higher LDL-C, higher neutrophil/lymphocyte ratio, and higher remnant cholesterol (RC). The multi-factor logistic regression analysis suggested that remnant cholesterol (odds ratio [OR] = 2.09, 95% confidence interval [CI] [1.40–3.11], P < 0.001), GS score (OR = 1.01, 95% CI [1.00, 1.02], P = 0.002), medical history of COPD (OR = 4.56, 95% CI [1.98, 10.40], P < 0.001), and monocyte (OR = 1.30, 95% CI [1.04, 1.70], P < 0.001) were independent risk factors for ISR. A nomogram was generated and displayed favorable fitting (Hosmer-Lemeshow test P = 0.609), discrimination (area under ROC curve was 0.847), and clinical usefulness by decision curve analysis. Conclusion Patients with certain preoperative characteristics, such as a history of COPD, higher GS scores, higher levels of RC, and monocytes, who undergo PCI may have a higher risk of developing ISR. The predictive nomogram, based on the above predictors, can be used to help identify patients who are at a higher risk of ISR early on, with a view to provide post-PCI health management for patients.
Collapse
Affiliation(s)
- Yinhua Luo
- Department of Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Shiyan, Hubei Province, 442000, People’s Republic of China
| | - Ni Tan
- Pulmonary and Critical Care Medicine, Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Enshi Prefecture, Hubei Province, 445000, People’s Republic of China
| | - Jingbo Zhao
- Cardiovascular Disease Center, Central Hospital of Tujia and Miao Autonomous Prefecture, Enshi Prefecture, Hubei Province, 445000, People’s Republic of China
| | - Yuanhong Li
- Cardiovascular Disease Center, Central Hospital of Tujia and Miao Autonomous Prefecture, Enshi Prefecture, Hubei Province, 445000, People’s Republic of China
- Correspondence: Yuanhong Li, Cardiovascular Disease Center, Central Hospital of Tujia and Miao Autonomous Prefecture, Hubei University of Medicine, Enshi Prefecture, People’s Republic of China, Email
| |
Collapse
|
107
|
Carobbio A, Vannucchi AM, De Stefano V, Masciulli A, Guglielmelli P, Loscocco GG, Ramundo F, Rossi E, Kanthi Y, Tefferi A, Barbui T. Neutrophil-to-lymphocyte ratio is a novel predictor of venous thrombosis in polycythemia vera. Blood Cancer J 2022; 12:28. [PMID: 35145055 PMCID: PMC8831521 DOI: 10.1038/s41408-022-00625-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/21/2022] [Accepted: 01/26/2022] [Indexed: 11/09/2022] Open
Abstract
We investigated the neutrophil-to-lymphocyte ratio (NLR) as a predictor of thrombosis in polycythemia vera (PV). After a median follow-up of 2.51 years, of 1508 PV patients enrolled in the ECLAP study, 82 and 84 developed arterial and venous thrombosis, respectively. Absolute counts of total leukocytes, neutrophils, lymphocytes, platelets, and the NLR were tested by generalized additive models (GAM) to evaluate their trend in continuous scale of thrombotic risk. Only for venous thrombosis, we showed that baseline absolute neutrophil and lymphocyte counts were on average respectively higher (median: 6.8 × 109/L, p = 0.002) and lower (median: 1.4 × 109/L, p = 0.001), leading to increased NLR values (median: 5.1, p = 0.002). In multivariate analysis, the risk of venous thrombosis was independently associated with previous venous events (HR = 5.48, p ≤ 0.001) and NLR values ≥5 (HR = 2.13, p = 0.001). Moreover, the relative risk in both low- and high-standard risk groups was almost doubled in the presence of NLR ≥ 5. These findings were validated in two Italian independent external cohorts (Florence, n = 282 and Rome, n = 175) of contemporary PV patients. Our data support recent experimental work that venous thrombosis is controlled by innate immune cells and highlight that NLR is an inexpensive and easily accessible prognostic biomarker of venous thrombosis.
Collapse
Affiliation(s)
| | - Alessandro Maria Vannucchi
- Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), Department of Experimental and Clinical Medicine, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Valerio De Stefano
- Section of Hematology, Department of Radiological and Hematological Sciences, Catholic University, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
| | - Arianna Masciulli
- FROM Research Foundation, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Paola Guglielmelli
- Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), Department of Experimental and Clinical Medicine, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Giuseppe Gaetano Loscocco
- Center Research and Innovation of Myeloproliferative Neoplasms (CRIMM), Department of Experimental and Clinical Medicine, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Francesco Ramundo
- Section of Hematology, Department of Radiological and Hematological Sciences, Catholic University, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
| | - Elena Rossi
- Section of Hematology, Department of Radiological and Hematological Sciences, Catholic University, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
| | | | - Ayalew Tefferi
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Tiziano Barbui
- FROM Research Foundation, Papa Giovanni XXIII Hospital, Bergamo, Italy.
| |
Collapse
|
108
|
Could the systemic immune-inflammation index be a predictor to estimate cerebrovascular events in hypertensive patients? Blood Press Monit 2022; 27:33-38. [PMID: 34992205 DOI: 10.1097/mbp.0000000000000560] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVES Hypertension is one of the most important risk factors for cardiovascular and cerebrovascular events. Inflammatory processes occupy an important place in the pathogenesis of hypertension. Many studies have studied inflammatory markers responsible for the onset of hypertension and organ damage. In this study, we investigated whether the systemic immune-inflammation index (SII) (platelet × neutrophil/lymphocyte), - one of the new inflammatory markers - can be used to predict cerebrovascular events in hypertensive patients. METHODS Ambulatory blood pressure monitoring results between January 2019 and June 2020 of approximately 379 patients followed up with hypertension were retrospectively analyzed. These patients were divided into two groups as with or without a previous cerebrovascular event in the analyzed database. In all patients, complete blood count and biochemistry test results just before the cerebrovascular event were found from the database. SII, atherogenic index, neutrophil-lymphocyte ratio were calculated from the complete blood count. Forty-nine patients with stroke (group 1: 12.9%; mean age: 64.3 ± 14.6) and 330 patients without stroke (group 2: 87.1%; mean age: 50.8 ± 14.4). RESULTS Ambulatory blood pressure measurements were lower in group 1. Lipid parameters were also lower in this group. Receiver operating characteristic curve analysis showed that SII had a sensitivity of 85.7% and specificity of 84.8 % for stroke in individuals who participated in the study when the cutoff value of SII was 633.26 × 103 (P = 0.0001) area under curve (95%); 0.898 (0.856-0.941). In multivariate logistic regression analysis, age and SII were significantly associated with a higher risk of stroke. Age, (hazard ratio:1.067; 95% CI, 1.021-1.115), SII (hazard ratio:1.009; 95% CI, 1.000-1.009), respectively. CONCLUSIONS In conclusion, SII is a simple, useful new inflammatory parameter for predicting stroke from hypertension. We found that the high SII levels increase the risk of stroke in hypertensive patients.
Collapse
|
109
|
Sauer F, Riou M, Charles AL, Meyer A, Andres E, Geny B, Talha S. Pathophysiology of Heart Failure: A Role for Peripheral Blood Mononuclear Cells Mitochondrial Dysfunction? J Clin Med 2022; 11:jcm11030741. [PMID: 35160190 PMCID: PMC8836880 DOI: 10.3390/jcm11030741] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/24/2022] [Accepted: 01/27/2022] [Indexed: 02/06/2023] Open
Abstract
Heart failure (HF) is a leading cause of hospitalization in patients aged more than 65 years and is associated with high mortality rates. A better comprehension of its physiopathology is still needed, and, in addition to neurohormonal systems and sodium glucose co-transporter 2 modulations, recent studies focus on the mitochondrial respiration of peripheral blood circulating cells (PBMCs). Thus, cardiovascular metabolic risk factors and cellular switch with an increased neutrophil/lymphocytes ratio might favor the decreased PBMC mitochondrial respiration observed in relation with HF severity. PBMCs are implicated in the immune system function and mitochondrial dysfunction of PBMC, potentially induced by their passage through a damaged heart and by circulating mitoDAMPs, which can lead to a vicious circle, thus sustaining negative cardiac remodeling during HF. This new approach of HF complex pathophysiology appears to be a promising field of research, and further studies on acute and chronic HF with reduced or preserved LVEF are warranted to better understand whether circulating PBMC mitochondrial function and mitoDAMPs follow-ups in HF patients might show diagnosis, prognosis or therapeutic usefulness.
Collapse
Affiliation(s)
- François Sauer
- University of Strasbourg, Translational Medicine Federation of Strasbourg (FMTS), Faculty of Medicine, Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, 11 rue Humann, 67000 Strasbourg, France; (F.S.); (M.R.); (A.-L.C.); (A.M.); (E.A.); (S.T.)
- University Hospital of Strasbourg, Physiology and Functional Exploration Service, 1 Place de l’Hôpital, 67091 Strasbourg, France
| | - Marianne Riou
- University of Strasbourg, Translational Medicine Federation of Strasbourg (FMTS), Faculty of Medicine, Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, 11 rue Humann, 67000 Strasbourg, France; (F.S.); (M.R.); (A.-L.C.); (A.M.); (E.A.); (S.T.)
- University Hospital of Strasbourg, Physiology and Functional Exploration Service, 1 Place de l’Hôpital, 67091 Strasbourg, France
| | - Anne-Laure Charles
- University of Strasbourg, Translational Medicine Federation of Strasbourg (FMTS), Faculty of Medicine, Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, 11 rue Humann, 67000 Strasbourg, France; (F.S.); (M.R.); (A.-L.C.); (A.M.); (E.A.); (S.T.)
- University Hospital of Strasbourg, Physiology and Functional Exploration Service, 1 Place de l’Hôpital, 67091 Strasbourg, France
| | - Alain Meyer
- University of Strasbourg, Translational Medicine Federation of Strasbourg (FMTS), Faculty of Medicine, Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, 11 rue Humann, 67000 Strasbourg, France; (F.S.); (M.R.); (A.-L.C.); (A.M.); (E.A.); (S.T.)
- University Hospital of Strasbourg, Physiology and Functional Exploration Service, 1 Place de l’Hôpital, 67091 Strasbourg, France
| | - Emmanuel Andres
- University of Strasbourg, Translational Medicine Federation of Strasbourg (FMTS), Faculty of Medicine, Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, 11 rue Humann, 67000 Strasbourg, France; (F.S.); (M.R.); (A.-L.C.); (A.M.); (E.A.); (S.T.)
- Internal Medicine, Diabete and Metabolic Diseases Service, University Hospital of Strasbourg, 1 Place de l’Hôpital, 67091 Strasbourg, France
| | - Bernard Geny
- University of Strasbourg, Translational Medicine Federation of Strasbourg (FMTS), Faculty of Medicine, Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, 11 rue Humann, 67000 Strasbourg, France; (F.S.); (M.R.); (A.-L.C.); (A.M.); (E.A.); (S.T.)
- University Hospital of Strasbourg, Physiology and Functional Exploration Service, 1 Place de l’Hôpital, 67091 Strasbourg, France
- Correspondence:
| | - Samy Talha
- University of Strasbourg, Translational Medicine Federation of Strasbourg (FMTS), Faculty of Medicine, Team 3072 “Mitochondria, Oxidative Stress and Muscle Protection”, 11 rue Humann, 67000 Strasbourg, France; (F.S.); (M.R.); (A.-L.C.); (A.M.); (E.A.); (S.T.)
- University Hospital of Strasbourg, Physiology and Functional Exploration Service, 1 Place de l’Hôpital, 67091 Strasbourg, France
| |
Collapse
|
110
|
Shan Y, Wang Q, Zhang Y, Tong X, Pu S, Xu Y, Gao X. High remnant cholesterol level is relevant to diabetic retinopathy in type 2 diabetes mellitus. Lipids Health Dis 2022; 21:12. [PMID: 35057797 PMCID: PMC8772129 DOI: 10.1186/s12944-021-01621-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/29/2021] [Indexed: 02/06/2023] Open
Abstract
Background Diabetic retinopathy (DR) is the primary oculopathy causing blindness in diabetic patients. Currently, there is increasing interest in the role of lipids in the development of diabetic retinopathy, but it remains controversial. Remnant cholesterol (RC) is an inexpensive and easily measurable lipid parameter; however, the relationship between RC and DR in type 2 diabetes mellitus (T2DM) has not been elucidated. This research investigates the relevance between RC levels and DR severity while building a risk prediction model about DR. Methods In this single-centre retrospective cross-sectional study. Each hospitalised T2DM patient had no oral lipid-lowering drugs in the past three months, and coronary angiography showed epicardial coronary artery stenosis of less than 50% and completed seven-field stereo photographs, fluorescein fundus angiography, and optical coherence tomography detection. The RC value is calculated according to the internationally recognised formula. Binary logistic regression was used to correct confounding factors, and the receiver operating characteristic (ROC) analysis was used to identify risk factors and assess the nomogram’s diagnostic efficiency. Results A total of 456 T2DM patients were included in the study. The RC levels in the DR team was higher [0.74 (0.60–1.12) mmo/l vs 0.54 (0.31–0.83) mmol/l P < 0.001] in the non-DR team. After adjusting for confounding elements, RC levels are still associated with DR risk (OR = 5.623 95%CI: 2.996–10.556 P < 0.001). The ratio of DR in every stage (except mild non-proliferative diabetic retinopathy) and DME in the high RC level team were further increased compared to the low-level team (all P < 0.001). After ROC analysis, the overall risk of DR was predicted by a nomogram constructed for RC, diabetes duration, and the neutrophil-lymphocyte ratio as 0.758 (95%CI 0.714–0.802 P < 0.001). Conclusions High RC levels may be a potential risk factor for diabetic retinopathy, and the nomogram does better predict DR. Despite these essential findings, the limitation of this study is that it is single-centred and small sample size analysis. Supplementary Information The online version contains supplementary material available at 10.1186/s12944-021-01621-7.
Collapse
|
111
|
Systemic Immune-Inflammation Index: A Novel Predictor of Coronary Thrombus Burden in Patients with Non-ST Acute Coronary Syndrome. Medicina (B Aires) 2022; 58:medicina58020143. [PMID: 35208466 PMCID: PMC8875451 DOI: 10.3390/medicina58020143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/28/2021] [Accepted: 12/30/2021] [Indexed: 01/01/2023] Open
Abstract
Background and Objectives: Excessive coronary thrombus burden is known to cause an increase in mortality and major adverse cardiac events (MACEs) in NSTE-ACS (non-ST acute coronary syndrome) patients. We investigated the association between the systemic immune-inflammation index (SII) and coronary thrombus burden in patients with non-ST segment elevation myocardial infarction (NSTEMI) who underwent coronary angiography and percutaneous coronary intervention (PCI). Materials and Methods: A total of 389 patients with the diagnosis of NSTEMI participated in our study. Coronary thrombus burden was classified in the TIMI (thrombolysis in myocardial infarction) thrombus grade scale and patients were divided into two groups: a TIMI thrombus grade 0–1 group (n = 209, 157 males) and a TIMI thrombus grade 2–6 group (n = 180, 118 males). Demographics, angiographic lesion images, coronary thrombus burden, clinical risk factors, laboratory parameters, and SII score were compared between the two groups. Results: The high thrombus burden patient group had a higher neutrophil count, WBC count, platelet count, and systemic immune-inflammation index (SII) (p < 0.001). The receiver operating characteristic (ROC) curve analysis showed that at a cutoff of 1103, the value of SII manifested 74.4% sensitivity and 74.6% specificity for detecting a high coronary thrombus burden. Conclusions: Our study showed that the SII levels at hospital admission were independently associated with high coronary thrombus with NSTEMI.
Collapse
|
112
|
Kasten-Jolly J, Lawrence DA. Differential blood leukocyte populations based on individual variances and age. Immunol Res 2022; 70:114-128. [PMID: 35023048 PMCID: PMC8754550 DOI: 10.1007/s12026-021-09257-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 12/09/2021] [Indexed: 12/26/2022]
Abstract
Blood was collected from the New York State Department of Health (NYSDOH) employees to assess variances in leukocyte numbers in January, May, and September throughout a year and over many years. Women and men of ages 20 to 80 volunteered to donate for this program. Most of the blood came from healthy individuals, and many remained healthy throughout the years of their blood donations. The major objective was to determine the extent that blood leukocyte numbers change so that transient vs more lingering changes may be helpful in assessing health status. Since some donors remained in the program for 14 years, age influences over time could be determined. Within a short period of 2-3 years, the flow cytometric immunophenotypic profile of blood lymphocyte is relatively stable with a CV% of < 20%. However, as humans age, the blood CD3+ T cell, CD8+ T cell, B cell, NKT cell, and CD4-/CD8- double-negative T cell (DN-T cell) subsets declined in cell numbers/μL, but the double-positive CD4+/CD8+ T cells (DP-T cells) increased in numbers. The extent and chronology of a variance, e.g., a subset exceeding its 75th or 90th percentile, might be indicative of a transient or chronic physiological or psychosocial stress affecting health or a developing pathology; however, because of the wide ranges of cell numbers/μL for each subset among individuals reported as healthy, everyone's immunity and health must be carefully evaluated. A CD4 to CD8 ratio (4/8R) of < 1 has been used to define an immunodeficiency such as HIV-induced AIDS, but a high 4/8R is less well associated with health status. A high 4/8R or granulocyte to lymphocyte ratio (GLR) might be an indicator of a stress, infection, or immune-related pathology. Sporadic and longitudinal increases of GLRs are reported. The results suggest that there are some age and sex differences in leukocyte numbers; stress influences on the blood profile of leukocytes likely exist. However, some values exceeding 2 standard deviations from means do not necessarily predict a health concern, whereas a longitudinal increase or decline might be indicative of a need for further evaluations.
Collapse
Affiliation(s)
- Jane Kasten-Jolly
- Wadsworth Center, New York State Department of Health, Albany, NY, 12208, USA
| | - David A Lawrence
- Wadsworth Center, New York State Department of Health, Albany, NY, 12208, USA.
- School of Public Health, University of Albany, Rensselaer, NY, USA.
| |
Collapse
|
113
|
Caldeira de Albuquerque FVDS, Dias-Neto MF, Rocha-Neves JMPD, Videira Reis PJVD. Red Blood Cell Distribution Width Predicts Myocardial Infarction and Mortality After Vascular Surgery-A Prospective Cohort Study. World J Surg 2022; 46:957-965. [PMID: 35022800 DOI: 10.1007/s00268-022-06441-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND This study aims to investigate the association between preoperative Red blood cell Distribution Width (RDW) and postoperative outcomes, including myocardial infarction (MI), and mortality. METHODS A prospective cohort including all patients submitted to elective vascular arterial surgery at a university hospital. The primary and secondary outcomes were 30-day mortality and 30-day MI, respectively. RESULTS Atrial fibrillation, chronic kidney disease (CKD), and dependent functional status were more prevalent in deceased patients. After multivariable analysis, age (adjusted OR 1.08, 95% Confidence Interval [1.01-1.15], p = 0.027) and RDW-standard deviation (RDW-SD) (1.08 [1.01-1.16], p = 0.032) remained independent predictors of mortality. Patients with MI had higher rates of diabetes, CKD, dependent functional status, ASA physical status IV, and insulin medication. After multivariable analysis, dependent functional status (4.8 [1.6-15.0], p = 0.007), insulin medication (4.4 [1.5-12.6], p = 0.007) and RDW-SD (1.10 [1.02-1.19], p = 0.020) were independent predictors of MI. CONCLUSION RDW-SD independently predicted postoperative MI and mortality, and may provide valuable information for prevention and early management of adverse outcomes.
Collapse
Affiliation(s)
| | - Marina Felicidade Dias-Neto
- Department of Angiology and Vascular Surgery, São João University Hospital Center, Porto, Portugal.,Faculty of Medicine, Surgery and Physiology-Cardiovascular R&D Centre (UNIC), University of Porto, Porto, Portugal
| | - João Manuel Palmeira da Rocha-Neves
- Department of Angiology and Vascular Surgery, São João University Hospital Center, Porto, Portugal.,Biomedicine Department-Unit of Anatomy, Faculty of Medicine, University of Porto, Porto, Portugal
| | | |
Collapse
|
114
|
Perera N, de Silva A, Kumbukage M, Rambukwella R, Indrakumar J. Neutrophil Lymphocyte Ratio as a Marker of In-Hospital Deterioration in COVID-19: Observations From a Resource Constraint Setting. CLINICAL PATHOLOGY (THOUSAND OAKS, VENTURA COUNTY, CALIF.) 2022; 15:2632010X221090898. [PMID: 35450133 PMCID: PMC9016554 DOI: 10.1177/2632010x221090898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 03/10/2022] [Indexed: 12/19/2022]
Abstract
Introduction and Objectives: The study was conducted to assess the association of neutrophil lymphocyte
ratio (NLR) in COVID-19 and to identify the cut-off value that predicts
mortality, need of respiratory support and admission to high-dependency or
intensive care. Methods: A retrospective observational study was conducted to collect demographic
data, clinical variables, the neutrophil-lymphocyte ratio on-admission and
the outcome of confirmed COVID-19 patients admitted to a tertiary care
center in Sri Lanka. Results: There were 208 patients with a median age of 56 years (IQR 43-67) and 98
(47.1%) males. The median neutrophil count was 4.07 × 103/µL (IQR
2.97-6.79) and the median lymphocyte count was 1.74 × 103/µL (IQR
1.36-4.75). The calculated NLR ranged from 0.12 to 48.28 with a median value
of 2.32 (IQR 1.37-4.76). A NLR value >3.6 predicted development of severe
disease requiring respiratory support, transfer to a high-dependency or an
intensive care unit and/or succumbing to the illness with a sensitivity 80%
and specificity 80% (area under the curve 0.8, 95% CI 0.72-0.88,
P < .0001). The adjusted odds ratio of NLR > 3.6
on predicting severe disease was 11.1, 95% CI 4.5- 27.0,
P < .0001. Conclusions: A NLR > 3.6 is a useful variable to be included in risk prediction scores
in Sri Lanka.
Collapse
Affiliation(s)
- Nilanka Perera
- Department of Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Western Province, Sri Lanka
| | - Ashani de Silva
- Department of Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Western Province, Sri Lanka
| | - Mahesh Kumbukage
- Research unit, Family Health Bureau, Colombo, Western Province, Sri Lanka
| | - Roshan Rambukwella
- Research unit, Family Health Bureau, Colombo, Western Province, Sri Lanka
| | - Jegarajah Indrakumar
- Department of Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Western Province, Sri Lanka
| |
Collapse
|
115
|
Qiu Z, Guo T, Sheng X, Tang Y, Du H. Prognostic Value of the Neutrophil-to-Lymphocyte Ratio in Patients with Chronic Internal Carotid Artery Occlusion Complicated by Cerebral Infarction. Neuropsychiatr Dis Treat 2022; 18:2265-2271. [PMID: 36268267 PMCID: PMC9578499 DOI: 10.2147/ndt.s384512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/08/2022] [Indexed: 12/03/2022] Open
Abstract
PURPOSE This study aims to investigate the prognostic value of the peripheral neutrophil-to-lymphocyte ratio (NLR) in patients with chronic internal carotid artery occlusion (CICAO) complicated by cerebral infarction. PATIENTS AND METHODS The clinical data of 99 CICAO patients complicated by cerebral infarction were retrospectively analyzed. The modified Rankin Scale (mRS) was used to assess their 3-month prognosis, and a multivariate logistic regression model was established to explore risk factors for poor prognosis. RESULTS Multivariate logistic regression analysis demonstrated that NLR (OR=2.114; 95% CI: 1.129-3.959) and baseline National Institute of Health Stroke Scale (NIHSS; OR=1.288, 95% CI: 1.053-1.574) score were risk factors of poor prognosis. The area under the receiver operator characteristic (ROC) curve of NLR in predicting the 3-month outcome after onset was 0.717 (95% CI: 0.606-0.828, P<0.000). The optimal cut-off value was 3.22, with a sensitivity of 0.743 and a specificity of 0.791. CONCLUSION NLR is an independent risk factor for the poor prognosis of CICAO patients complicated by cerebral infarction and can serve as an indicator for clinical prognosis.
Collapse
Affiliation(s)
- Zhuoyin Qiu
- Department of Neurology, Suzhou Ninth People's Hospital, Suzhou, People's Republic of China.,Department of Neurology, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, People's Republic of China
| | - Tingting Guo
- Department of Neurology, Suzhou Ninth People's Hospital, Suzhou, People's Republic of China.,Department of Neurology, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, People's Republic of China
| | - Xihua Sheng
- Department of Neurology, Suzhou Ninth People's Hospital, Suzhou, People's Republic of China.,Department of Neurology, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, People's Republic of China
| | - Ying Tang
- Department of Neurology, Suzhou Ninth People's Hospital, Suzhou, People's Republic of China.,Department of Neurology, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, People's Republic of China
| | - Huaping Du
- Department of Neurology, Suzhou Ninth People's Hospital, Suzhou, People's Republic of China.,Department of Neurology, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, People's Republic of China
| |
Collapse
|
116
|
Hajizadeh R, Ranhbar A, Sohrabi B, Shoar M, Kavandi H, Ghodratizadeh S, Sakha H, Mohammadi K. Neutrophil-to-Lymphocyte Ratio and Outpatient Management of Low-Risk Acute Pulmonary Embolism. HEART AND MIND 2022. [DOI: 10.4103/hm.hm_20_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
117
|
Xia W, Tan Y, Hu S, Li C, Jiang T. Predictive Value of Systemic Immune-Inflammation index and Neutrophil-to-Lymphocyte Ratio in Patients with Severe COVID-19. Clin Appl Thromb Hemost 2022; 28:10760296221111391. [PMID: 35765218 PMCID: PMC9247370 DOI: 10.1177/10760296221111391] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objective: It was initially reported that a novel coronavirus (COVID-19) had been identified in Wuhan, China, in December 2019.To date, COVID-19 is still threatening all humanity and has affected the public healthcare system and the world economic situation. Neutrophil-to-lymphocyte ratio (NLR) has also been demonstrated that associated with severity of COVID-19, but little is known about systemic immune-inflammation index (SII) relation with COVID-19. Methods: One hundred and twenty-five patients with diagnosed COVID-19 including non-severe cases (n = 77) and severe cases (n = 48) were enrolled in this study. Each patient of clinical characteristic information, blood routine parameters, and the haemogram-derived ratios were collected, calculated, and retrospectively analyzed. Receiver operating characteristics (ROC) was performed to investigate whether these parameters could be used to the predictive value of patients with severe COVID-19. Results: White blood cell count (WBC), neutrophil count (NEU), red cell volume distribution width (RDW), NLR, Platelet to lymphocyte ratio (PLR), neutrophil-to-platelet ratio (NPR), and SII were significantly higher in the severe groups than in the non-severe group (p < 0.01).Conversely, the severe group had a markedly decreased lymphocyte count, basophil (Baso#) count, red blood cell count (RBC), Hemoglobin (HGB), hematocrit (HCT), and lymphocyte-to-monocyte ratio (LMR) (P < 0.01).ROC curve analysis showed the AUC, optimal cut-off value, sensitivity, specificity of NLR and SII to early predict severe-patients with COVID-19 were 0.867, 7.25, 70.83%, 92.21% and 0.860, 887.20, 81.25%, 81.82%, respectively. Conclusion The results suggest that the SII and NLR is a potential new diagnosed biomarker in severe-patients with COVID-19.
Collapse
Affiliation(s)
- Wei Xia
- Department of Laboratory Medicine, Jingzhou Central Hospital; Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, China
| | - Yafeng Tan
- Department of Laboratory Medicine, Jingzhou Central Hospital; Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, China
| | - Shengmei Hu
- Department of Medicine, Xiangyang Vocational and Technical Collage, Xiangyang, Hubei, China
| | - Chengbin Li
- Department of Laboratory Medicine, Jingzhou Central Hospital; Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, China
| | - Tao Jiang
- Department of Laboratory Medicine, Jingzhou Central Hospital; Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, China
| |
Collapse
|
118
|
Zhang H, Yan J, Niu J, Wang H, Li X. Association between lead and cadmium co-exposure and systemic immune inflammation in residents living near a mining and smelting area in NW China. CHEMOSPHERE 2022; 287:132190. [PMID: 34826933 DOI: 10.1016/j.chemosphere.2021.132190] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/02/2021] [Accepted: 09/04/2021] [Indexed: 06/13/2023]
Abstract
Exposure to both cadmium (Cd) and lead (Pb) can promote systemic inflammation. However, the effects of combined exposure to environmental levels of Cd and Pb on systemic immune inflammation have not been fully clarified. A total of 486 subjects (313 women and 173 men) living in either a control area or heavy metal-polluted area were included. Blood Cd and Pb and immune inflammation biomarkers were determined, including the eosinophil-lymphocyte ratio (ELR), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), and systemic immune-inflammation index (SII); moreover, the associations between exposure markers and systemic inflammation markers were analysed. The exposure levels in the polluted area were significantly higher than those in the control area. The NLR, PLR, and SII of subjects in the polluted area were higher and the LMR was lower than in the control area. Blood Pb and Cd levels are associated with elevated or decreased immune inflammation biomarkers in subjects from the exposed and control areas. Furthermore, co-exposure to both Cd and Pb was divided into high, middle, and low exposure groups. The subjects in the high co-exposure group displayed higher levels of ELR, NLR, and SII compared with the middle and low co-exposure group, and LMR levels displayed the opposite trend. Our data demonstrate that Cd and Pb co-exposure is associated with systemic immune inflammation, and the immune inflammatory response is aggravated with an increased co-exposure to Cd and Pb.
Collapse
Affiliation(s)
- Honglong Zhang
- The First School of Clinical Medical, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Jun Yan
- The First School of Clinical Medical, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China; Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China; Key Laboratory of Biotherapy and Regenerative Medicine of Gansu Province, Lanzhou, 730000, Gansu, People's Republic of China; Hepatopancreatobiliary Surgery Institute of Gansu Province, Medical College Cancer Center of Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Jingping Niu
- Institute of Occupational and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Haiping Wang
- The First School of Clinical Medical, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China; Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China; Key Laboratory of Biotherapy and Regenerative Medicine of Gansu Province, Lanzhou, 730000, Gansu, People's Republic of China; Hepatopancreatobiliary Surgery Institute of Gansu Province, Medical College Cancer Center of Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Xun Li
- The First School of Clinical Medical, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China; Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China; Key Laboratory of Biotherapy and Regenerative Medicine of Gansu Province, Lanzhou, 730000, Gansu, People's Republic of China; Hepatopancreatobiliary Surgery Institute of Gansu Province, Medical College Cancer Center of Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China.
| |
Collapse
|
119
|
Li C, Wan S, Li W, Wang Y, Li B, Chen Y, Sun P, Lyu J. Higher Neutrophil to Lymphocyte Ratio at Admission is Association with Post-PCI Depressive Symptoms in Patients with ACS. Neuropsychiatr Dis Treat 2022; 18:2981-2990. [PMID: 36578901 PMCID: PMC9792112 DOI: 10.2147/ndt.s387582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Depression and elevated blood biomarkers of inflammation are common in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). Neutrophil to lymphocyte ratio (NLR) is an indicator of peripheral inflammation and has been proved to be associated with both ACS and depression. PURPOSE Our aim was to evaluate the possible association between NLR at admission and post-PCI depressive symptoms at 1 month. PATIENTS AND METHODS A total of 224 patients with ACS who underwent PCI for the first time were recruited and completed 1-month follow-up. The 24-item Hamilton Depression Scale (HAMD-24) was used to measure depressive symptoms at 1 month after PCI. Logistic regression was used to analyze the relationship between different NLR levels and post-PCI depressive symptoms. A receiver operating characteristic (ROC) curve analysis was performed to assess the value of NLR for predicting post-PCI depressive symptoms and to determine its critical value. RESULTS Of the 224 enrolled patients, 52 (23.2%) patients were diagnosed with depressive symptoms at 1 month after PCI. Patients with depressive symptoms showed significantly higher level of NLR at admission than patients without depressive symptoms (4.33 (3.26, 7.01) vs 2.57 (1.72, 3.91), P < 0.001). The proportion of depressive symptoms in post-PCI patients increases progressively along with NLR quartile. In the results of multivariate-adjusted logistic regression analysis, the odds ratio (OR) of post-PCI depressive symptoms was 12.028 (95% CI, 2.642-54.752) for the lowest quartile of NLR compared with the highest quartile. According to the receiver operating characteristic curve (ROC), the area under the curve (AUC) for predicting post-PCI depressive symptoms was 0.716 (95% CI, 0.641-0.791; P < 0.001), and the optimal cutoff of NLR levels was 3.235 (sensitivity: 76.9%, specificity: 66.9%). CONCLUSION Higher NLR levels at admission were associated with post-PCI depressive symptoms at 1 month, suggesting that NLR might be useful inflammatory markers to predict post-PCI depressive symptoms at 1 month.
Collapse
Affiliation(s)
- Cexing Li
- ChinaThree Gorges University, Yichang, People's Republic of China
| | - Shaozhi Wan
- ChinaThree Gorges University, Yichang, People's Republic of China
| | - Wenqian Li
- ChinaThree Gorges University, Yichang, People's Republic of China
| | - Yue Wang
- ChinaThree Gorges University, Yichang, People's Republic of China
| | - Bingqing Li
- ChinaThree Gorges University, Yichang, People's Republic of China
| | - Yuwen Chen
- ChinaThree Gorges University, Yichang, People's Republic of China
| | - Peiyuan Sun
- ChinaThree Gorges University, Yichang, People's Republic of China
| | - Jianfeng Lyu
- Affiliated Renhe Hospital of China Three Gorges University, Department of Cardiology, Yichang, People's Republic of China
| |
Collapse
|
120
|
ÇALIŞKAN T, YİLMAZ I, HACIOGLU F, ERSOZ E, DOĞAN M, KARAARSLAN N. eyin Apselerinin Tanı ve Farmakolojik Tedavisinde NLO Değeri Önemli midir? ACTA MEDICA ALANYA 2021. [DOI: 10.30565/medalanya.946066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
121
|
Zhang WJ, Liu GQ, Shangguan JH, Zhu XD, Wang W, Guo QQ, Zhang JC, Wang K, Liu ZY, Song FH, Fan L, Li L, Zheng YY, Zhang JY. ADS Score as a Novel Predictor of Outcomes in Patients Who Underwent Percutaneous Coronary Intervention. Front Cardiovasc Med 2021; 8:720597. [PMID: 34966791 PMCID: PMC8710751 DOI: 10.3389/fcvm.2021.720597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: A novel AFR– albumin-derived neutrophil to lymphocyte ratio (dNLR) score (ADS) were reported to associate with clinical outcome in various malignancies, However, the relation between the ADS score and outcomes in coronary artery disease (CAD) patients after percutaneous coronary intervention (PCI) has not been investigated. Methods: Three thousand five hundred and sixty-one patients were divided into two groups according to ADS score: low group (ADS score <2; n = 2,682) and high group (ADS score ≥ 2; n = 879). Overall, there were 133 all-cause mortality (ACM) during the following up. The incidence of ACM in the low group is 2.7% (72/2,682) and high group is 6.9% (61/879). The ACM incidence was significantly higher in high group compared to that in the low group (P < 0.001). Cardiac mortality (CM) occurred in 82 patients: 44(1.6%) in the low group and 38 (4.3%) in the high group. There was significant difference in the CM incidence between the low group and high group (P < 0.001). Major adverse cardiac and cerebrovascular events (MACCE) occurred in 520 patients: 366 (13.6%) in the low group and 154 (17.5%) in the high group. There was significant difference in the MACCE incidence between the low group and high group (P = 0.005). Major adverse cardiac and events (MACE) occurred in 395 patients: 281(10.5%) in the low group and 114 (13.0%) in the high group. There was significant difference in the MACE incidence between the low group and high group (P = 0.041). The multivariate Cox proportional hazards model showed that ADS score was independently correlated with the ACM [adjusted HR = 2.031 (1.357–3.039), P = 0.001]; CM [adjusted HR = 1.883 (1.127–3.147), P = 0.016]; MACCE [adjusted HR = 1.352 (1.096–1.668), P = 0.005], and MACE [adjusted HR = 1.260 (0.987–1.608), P = 0.063]. Conclusion: The present study indicated that the ADS score was associated with long-term mortality, the MACCE, and the MACE in CAD patients underwent PCI.
Collapse
Affiliation(s)
- Wen-Jing Zhang
- Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
| | - Gang-Qiong Liu
- Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
| | - Jia-Hong Shangguan
- Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
| | - Xiao-Dan Zhu
- Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
| | - Wei Wang
- Henan Medical Association, Zhengzhou, China
| | - Qian-Qian Guo
- Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
| | - Jian-Chao Zhang
- Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
| | - Kai Wang
- Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
| | - Zhi-Yu Liu
- Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
| | - Feng-Hua Song
- Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
| | - Lei Fan
- Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
| | - Ling Li
- Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ying-Ying Zheng
- Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
| | - Jin-Ying Zhang
- Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, China
| |
Collapse
|
122
|
Network Pharmacology Study on Molecular Mechanisms of Zhishi Xiebai Guizhi Decoction in the Treatment of Coronary Heart Disease. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:3574321. [PMID: 34966435 PMCID: PMC8712121 DOI: 10.1155/2021/3574321] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/15/2021] [Accepted: 11/25/2021] [Indexed: 12/26/2022]
Abstract
Background Coronary heart disease is characterized by the formation of arterial plaque. If not taken seriously, it will cause serious consequences such as myocardial infarction and heart failure. Zhishi Xiebai Guizhi Decoction first appeared in “Synopsis of Prescriptions of the Golden Chamber” and is a representative prescription for the treatment of coronary heart disease. This study aims to explain the mechanism of Zhishi Xiebai Guizhi Decoction in the treatment of coronary heart disease through network pharmacology and clinical trials. Methods We first identified the core compounds of Zhishi Xiebai Guizhi Decoction and their potential targets through TCMSP. Then, We analyzed the molecular targets of Zhishi Xiebai Guizhi Decoction in coronary heart disease with OMIM and GeneCards databases. After the common targets were screened out, we manage to figure out the pathways of these target genes through STRING. Finally, we verify the treatment results in clinical trials. Results Through network pharmacology analysis, we discovered that several core compounds of Zhishi Xiebai Guizhi Decoction have anti-inflammatory effects and are of great significance to treatment of cardiovascular diseases. The mechanism may be closely related to PPARγ, inflammation, TNF signaling pathway, AMPK signaling pathway, and PI3K-Akt signaling pathway. Clinical trials have also proved the key role of inflammation. Conclusions Zhishi Xiebai Guizhi Decoction may play a role in treating coronary heart disease by activating PPARγ. TNF signaling pathway, AMPK signaling pathway, and PI3K-Akt signaling pathway are potential mechanisms as well. The application of network pharmacology can provide a novel method for the research of Chinese herbal medicine. We hope that Zhishi Xiebai Guizhi Decoction will be recognized as a complementary or alternative treatment for coronary heart disease.
Collapse
|
123
|
Krečak I, Holik H, Morić Perić M, Zekanović I, Coha B, Valovičić Krečak M, Gverić-Krečak V, Lucijanić M. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as prognostic biomarkers in polycythemia vera. Int J Lab Hematol 2021; 44:e145-e148. [PMID: 34970854 DOI: 10.1111/ijlh.13786] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/09/2021] [Accepted: 12/15/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Ivan Krečak
- Department of Internal Medicine, General Hospital of Šibenik-Knin County, Šibenik, Croatia
| | - Hrvoje Holik
- Department of Internal Medicine, "Dr. Josip Benčević" General Hospital, Slavonski Brod, Croatia.,School of Medicine, University of Osijek, Osijek, Croatia
| | | | - Ivan Zekanović
- Department of Internal Medicine, General Hospital Zadar, Zadar, Croatia
| | - Božena Coha
- Department of Internal Medicine, "Dr. Josip Benčević" General Hospital, Slavonski Brod, Croatia
| | | | - Velka Gverić-Krečak
- Department of Internal Medicine, General Hospital of Šibenik-Knin County, Šibenik, Croatia
| | - Marko Lucijanić
- University Hospital Dubrava, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| |
Collapse
|
124
|
Liu C, Wu M, Fu M, Wang H, Nie J. Dose-response relationships between polycyclic aromatic hydrocarbon exposure and blood cell counts among coke oven workers: a sex-stratified analysis. BMJ Open 2021; 11:e046843. [PMID: 35099406 PMCID: PMC8719181 DOI: 10.1136/bmjopen-2020-046843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES To explore sex differences and dose-response relationships between nine urinary polycyclic aromatic hydrocarbon (PAH) metabolites and neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and complete blood counts among coke oven workers. DESIGN AND SETTING A cross-sectional study with stratified sex was conducted in Shanxi, China. PARTICIPANTS A total of 458 male workers and 226 female workers were selected. PRIMARY AND SECONDARY OUTCOME MEASURES General linear models, p values for trend tests and natural cubic spline models were used to explore the dose-response relationships between nine urinary PAH metabolites and NLR, PLR and complete blood counts. RESULT Compared with male workers, female workers had lower exposure level of PAH (0.95 ng/mL vs 1.38 ng/mL). Only among female workers did we observe that a 1-unit increase in lg(1-OHPyr) was related to a 0.149 (95% CI: 0.055 to 0.242; p for trend=0.041) and 0.103 (95% CI: 0.025 to 0.181; p for trend=0.007) increase in lg(NLR) and lg(PLR), and a 0.116 (95% CI: -0.179 to -0.054; p for trend=0.007) decrease in lg(lymphocyte counts (LYMs)). A 1-unit increase in lg(2-OHNap) was related to a 0.045 (95% CI: 0.003 to 0.086; p for trend=0.037) increase in lg(PLR) and a 0.029 (95% CI: -0.056 to -0.002; p for trend=0.030) and 0.016 (95% CI: -0.029 to -0.003; p for trend=0.010) decrease in lg(white blood cell counts (WBCs)) and lg(haemoglobin (HGB)). CONCLUSION Female workers' NLR, PLR, WBCs, HGB and LYMs may be more susceptible than those of male workers when affected by PAH.
Collapse
Affiliation(s)
- Chengjuan Liu
- Occupational Health, Shanxi Medical University School of Public Health, Taiyuan, Shanxi, China
| | - Min Wu
- Occupational Health, Shanxi Medical University School of Public Health, Taiyuan, Shanxi, China
| | - Mengmeng Fu
- Occupational Health, Shanxi Medical University School of Public Health, Taiyuan, Shanxi, China
| | - Huimin Wang
- Occupational Health, Shanxi Medical University School of Public Health, Taiyuan, Shanxi, China
| | - Jisheng Nie
- Occupational Health, Shanxi Medical University School of Public Health, Taiyuan, Shanxi, China
| |
Collapse
|
125
|
Hedbrant A, Eklund D, Andersson L, Bryngelsson IL, Persson A, Westberg H, Särndahl E. Effects on white blood cell counts and the NLRP3 inflammasome due to dust and cobalt exposure in the hard metal industry. Biomarkers 2021; 27:60-70. [PMID: 34872432 DOI: 10.1080/1354750x.2021.2013538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION In light of potential negative health effects of cobalt exposure, a characterization of inflammatory mechanisms in exposed individuals is warranted. The current study investigated cobalt exposure in the Swedish hard metal industry and its relationship to inflammatory markers, including NLRP3 inflammasome activation and white blood cell (WBC) counts. MATERIALS AND METHODS Inhalable cobalt and dust exposures, and systemic cobalt levels, were determined for 72 workers in the hard metal industry and linear regression models were applied to correlate exposure to markers of inflammasome activation and WBC counts. RESULTS Mean exposures to inhalable dust (0.11 mg/m3) and cobalt (0.0034 mg/m3) were below the Swedish occupational exposure limits, and these low exposures did not correlate with any investigated outcomes. Instead, cobalt blood levels significantly correlated with a ca 10% decrease in IL-18 plasma levels per 10 nM cobalt increase. Furthermore, pre-shift cobalt blood and/or urine levels significantly correlated with some WBC measures, including decreased neutrophil-to-lymphocyte ratio, increased lymphocyte-to-monocyte ratio, and lymphocyte counts. CONCLUSION The low inhalable particle exposures had no impact on WBC counts and inflammasome activation. Instead, systemic cobalt levels, which also include skin exposure, demonstrated possible suppressive effects on inflammatory responses in cobalt-exposed individuals in the hard metal industry.
Collapse
Affiliation(s)
- Alexander Hedbrant
- Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden.,Faculty of Medicine and Health, Inflammatory Response and Infection Susceptibility Centre (iRiSC), Örebro University, Örebro, Sweden
| | - Daniel Eklund
- Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden.,Faculty of Medicine and Health, Inflammatory Response and Infection Susceptibility Centre (iRiSC), Örebro University, Örebro, Sweden
| | - Lena Andersson
- Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden.,Faculty of Medicine and Health, Inflammatory Response and Infection Susceptibility Centre (iRiSC), Örebro University, Örebro, Sweden.,Department of Occupational and Environmental Medicine, Örebro University Hospital, Örebro, Sweden
| | - Ing-Liss Bryngelsson
- Department of Occupational and Environmental Medicine, Örebro University Hospital, Örebro, Sweden
| | - Alexander Persson
- Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden.,Faculty of Medicine and Health, Inflammatory Response and Infection Susceptibility Centre (iRiSC), Örebro University, Örebro, Sweden
| | - Håkan Westberg
- Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden.,Faculty of Medicine and Health, Inflammatory Response and Infection Susceptibility Centre (iRiSC), Örebro University, Örebro, Sweden.,Department of Occupational and Environmental Medicine, Örebro University Hospital, Örebro, Sweden
| | - Eva Särndahl
- Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden.,Faculty of Medicine and Health, Inflammatory Response and Infection Susceptibility Centre (iRiSC), Örebro University, Örebro, Sweden
| |
Collapse
|
126
|
Marin BS, Cesen F, Laurinavicius AG, Santos RD, Bittencourt MS. Razão Neutrófilo-Linfócito e Aterosclerose da Aorta Abdominal entre Indivíduos Assintomáticos. Arq Bras Cardiol 2021; 118:729-734. [PMID: 35137782 PMCID: PMC9007006 DOI: 10.36660/abc.20201163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 05/12/2021] [Indexed: 11/18/2022] Open
Abstract
Fundamento A razão neutrófilo-linfócito (RNL) tem sido proposta como um marcador inflamatório possivelmente associado a aterosclerose coronariana, embora a maioria dos dados atuais seja restrita à fase aguda. Além disso, a associação entre a RNL e a aterosclerose extracoronariana ainda não está clara. Objetivo Analisar a associação entre a RNL e aterosclerose da aorta abdominal (AtAA). Métodos Foram incluídos pacientes assintomáticos submetidos a um programa de rastreamento. A AtAA foi avaliada através de ultrassom. Os números absolutos de leucócitos e linfócitos foram utilizados para calcular a RNL. Foi estabelecido um nível de significância estatística de 0,05. Resultados De 36.985 indivíduos (idade: 42±10 anos, 72% homens), foi identificada a presença de AtAA em 7%. Aqueles com AtAA eram mais velhos e tinham maior propensão a serem homens e diabéticos. A presença de AtAA foi associada a RNL aumentada (odds ratio [OR] 1,17; intervalo de confiança de 95% [IC95%] 1,13-1,21). No entanto, a associação deixou de ser significativa quando a análise foi ajustada para os fatores de risco (OR 1,02; IC95% 0,97-1,06), principalmente devido à inclusão da idade no modelo. Quando os neutrófilos e linfócitos foram analisados separadamente, a associação negativa entre os linfócitos e a RNL foi invertida com a inclusão da idade, o que sugere um forte efeito confundidor da idade na relação entre linfócitos e aterosclerose. Por fim, a associação entre os neutrófilos e a AtAA deixou de ser significativa após o ajuste adicional para os fatores de risco tradicionais, mas não apenas para a idade. Conclusão Embora a RNL tenha se associado a AtAA, foi principalmente devido ao efeito confundidor da idade. No geral, os resultados sugerem um papel limitado da contagem de leucócitos como biomarcador de AtAA.
Collapse
|
127
|
Shi M, Yang C, Tang QW, Xiao LF, Chen ZH, Zhao WY. The Prognostic Value of Neutrophil-to-Lymphocyte Ratio in Patients With Aneurysmal Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis of Observational Studies. Front Neurol 2021; 12:745560. [PMID: 34867727 PMCID: PMC8636120 DOI: 10.3389/fneur.2021.745560] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/12/2021] [Indexed: 12/26/2022] Open
Abstract
The neutrophil–to-lymphocyte ratio (NLR), as an essential systemic inflammation factor, has been widely used as a prognostic indicator in various diseases, such as malignant tumors, cardiovascular disease, and intracranial hemorrhage. An increasing number of studies have believed that NLR is a valuable predictor of prognosis for patients with aneurysmal subarachnoid hemorrhage (aSAH). However, these results remain controversial. In the current study, we planned to carry out a systematic review and meta-analysis to investigate the association between NLR and poor outcome, and the occurrence of delayed cerebral ischemia (DCI). We carried out a comprehensive search for published literatures on PubMed, EMBASE, Cochrane Library, and Web of Science databases from inception to April 1, 2021. We conducted an assessment of all included studies based on the principles proposed in the Newcastle-Ottawa Quality Assessment Scale (NOS). Poor outcome and the occurrence of DCI were considered as the main outcome measure. We calculated the pooled odds ratio (OR) and corresponding 95% confidence interval (CI) to examine the strength of the association of NLR with poor outcome or the occurrence of DCI. We strictly selected a total of 10 studies comprising 4,989 patients. Nine studies reported the association between NLR and poor outcome, and five studies reported the association between NLR and the occurrence of DCI. The pooled results indicated higher NLR was significantly associated with both poorer outcomes (OR = 1.32, 95%CI 1.11–1.57; P = 0.002, I2 = 87%), and the occurrence of DCI (OR = 1.72, 95%CI 1.22–2.41; P = 0.002, I2 = 82%) in aSAH patients. The NLR is a valuable indicator of inflammation to independently predict poor outcome and occurrence of DCI after aSAH, where a higher NLR is significantly associated with poor outcomes and occurrence of DCI. These findings suggest that the NLR can help clinicians evaluate the prognosis and identify potentially severe patients early, which may contribute to better management and improve poor prognosis of aSAH patients.
Collapse
Affiliation(s)
- Min Shi
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Chao Yang
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Qing-Wen Tang
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Ling-Fei Xiao
- Department of Orthopaedics, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zu-Han Chen
- Institute of Hepatobiliary Diseases of Wuhan University, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Wen-Yuan Zhao
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| |
Collapse
|
128
|
Onur D, Neslihan AK, Samet K. A comparative study of complete blood count inflammatory markers in substance-free acute psychotic disorder and substance-induced psychosis. Early Interv Psychiatry 2021; 15:1522-1530. [PMID: 33254284 DOI: 10.1111/eip.13089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 09/06/2020] [Accepted: 11/15/2020] [Indexed: 11/29/2022]
Abstract
AIM Recent studies showed a compare complete blood count (CBC) with its related measurements, including neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), and platelet to lymphocyte ratio, are a simple and affordable test for inflammatory markers. The aim of this controlled study is to compare CBC inflammatory markers in substance-induced psychosis (SIP) and substance-free acute psychotic disorder (SF-APD) and to evaluate whether these CBC inflammation values can be used in diagnosis. METHODS This retrospective study was conducted with the data of 76 SF-APD patients (including 60 cases of first-episode psychosis [FEP]), 98 SIP patients (including 48 cases of FEP), and 32 controls. RESULTS Patients with SF-APD and SIP had higher white blood cell counts, neutrophil and monocyte counts, and MLR than controls. An increased NLR was more distinct in SF-APD, while an increased MLR was observed in APD (both SF and SI) and FEP groups more than in the controls. A receiver operating characteristic analysis showed that the NLR could contribute to the identification of SF-APD (52.6% sensitivity and 12.5% specificity, area under curve [AUC] = 0.704, 2.47 cutoff value) while an MLR could contribute to the identification of APD (70.1% sensitivity and 12.5% specificity, AUC = 0.842) as well as FEP (71.3% sensitivity and 12.5% specificity AUC = 0.831) with 0.26 cutoff value. CONCLUSIONS An NLR and MLR might be of interest for inflammatory processes involved in acute and first-episode psychotic events, regardless of substance involvement.
Collapse
Affiliation(s)
- Durmaz Onur
- Department of Psychiatry, Erenköy Mental Health and Neurology Training & Research Hospital, İstanbul, Turkey
| | - Akkişi Kumsar Neslihan
- Department of Psychiatry, Erenköy Mental Health and Neurology Training & Research Hospital, İstanbul, Turkey
| | - Kurnaz Samet
- Department of Psychiatry, Erenköy Mental Health and Neurology Training & Research Hospital, İstanbul, Turkey
| |
Collapse
|
129
|
Chung BR, Huang YT, Lai PC. Can preoperative neutrophil-to-lymphocyte ratio predict in-hospital mortality in postoperative patients with Stanford type A aortic dissection? Evidence-based appraisal by meta-analysis and GRADE. Tzu Chi Med J 2021; 33:388-394. [PMID: 34760636 PMCID: PMC8532590 DOI: 10.4103/tcmj.tcmj_249_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/07/2020] [Accepted: 10/27/2020] [Indexed: 11/10/2022] Open
Abstract
Objectives: In-hospital mortality in postoperative patients with type A aortic dissection (AAD) is high. Neutrophil-to-lymphocyte ratio (NLR) is a novel predictor of adverse outcomes in many cardiovascular diseases. We examine NLR as a predictive tool in AAD in this meta-analysis. Materials and Methods: We systematically searched in four databanks. Risk of bias was appraised using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. The midas and metandi commands in Stata 15 were used for the meta-analysis. The certainty of evidence was assessed by the Grading of Recommendations, Assessment, Development, and Evaluation methodology (GRADE). Results: Four studies with 502 cases in total were included. Pooled sensitivity and specificity were 0.71 (95% confidence interval [CI] = 0.52–0.79) and 0.64 (95% CI = 0.55–0.71), respectively. Area under the hierarchical summary receiver operating characteristic curve yielded 0.73 (95% CI = 0.68–0.76). The diagnostic odds ratio was 4.42 (95% CI = 2.56–7.62). Pooled positive and negative likelihood ratios yielded 1.98 (95% CI = 1.53–2.55) and 0.45 (95% CI = 0.32–0.62), respectively. When the pretest probabilities were 25%, 50%, and 75%, the positive posttest probabilities were 40%, 66%, and 86%, and the negative posttest probabilities were 13%, 31%, and 57%, respectively, according to the Fagan's nomogram plot. The overall certainty of evidence in GRADE was low and very low in sensitivity and specificity, respectively. Conclusion: The pooled diagnostic values of preoperative NLR, an inexpensive and routine laboratory examination, provide a practicable help for predicting in-hospital mortality for patients with postoperative AAD in our meta-analysis.
Collapse
Affiliation(s)
- Bing-Ru Chung
- Division of Cardiovascular Surgery, Department of Surgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Yen-Ta Huang
- Division of Experimental Surgery, Department of Surgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,Department of Surgery, Surgical Intensive Care Unit, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,Department of Pharmacology, Tzu Chi University, Hualien, Taiwan
| | - Pei-Chun Lai
- Department of Medical Education, Evidence-based Medicine Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,Department of Pediatrics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| |
Collapse
|
130
|
Tsouloufi TK, Frezoulis PS, Soubasis N, Kritsepi-Konstantinou M, Oikonomidis IL. Diagnostic and prognostic value of peripheral blood leucocyte ratios in sick cats. Acta Vet Hung 2021; 69:308-314. [PMID: 34747357 DOI: 10.1556/004.2021.00042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 09/23/2021] [Indexed: 11/19/2022]
Abstract
The objective of this study was to assess the diagnostic and prognostic utility of feline neutrophil-to-lymphocyte (NLR) and lymphocyte-to-monocyte ratios (LMR) in a variety of underlying diseases. Five-year medical records from cats presenting to the internal medicine unit of a veterinary teaching hospital were retrospectively reviewed. Cats were considered for inclusion based on complete medical records. ADVIA 120 was used for the complete blood counts; the NLR and LMR were calculated by dividing the absolute numbers of the respective leucocytes. Two hundred and nineteen sick and 20 healthy cats were included in the study. The median NLR and LMR were significantly (P < 0.05) elevated and decreased, respectively, in cats with infectious, neoplastic and chronic kidney diseases compared to controls. Additionally, cats with neoplasia had significantly higher median NLR compared to cats with urinary tract and gastrointestinal diseases. Non-survivors had significantly higher NLR and lower LMR compared to survivors. Both ratios had suboptimal prognostic performance for the outcome of sick cats (NLR sensitivity: 37.9%, specificity: 86.4%; LMR sensitivity: 69.0%, specificity: 61.0%). Many different disease categories were associated with increased NLR and decreased LMR compared to controls, but the overall prognostic performance of the two leucocyte ratios was suboptimal.
Collapse
Affiliation(s)
- Theodora K Tsouloufi
- 1 School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Petros S Frezoulis
- 1 School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- 2 Southfields Veterinary Specialists, Laindon, Essex, UK
| | - Nectarios Soubasis
- 1 School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Kritsepi-Konstantinou
- 1 School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis L Oikonomidis
- 1 School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|
131
|
Sung HM, Lee SH, Oh AR, Kim S, Kim J, Gook J, Jang JN, Park J. Association between preoperative neutrophil-lymphocyte ratio and mortality after plastic and reconstructive surgery. Sci Rep 2021; 11:21541. [PMID: 34728689 PMCID: PMC8564523 DOI: 10.1038/s41598-021-00901-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 10/12/2021] [Indexed: 11/09/2022] Open
Abstract
Predictive factors associated with postoperative mortality have not been extensively studied in plastic and reconstructive surgery. Neutrophil-lymphocyte ratio (NLR), a systemic inflammation index, has been shown to have a predictive value in surgery. We aimed to evaluate association between preoperative NLR and postoperative outcomes in patients undergoing plastic and reconstructive surgery. From January 2011 to July 2019, we identified 7089 consecutive adult patients undergoing plastic and reconstructive surgery. The patients were divided according to median value of preoperative NLR of 1.84. The low NLR group was composed of 3535 patients (49.9%), and 3554 patients (50.1%) were in the high NLR group. The primary outcome was mortality during the first year, and overall mortality and acute kidney injury were also compared. In further analysis, outcomes were compared according to quartile of NLR, and a receiver operating characteristic curve was constructed to estimate the threshold associated with 1-year mortality. This observational study showed that mortality during the first year after plastic and reconstructive surgery was significantly increased in the high NLR group (0.7% vs. 3.5%; hazard ratio, 4.23; 95% confidence interval, 2.69-6.63; p < 0.001), and a graded association was observed between preoperative NLR and 1-year mortality. The estimated threshold of preoperative NLR was 2.5, with an area under curve of 0.788. Preoperative NLR may be associated with 1-year mortality after plastic and reconstructive surgery. Further studies are needed to confirm our findings.
Collapse
Affiliation(s)
- Ha Min Sung
- Link Plastic Surgery Clinic, Seoul, South Korea
| | - Seung-Hwa Lee
- Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Heart Vascular Stroke Institute, Seoul, South Korea.,Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, South Korea
| | - Ah Ran Oh
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.,Department of Anesthesiology and Pain Medicine, Kangwon National University Hospital, Chuncheon, South Korea
| | - Sojin Kim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Jeayoun Kim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Joonhee Gook
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Jae Ni Jang
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Jungchan Park
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea. .,Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, South Korea.
| |
Collapse
|
132
|
Yilmaz B, Somay E, Selek U, Topkan E. Pretreatment Systemic Immune-Inflammation Index Predict Needs for Teeth Extractions for Locally Advanced Head and Neck Cancer Patients Undergoing Concurrent Chemoradiotherapy. Ther Clin Risk Manag 2021; 17:1113-1121. [PMID: 34703240 PMCID: PMC8536877 DOI: 10.2147/tcrm.s334556] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/10/2021] [Indexed: 12/13/2022] Open
Abstract
Background To evaluate the utility of pretreatment systemic immune-inflammation index (SII) in predicting the teeth caries and need for tooth extraction after concurrent chemoradiotherapy (C-CRT) for locally advanced squamous-cell head and neck cancer (LA-SCHNC) patients. Methods The records of LA-SCHNC patients who underwent formal dental evaluations at pre- and post-C-CRT periods were retrospectively analyzed. The pretreatment SII values were calculated using the platelet, neutrophil, and lymphocyte measures acquired on the first day of C-CRT: SII=Platelets×neutrophils/lymphocytes. Receiver operating characteristic (ROC) curve analysis was employed to identify the ideal pre-C-CRT SII cutoff that may predict the teeth caries and the need for tooth extraction after the C-CRT. The primary endpoint was the link between the pre-C-CRT SII and the need for tooth extraction during the follow-up period. Results A sum of 126 patients were included. Median follow-up was 4.9 years (range: 2.7–7.8). Nasopharyngeal and laryngeal cancers comprised the majority (75.4%) study cohort. Post-treatment teeth extractions were reported in 62.7% patients. The optimal cutoff was 558 [Area under the curve (AUC): %76.8 sensitivity: 72.3%; and specificity: 70.9%] that grouped the patients into two subgroups with significantly different post-C-CRT tooth extraction rates: Group 1: SII≤558 (n = 70) and SII>558 (n = 56), respectively. Correlation analysis revealed a significant relationship between the pretreatment SII and the tooth extraction rates after the C-CRT (rs:0.89: P = 0.001). The comparative analysis displayed that the teeth extractions rates were significantly higher in the SII>558 group (77.1% versus 51.4% for SII≤558; Hazard ratio: 1.68; P = 0.001). Further analyses showed that the pre-C-CRT SII>558 was the unique factor associated with meaningfully higher necessities for post-C-CRT teeth extractions. Conclusion The present outcomes intimated that high pretreatment SII levels were linked to significantly increased post-treatment teeth extractions in LA-SCHNC patients undergoing definitive C-CRT.
Collapse
Affiliation(s)
- Busra Yilmaz
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Baskent University, Ankara, Turkey
| | - Efsun Somay
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Baskent University, Ankara, Turkey
| | - Ugur Selek
- Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.,Department of Radiation Oncology, MD Anderson Cancer Center, The University of Texas, Houston, TX, USA
| | - Erkan Topkan
- Department of Radiation Oncology, Faculty of Medicine, Baskent University, Adana, Turkey
| |
Collapse
|
133
|
Liu GQ, Zhang WJ, Shangguan JH, Zhu XD, Wang W, Guo QQ, Zhang JC, Wang K, Liu ZY, Song FH, Fan L, Zheng YY, Zhang JY. Association of Derived Neutrophil-To-Lymphocyte Ratio With Prognosis of Coronary Heart Disease After PCI. Front Cardiovasc Med 2021; 8:705862. [PMID: 34604350 PMCID: PMC8484317 DOI: 10.3389/fcvm.2021.705862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/16/2021] [Indexed: 01/22/2023] Open
Abstract
Aims: The present study aimed to investigate the prognostic role of derived neutrophil-to-lymphocyte ratio (dNLR) in patients with coronary heart disease (CHD) after PCI. Methods: A total of 3,561 post-PCI patients with CHD were retrospectively enrolled in the CORFCHD-ZZ study from January 2013 to December 2017. The patients (3,462) were divided into three groups according to dNLR tertiles: the first tertile (dNLR < 1.36; n = 1,139), second tertile (1.36 ≥ dNLR < 1.96; n = 1,166), and third tertile(dNLR ≥ 1.96; n = 1,157). The mean follow-up time was 37.59 ± 22.24 months. The primary endpoint was defined as mortality (including all-cause death and cardiac death), and the secondary endpoint was major adverse cardiovascular events (MACEs) and major adverse cardiovascular and cerebrovascular events (MACCEs). Results: There were 2,644 patients with acute coronary syndrome (ACS) and 838 patients with chronic coronary syndrome (CCS) in the present study. In the total population, the all-cause mortality (ACM) and cardiac mortality (CM) incidence was significantly higher in the third tertile than in the first tertile [hazard risk (HR) = 1.8 (95% CI: 1.2–2.8), p = 0.006 and HR = 2.1 (95% CI: 1.23–3.8), p = 0.009, respectively]. Multivariate Cox regression analyses suggested that compared with the patients in the first tertile than those in the third tertile, the risk of ACM was increased 1.763 times (HR = 1.763, 95% CI: 1.133–2.743, p = 0.012), and the risk of CM was increased 1.763 times (HR = 1.961, 95% CI: 1.083–3.550, p = 0.026) in the higher dNLR group during the long-term follow-up. In both ACS patients and CCS patients, there were significant differences among the three groups in the incidence of ACM in univariate analysis. We also found that the incidence of CM was significantly different among the three groups in CCS patients in both univariate analysis (HR = 3.541, 95% CI: 1.154–10.863, p = 0.027) and multivariate analysis (HR = 3.136, 95% CI: 1.015–9.690, p = 0.047). Conclusion: The present study suggested that dNLR is an independent and novel predictor of mortality in CHD patients who underwent PCI.
Collapse
Affiliation(s)
- Gang-Qiong Liu
- Department of Cardiology, Key Laboratory of Cardiac Injury and Repair of Henan Province, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wen-Jing Zhang
- Department of Cardiology, Key Laboratory of Cardiac Injury and Repair of Henan Province, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jia-Hong Shangguan
- Department of Cardiology, Key Laboratory of Cardiac Injury and Repair of Henan Province, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Administration Department of Henan Medical Association, Zhengzhou, China
| | - Xiao-Dan Zhu
- Department of Cardiology, Key Laboratory of Cardiac Injury and Repair of Henan Province, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Administration Department of Henan Medical Association, Zhengzhou, China
| | - Wei Wang
- Administration Department of Henan Medical Association, Zhengzhou, China
| | - Qian-Qian Guo
- Department of Cardiology, Key Laboratory of Cardiac Injury and Repair of Henan Province, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jian-Chao Zhang
- Department of Cardiology, Key Laboratory of Cardiac Injury and Repair of Henan Province, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Kai Wang
- Department of Cardiology, Key Laboratory of Cardiac Injury and Repair of Henan Province, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhi-Yu Liu
- Department of Cardiology, Key Laboratory of Cardiac Injury and Repair of Henan Province, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Feng-Hua Song
- Department of Cardiology, Key Laboratory of Cardiac Injury and Repair of Henan Province, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lei Fan
- Department of Cardiology, Key Laboratory of Cardiac Injury and Repair of Henan Province, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ying-Ying Zheng
- Department of Cardiology, Key Laboratory of Cardiac Injury and Repair of Henan Province, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jin-Ying Zhang
- Department of Cardiology, Key Laboratory of Cardiac Injury and Repair of Henan Province, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| |
Collapse
|
134
|
Verheyen VJ, Remy S, Govarts E, Colles A, Rodriguez Martin L, Koppen G, Voorspoels S, Bruckers L, Bijnens EM, Vos S, Morrens B, Coertjens D, De Decker A, Franken C, Den Hond E, Nelen V, Covaci A, Loots I, De Henauw S, Van Larebeke N, Teughels C, Nawrot TS, Schoeters G. Urinary Polycyclic Aromatic Hydrocarbon Metabolites Are Associated with Biomarkers of Chronic Endocrine Stress, Oxidative Stress, and Inflammation in Adolescents: FLEHS-4 (2016-2020). TOXICS 2021; 9:toxics9100245. [PMID: 34678941 PMCID: PMC8537433 DOI: 10.3390/toxics9100245] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 01/06/2023]
Abstract
Polycyclic aromatic hydrocarbons (PAHs) are environmental pollutants of public health concern. Multiple biological mechanisms have been hypothesized to contribute to PAHs-associated adverse health effects. Little is known about the impact of PAHs on endocrine stress and inflammation in adolescence. We examined 393 Flemish adolescents (14-15 years) cross-sectionally, measured urinary concentrations of hydroxylated naphthalene, fluorene, phenanthrene and pyrene metabolites, and calculated the sum of all measured metabolites. We determined hair cortisol concentration (HCC) as endocrine stress biomarker, leucocyte counts and neutrophil-lymphocyte ratio (NLR) in peripheral blood as inflammatory biomarkers, and urinary 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG) concentration as oxidative stress biomarker. Exposure-response associations were analyzed by multiple regression, adjusted for a priori selected covariates. A doubling of 1-hydroxypyrene concentration was associated with a factor of 1.13 (95% CI: 1.03, 1.24) increase in HCC and a factor of 1.07 (95% CI: 1.02, 1.13) increase in 8-oxodG. Doublings of 2- and 3-hydroxyphenanthrene concentrations were associated with a factor of 1.08 (95% CI: 1.02, 1.14) and 1.06 (95% CI: 1.00, 1.12) increase in 8-oxodG, respectively. Doubling of 2-hydroxyphenanthrene and of the sum of 2- and 3-hydroxyfluorene was associated with, respectively, a factor of 1.08 (95% CI: 1.02, 1.14) and 1.06 (95% CI: 1.01, 1.13) increase in NLR. Our results indicate the glucocorticoid pathway as a potential target for PAH exposure in adolescents and suggest oxidative stress, endocrine stress, and inflammation in adolescence as underlying mechanisms and early markers for PAH-related adverse health effects.
Collapse
Affiliation(s)
- Veerle J. Verheyen
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (S.R.); (E.G.); (A.C.); (L.R.M.); (G.K.); (G.S.)
- Department of Biomedical Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
- Correspondence:
| | - Sylvie Remy
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (S.R.); (E.G.); (A.C.); (L.R.M.); (G.K.); (G.S.)
| | - Eva Govarts
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (S.R.); (E.G.); (A.C.); (L.R.M.); (G.K.); (G.S.)
| | - Ann Colles
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (S.R.); (E.G.); (A.C.); (L.R.M.); (G.K.); (G.S.)
| | - Laura Rodriguez Martin
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (S.R.); (E.G.); (A.C.); (L.R.M.); (G.K.); (G.S.)
| | - Gudrun Koppen
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (S.R.); (E.G.); (A.C.); (L.R.M.); (G.K.); (G.S.)
| | - Stefan Voorspoels
- VITO GOAL, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium;
| | - Liesbeth Bruckers
- I-BioStat, Data Science Institute, Hasselt University, Martelarenlaan 42, 3500 Hasselt, Belgium;
| | - Esmée M. Bijnens
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium; (E.M.B.); (S.V.); (T.S.N.)
| | - Stijn Vos
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium; (E.M.B.); (S.V.); (T.S.N.)
| | - Bert Morrens
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Sint-Jacobstraat 2, 2000 Antwerp, Belgium; (B.M.); (D.C.); (I.L.)
| | - Dries Coertjens
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Sint-Jacobstraat 2, 2000 Antwerp, Belgium; (B.M.); (D.C.); (I.L.)
| | - Annelies De Decker
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000 Antwerp, Belgium; (A.D.D.); (C.F.); (E.D.H.); (V.N.)
| | - Carmen Franken
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000 Antwerp, Belgium; (A.D.D.); (C.F.); (E.D.H.); (V.N.)
| | - Elly Den Hond
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000 Antwerp, Belgium; (A.D.D.); (C.F.); (E.D.H.); (V.N.)
| | - Vera Nelen
- Provincial Institute of Hygiene, Kronenburgstraat 45, 2000 Antwerp, Belgium; (A.D.D.); (C.F.); (E.D.H.); (V.N.)
| | - Adrian Covaci
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium;
| | - Ilse Loots
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Sint-Jacobstraat 2, 2000 Antwerp, Belgium; (B.M.); (D.C.); (I.L.)
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium;
| | - Nicolas Van Larebeke
- Analytical, Environmental and Geo-Chemistry, Vrije Universiteit Brussel, 1050 Brussels, Belgium;
- Department of Radiotherapy and Experimental Cancerology, Ghent University, B-9000 Ghent, Belgium
| | - Caroline Teughels
- Flemish Planning Bureau for the Environment and Spatial Development, Koning Albert II laan 20, bus 8, 1000 Brussels, Belgium;
| | - Tim S. Nawrot
- Centre for Environmental Sciences, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium; (E.M.B.); (S.V.); (T.S.N.)
| | - Greet Schoeters
- VITO Health, Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; (S.R.); (E.G.); (A.C.); (L.R.M.); (G.K.); (G.S.)
- Department of Biomedical Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| |
Collapse
|
135
|
Marazziti D, Torrigiani S, Carbone MG, Mucci F, Flamini W, Ivaldi T, Osso LD. Neutrophil/lymphocyte, platelet/lymphocyte and monocyte/lymphocyte ratios in mood disorders. Curr Med Chem 2021; 29:5758-5781. [PMID: 34551689 DOI: 10.2174/0929867328666210922160116] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/27/2021] [Accepted: 08/04/2021] [Indexed: 11/22/2022]
Abstract
Major depressive disorder (MDD) and bipolar disorders (BDs), the most severe types of mood disorders (MDs), are considered as among the most disabling illnesses worldwide. Several studies suggested that inflammatory neuroinflammation might be involved in the pathophysiology of MDs, while reporting increasing data on the relationships between these processes and classical neurotransmitters, hypothalamus-pituitary-adrenal axis (HPA), and neurotrophic factors. The assessment of neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and monocyte/lymphocyte ratio (MLR) in peripheral blood represents a simple method to evaluate the inflammatory status. The aim of the present paper was to review the literature on the possible relationships between NLR, PLR and MLR in MDs, and to comment on their possible wider use in clinical research. Thirty-five studies were included in the present review. The majority of them higher values of these parameters, particularly NLR values, in patients with MDs, when compared to healthy subjects. The increase would appear more robust in patients with BD during a manic episode, thus indicating that it could be considered as both state and trait markers. In addition, increased NLR and PLR levels seem to represent prognostic elements for the early discovery of post-stroke depression. The findings of the present review would indicate the need to carry our further studies in this field. In particular, NLR, PLR and MLR seem to be promising tools to detect economically and easily the activation of the inflammatory system, and to perhaps evaluate the etiology and course of MDs. Again, they could suggest some information to better understand the relationship between inflammatory and cardiovascular disease and MDs, and thus, to provide clinical implications in terms of management and treatment.
Collapse
Affiliation(s)
- Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa. Italy
| | - Samuele Torrigiani
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa. Italy
| | - Manuel G Carbone
- Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, 21100 Varese. Italy
| | - Federico Mucci
- Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, 21100 Varese. Italy
| | - Walter Flamini
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa. Italy
| | - Tea Ivaldi
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa. Italy
| | - Liliana Dell' Osso
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa. Italy
| |
Collapse
|
136
|
Bai Z, Ma Y, Shi Z, Li T, Hu S, Shi B. Nomogram for the Prediction of Intrahospital Mortality Risk of Patients with ST-Segment Elevation Myocardial Infarction Complicated with Hyperuricemia: A Multicenter Retrospective Study. Ther Clin Risk Manag 2021; 17:863-875. [PMID: 34456567 PMCID: PMC8387320 DOI: 10.2147/tcrm.s320533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/03/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose This study aimed to establish an accurate and easy predictive model for ST-segment elevation myocardial infarction (STEMI) patients with hyperuricemia, using readily available features to estimate intrahospital mortality risk. Patients and Methods This was a multicenter retrospective study involving the development of risk prediction models for intrahospital mortality among all STEMI patients with hyperuricemia from Zunyi Medical University Chest Pain Center’s specialized alliance between January 1, 2016 and June 30, 2020. The primary outcome was intrahospital mortality. A total of 48 candidate variables were considered from demographic and clinical data. The least absolute shrinkage and selection operator (LASSO) was used to develop a nomogram. Concordance index values, decision curve analysis, the area under the curve (AUC), and clinical impact curves were examined. In this study, 489 patients with STEMI were included in the training dataset and an additional 209 patients from the 44 chest pain centers were included in the test cohort. B-type natriuretic peptides, α-hydroxybutyrate dehydrogenase (α-HBDH), cystatin C, out-of-hospital cardiac arrest (OHCA), shock index, and neutrophil-to-lymphocyte ratio were associated with intrahospital mortality and included in the nomogram. Results The model showed good discrimination power, and the AUC generated to predict survival in the training set was 0.875 (95% confidence interval, 0.825–0.925). In the validation set, the AUC of survival predictions was 0.87 (95% confidence interval, 0.792–0.947). Calibration plots and decision curve analysis showed good model performance in both datasets. A web-based calculator (https://bzxzmu.shinyapps.io/STEMI-with-Hyperuricemia-intrahospital-mortality/) was established based on the nomogram model, which was used to measure the levels of OHCA, neutrophil-to-lymphocyte ratio, shock index, α-HBDH, cystatin C, and B-type natriuretic peptides. Conclusion For practical applications, this model may prove clinically useful for personalized therapy management in patients with STEMI with hyperuricemia.
Collapse
Affiliation(s)
- Zhixun Bai
- Department of Internal Medicine, The Second Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China.,Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China.,Affiliated Hospital of Zunyi Medical University Cross-Regional Specialized Alliance, Zunyi, Guizhou, People's Republic of China.,College of Medicine, Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Yi Ma
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China.,Affiliated Hospital of Zunyi Medical University Cross-Regional Specialized Alliance, Zunyi, Guizhou, People's Republic of China.,Department of Cardiology, Affiliated Yinjiang County People's Hospital of Zunyi Medical University, Tongren, Guizhou, People's Republic of China
| | - Zhiyun Shi
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China.,Affiliated Hospital of Zunyi Medical University Cross-Regional Specialized Alliance, Zunyi, Guizhou, People's Republic of China.,Department of Cardiology, Affiliated Qianxi County People's Hospital of Zunyi Medical University, Bijie, Guizhou, People's Republic of China
| | - Ting Li
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China.,Affiliated Hospital of Zunyi Medical University Cross-Regional Specialized Alliance, Zunyi, Guizhou, People's Republic of China.,Department of Cardiology, Affiliated Dafang County People's Hospital of Zunyi Medical University, Bijie, Guizhou, People's Republic of China
| | - Shan Hu
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China.,Affiliated Hospital of Zunyi Medical University Cross-Regional Specialized Alliance, Zunyi, Guizhou, People's Republic of China.,College of Medicine, Soochow University, Suzhou, Jiangsu, People's Republic of China.,Department of Cardiology, Affiliated Tongzi County People's Hospital of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China
| | - Bei Shi
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China.,Affiliated Hospital of Zunyi Medical University Cross-Regional Specialized Alliance, Zunyi, Guizhou, People's Republic of China.,College of Medicine, Soochow University, Suzhou, Jiangsu, People's Republic of China
| |
Collapse
|
137
|
Yıldız MB, Yıldız E. Evaluation of serum neutrophil-to-lymphocyte ratio in corneal graft rejection after low-risk penetrating keratoplasty. Int Ophthalmol 2021; 42:57-63. [PMID: 34387791 DOI: 10.1007/s10792-021-01999-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 07/31/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate systemic inflammatory parameters in patients with corneal graft rejection after low-risk penetrating keratoplasty. METHODS Patients undergoing penetrating keratoplasty with indications of keratoconus, pseudophakic bullous keratopathy, and Fuchs endothelial dystrophy were analyzed retrospectively. Patients who had an endothelial rejection attack within two years post-transplant were included in the rejection group (n = 20), whereas patients with at least two years of post-transplant follow-up without graft rejection or failure were included in the control group (n = 46). All patients' clinical features and preoperative laboratory parameters were obtained from hospital records. The neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio, and platelet-to-lymphocyte ratio of the groups were calculated and compared. RESULTS There was no difference between the two groups in terms of age, sex, indication, postmortem time and storage time of grafts, graft diameter, follow-up time, and common systemic diseases (p > 0.05). The NLR was found to be significantly lower in the rejection group when compared with the control group (2.04 ± 1.17, 2.66 ± 0.91, respectively, p = 0.023). There was no significant difference between the groups in terms of MLR and PLR (p = 0.243, p = 0.101, respectively). CONCLUSIONS Although a high NLR value, which is an indicator of systemic inflammatory condition, is associated with many ocular diseases, NLR was found to be lower in patients with a rejection episode after transplant surgery when compared with the control group. Further studies are needed to clarify the role of these hematologic parameters in graft rejection.
Collapse
Affiliation(s)
- Merve Beyza Yıldız
- Haydarpaşa Numune Training and Research Hospital, Department of Ophthalmology, University of Health Sciences, Tıbbiye Street, Nu: 23, 34668, Uskudar/Istanbul, Turkey.
| | - Elvin Yıldız
- Haydarpaşa Numune Training and Research Hospital, Department of Ophthalmology, University of Health Sciences, Tıbbiye Street, Nu: 23, 34668, Uskudar/Istanbul, Turkey
| |
Collapse
|
138
|
Dettori P, Paliogiannis P, Pascale RM, Zinellu A, Mangoni AA, Pintus G. Blood Cell Count Indexes of Systemic Inflammation in Carotid Artery Disease: Current Evidence and Future Perspectives. Curr Pharm Des 2021; 27:2170-2179. [PMID: 33355049 DOI: 10.2174/1381612826666201222155630] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 11/10/2020] [Indexed: 11/22/2022]
Abstract
Carotid artery disease is commonly encountered in clinical practice and accounts for approximately 30% of ischemic strokes in the general population. Numerous biomarkers have been investigated as predictors of the onset and progression of carotid disease, the occurrence of cerebrovascular complications, and overall prognosis. Among them, blood cell count (BCC) indexes of systemic inflammation might be particularly useful, from a pathophysiological and clinical point of view, given the inflammatory nature of the atherosclerotic process. The aim of this review is to discuss the available evidence regarding the role of common BCC indexes, such as the neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), platelet to lymphocyte ratio (PLR), mean platelet volume (MPV), platelet distribution width (PDW), and red cell distribution width (RDW), in the diagnosis and risk stratification of carotid artery disease, and their potential clinical applications.
Collapse
Affiliation(s)
| | - Panagiotis Paliogiannis
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Rosa M Pascale
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Arduino A Mangoni
- Department of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Gianfranco Pintus
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| |
Collapse
|
139
|
Chen Y, Chai Q, Wang Q, Zhang Z, Shan Y, Lu D, Liu M, Wu W. Neutrophil-to-lymphocyte ratio is associated with coronary microvascular dysfunction in type 2 diabetes mellitus patients. Diabetes Res Clin Pract 2021; 178:108983. [PMID: 34311023 DOI: 10.1016/j.diabres.2021.108983] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/13/2021] [Accepted: 07/21/2021] [Indexed: 11/24/2022]
Abstract
AIMS Our study is aimed to investigate the relationship between neutrophil-to-lymphocyte ratio (NLR) and coronary microvascular dysfunction (CMD) in type 2 diabetes mellitus (T2DM) patients. METHODS We retrospect the consecutive medical files of 160 T2DM patients and recorded their clinical information and laboratory findings. Patients were divided into CMD group (n = 87) and non-CMD group (n = 73). We compared the NLR values of the two groups. Meanwhile we also observed the prevalence of CMD at different NLR levels. Then, logistic regression and ROC analysis were performed. RESULTS NLR value of CMD group was significantly lower than non-CMD group (2.01 ± 0.74 vs 2.53 ± 0.69, P<0.001). Prevalence of CMD in low (NLR ≤ 1.53, n = 30), medium (1.53 < NLR ≤ 2.20, n = 53) and high (NLR > 2.20, n = 77) group were 90%, 61.1%, and 39.2% respectively. The prevalence of CMD significantly increased as NLR level decreased. After adjusting potential related factors, NLR was still significantly correlated with CMD (OR = 0.295, 95 %CI:0.162-0.539, P < 0.001). The area under ROC curve (AUC) was 0.707 (95 %CI:0.627-0.786, P < 0.001). CONCLUSIONS Our results showed that NLR is associated with CMD in T2DM patients, and the prevalence of CMD may increase as NLR level decrease.
Collapse
Affiliation(s)
- Yangwen Chen
- Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, People's Republic of China
| | - Qian Chai
- Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, People's Republic of China
| | - Qian Wang
- Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, People's Republic of China
| | - Ziying Zhang
- Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, People's Republic of China
| | - Yongyan Shan
- Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, People's Republic of China
| | - Dexue Lu
- Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, People's Republic of China
| | - Meili Liu
- Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, People's Republic of China
| | - Weihua Wu
- Department of Endocrinology, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, People's Republic of China.
| |
Collapse
|
140
|
Ozgeyik M, Ozgeyik MO. Long-term Prognosis after Treatment of Total Occluded Coronary Artery is well Predicted by Neutrophil to High-Density Lipoprotein Ratio: a Comparison Study. ACTA ACUST UNITED AC 2021; 61:60-67. [PMID: 34397343 DOI: 10.18087/cardio.2021.7.n1637] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/29/2021] [Indexed: 11/18/2022]
Abstract
Aim Mortality prediction is very important for more effective treatment of patients with acute coronary syndrome. Hematological and lipid parameters have been used for this purpose, as this approach is non-invasive and cost effective. In this study, our aim was to evaluate which parameter predicts mortality most accurately.Material and Methods Data of 554 patients with at least one total coronary artery occlusion were collected retrospectively. Receiver operating characteristic curves were used to determine the optimal cut-off points of Neu / HDL, Neu / Lym, Mono / HDL, Trig / HDL, HDL / LDL, Plt / Lym and Lym / HDL according to long-term cardiovascular survival. Median follow-up time was 520 days, and 30 patients died.Results The mean age was 60.96±0.50 yrs. The area under the curve (AUC) for Neu / HDL was 0.830 (p<0.001, 95 % confidence interval [CI]: 0.753 to 0.908). The cut-off point was 0.269, with a sensitivity of 74.2 % and a specificity of 74.2 %. The AUC for Neu / Lym was 0.688 (p<0.001, 95 % CI: 0.586 to 0.790). The cut-off point was 5.322, with a sensitivity of 67.7 % and a specificity of 67.1 %. The Neu / HDL (hazard ratio, HR [confidence interval, CI]: 0.202 [0.075-0.545], p=0.002) and Neu / Lym (0.306 [0.120-0.777], p=0.013) were associated with increased risk of death according to multivariate Cox regression analysis.Conclusions Neu / HDL offers a better long-term mortality prediction than Neu / Lym, Mono / HDL, Trig / HDL, HDL / LDL, Plt / Lym, or Lym / HDL after treatment of total coronary artery occlusion.
Collapse
Affiliation(s)
- Mehmet Ozgeyik
- Department of Cardiology, Ministry of Health, Eskisehir City Hospital, Eskisehir, Turkey
| | - Mufide Okay Ozgeyik
- Department of Hematology, Ministry of Health, Eskisehir City Hospital, Eskisehir, Turkey
| |
Collapse
|
141
|
He P, He LJ, Huang C, Hu JP, Sun SR. Neutrophil-to-Lymphocyte Ratio and Treatment Failure in Peritoneal Dialysis-Associated Peritonitis. Front Med (Lausanne) 2021; 8:699502. [PMID: 34381800 PMCID: PMC8350030 DOI: 10.3389/fmed.2021.699502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 06/22/2021] [Indexed: 11/29/2022] Open
Abstract
Objective: We sought to explore if there is an association between neutrophil-to-lymphocyte ratio (NLR) and treatment failure in patients with peritoneal dialysis-associated peritonitis (PDAP). Methods: Our cohort involved 337 episodes of PDAP experienced by 202 patients who were undergoing continuous ambulatory peritoneal dialysis at a single center from 1 July 2013 to 30 June 2018. The exposures were log-transformed NLR and a categorical variable grouped by the tertiles of NLR levels (T1, <3.75; T2, 3.75–6.53; and T3, >6.53) at baseline. Generalized estimating equation (GEE) and restricted cubic spline (RCS) analyses were done to determine the association between NLR and treatment failure, defined as catheter removal or all-cause mortality during therapy. Results: After adjusting for other potential predictors, the log-transformed NLR exhibited an incremental relationship with the risk of treatment failure (odds ratio, 1.82; 95% confidence interval, 1.05–3.15). RCS analyses showed that the relationship was positively and linearly correlated (P for nonlinearity = 0.104). As a three-level categorical variable, in reference to T1, the T3 of NLR showed a 3.41-fold increased venture of treatment failure in fully adjusted model. Subgroup analyses suggested that the prognostic relevance of NLR in PDAP was particularly significant in gram-negative peritonitis. Conclusions: A greater level of NLR at baseline was remarkably associated with a higher incidence of treatment failure among PDAP episodes regardless of other potential risk factors.
Collapse
Affiliation(s)
- Peng He
- Department of Nephrology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Li-Jie He
- Department of Nephrology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Chen Huang
- Department of Nephrology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Jin-Ping Hu
- Department of Nephrology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Shi-Ren Sun
- Department of Nephrology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| |
Collapse
|
142
|
OZTURK S, ERDOĞAN M, TURAN Y. Systemic immune-inflammation index and high-sensitivity cardiac troponin T in acute coronary syndromes. ACTA MEDICA ALANYA 2021. [DOI: 10.30565/medalanya.936506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
143
|
Alpua M, Say B, Yardimci I, Ergün U, Kisa U, Ceylan OD. First Admission Neutrophil-Lymphocyte Ratio May Indicate Acute Prognosis of Ischemic Stroke. Rambam Maimonides Med J 2021; 12:RMMJ.10440. [PMID: 34137680 PMCID: PMC8284988 DOI: 10.5041/rmmj.10440] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Our study aimed to determine the relationship between serum periostin levels, and the neutrophil-lymphocyte ratio (NLR) with ischemic stroke subtypes, clinical stroke scales, and acute prognosis in patients with acute ischemic stroke. MATERIALS AND METHODS Forty-two ischemic stroke patients and 39 age- and sex-matched healthy volunteers were included in our study. Demographic characteristics including age and gender were recorded. Blood serum periostin and NLR values were evaluated in the first 24 hours after admission. Serum periostin levels were compared with healthy controls of similar age and sex. Lesion localization was determined by cranial CT or diffusion MRI of the patients. Stroke scales were recorded on days 1 and 7 of hospitalization in the study group. RESULTS The mean serum periostin levels were higher than in the control group, but no statistically significant difference was found. There was no correlation between serum periostin levels and prognosis of stroke. First admission NLRs were statistically higher than in the control group. The first admission NLRs were positively correlated with the first admission National Institute of Health Stroke Scale score and the day 7 modified Rankin score. CONCLUSION Our study is the first study to evaluate both NLR and serum periostin levels in all types of acute ischemic stroke. While our study did not show that first admission serum periostin levels can be used as a biomarker in ischemic stroke, it did indicate that the first admission NLR can be used for acute prognosis of ischemic stroke.
Collapse
Affiliation(s)
- Murat Alpua
- Department of Neurology, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey
| | - Bahar Say
- Department of Neurology, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey
| | - Ilknur Yardimci
- Department of Neurology, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey
| | - Ufuk Ergün
- Department of Neurology, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey
| | - Ucler Kisa
- Department of Biochemistry, Kirikkale University, Faculty of Medicine, Kirikkale, Turkey
| | - Ozlem Doğan Ceylan
- Department of Medical Biochemistry, Ankara University, Faculty of Medicine, Ankara, Turkey
| |
Collapse
|
144
|
Mu Y, Hu B, Gao N, Pang L. Prognostic value of the neutrophil-to-lymphocyte ratio in acute organophosphorus pesticide poisoning. Open Life Sci 2021; 16:703-710. [PMID: 34307885 PMCID: PMC8284330 DOI: 10.1515/biol-2021-0069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/03/2021] [Accepted: 06/03/2021] [Indexed: 11/15/2022] Open
Abstract
This study investigates the ability of blood neutrophil-to-lymphocyte ratio (NLR) to predict acute organophosphorus pesticide poisoning (AOPP). Clinical data of 385 patients with AOPP were obtained within 24 h of admission, and NLR values were calculated based on neutrophil and lymphocyte counts. The patients were divided into two groups - good and poor - based on prognosis. Poor prognosis included in-hospital death and severe poisoning. The factors affecting prognosis were analyzed by logistic regression analysis, and the prognostic value of NLR was evaluated using the area under the receiver operating characteristic curve (AUC). Univariate logistic regression analysis showed that NLR levels, serum cholinesterase, and creatinine levels were good predictors of AOPP. Multivariate logistic regression analysis showed that high NLR was an independent risk factor for severe poisoning (adjusted odds ratio [AOR], 1.13; 95% CI, 1.10-1.17; p < 0.05) and in-hospital mortality (AOR, 1.07; 95% CI, 1.03-1.11; p < 0.05). NLR values >13 and >17 had a moderate ability to predict severe poisoning and in-hospital mortality, respectively (AUC of 0.782 [95% CI, 0.74-0.824] and 0.714 [95% CI, 0.626-0.803], respectively). Our results show that high NLR at admission is an independent indicator of poor prognosis in AOPP and can be used to optimize treatment and manage patients.
Collapse
Affiliation(s)
- Yuhang Mu
- Department of Emergency, First Hospital of Jilin University, No. 1 Xinmin Road, Changchun, 130021, China
| | - Boqi Hu
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, 130033, China
| | - Nan Gao
- Department of Emergency, Third Clinical Hospital of Changchun Traditional Chinese Medicine University, Changchun, 130117, China
| | - Li Pang
- Department of Emergency, First Hospital of Jilin University, No. 1 Xinmin Road, Changchun, 130021, China
| |
Collapse
|
145
|
Kinoshita H, Saito J, Takekawa D, Ohyama T, Kushikata T, Hirota K. Availability of preoperative neutrophil-lymphocyte ratio to predict postoperative delirium after head and neck free-flap reconstruction: A retrospective study. PLoS One 2021; 16:e0254654. [PMID: 34255810 PMCID: PMC8277034 DOI: 10.1371/journal.pone.0254654] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 06/30/2021] [Indexed: 01/04/2023] Open
Abstract
Postoperative delirium (POD) is a well-recognized postoperative complication and is associated with increased morbidity and mortality. We investigated whether the preoperative neutrophil-lymphocyte ratio (NLR) could be an effective predictor of POD after head and neck free-flap reconstruction. This was a single-center, retrospective, observational study. We analyzed the perioperative data of patients who had undergone elective head and neck free-flap reconstruction surgery. POD was assessed with the Intensive Care Delirium Screening Checklist (ICDSC) during admission to our intensive care unit (ICU). POD was defined as an ICDSC score ≥4. Risk factors for POD were evaluated by univariate and multivariate logistic regression analysis. We included 97 patients. The incidence of POD was 20.6% (20/97). Significantly longer ICU stays were observed in the patients with POD compared to those without POD (median [interquartile range]: 5 [4–6] vs. 4 [4–5], p = 0.031). Higher preoperative NLR values (3 <NLR ≤4 and 4 <NLR) were significantly associated with higher ICDSC scores compared to NLR ≤1 (4 [2–4] vs. 1 [1–1], p = 0.027 and 4 [1–4] vs. 1 [1–1], p = 0.038, respectively). The multivariable logistic regression analysis revealed that only a preoperative NLR >3.0 (adjusted Odds Ratio: 23.6, 95% Confidence Interval: 6.6–85.1; p<0.001) was independently associated with POD. The multivariate area under the receiver operator curve was significantly greater for the E-PRE-DELIRIC model with NLR compared to the E-PRE-DELIRIC model (0.87 vs. 0.60; p<0.001). The preoperative NLR may be a good predictor of POD in patients undergoing head and neck free-flap reconstruction.
Collapse
Affiliation(s)
- Hirotaka Kinoshita
- Department of Anesthesiology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
- * E-mail:
| | - Junichi Saito
- Department of Anesthesiology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Daiki Takekawa
- Department of Anesthesiology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Tasuku Ohyama
- Department of Anesthesiology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Tetsuya Kushikata
- Department of Anesthesiology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| | - Kazuyoshi Hirota
- Department of Anesthesiology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan
| |
Collapse
|
146
|
Perry LA, Liu Z, Loth J, Penny-Dimri JC, Plummer M, Segal R, Smith J. Perioperative Neutrophil-Lymphocyte Ratio Predicts Mortality After Cardiac Surgery: Systematic Review and Meta-Analysis. J Cardiothorac Vasc Anesth 2021; 36:1296-1303. [PMID: 34404595 DOI: 10.1053/j.jvca.2021.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Neutrophil-lymphocyte ratio (NLR) is an inflammatory biomarker that has been evaluated across a variety of surgical disciplines and is widely predictive of poor postoperative outcome, but its value in cardiac surgery is unclear. The authors did this systematic review and meta-analysis to determine the impact of elevated perioperative NLR on survival after cardiac surgery. DESIGN Systematic review and meta-analysis of study-level data. SETTING Multiple hospitals involved in an international pool of studies. PARTICIPANTS Adults undergoing cardiac surgery. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS The authors searched multiple databases from inception until November 2020. They generated summary hazard ratios (HR) and odds ratios (OR) for the association of elevated preoperative NLR with long-term and short-term mortality following cardiac surgery. They separately reported on elevated postoperative NLR. Between-study heterogeneity was explored using metaregression. The authors included 12 studies involving 13,262 patients undergoing cardiac surgery. Elevated preoperative NLR was associated with worse long-term (>30 days) (hazard ratio [HR] 1.56; 95% CI [confidence interval], 1.18-2.06; 8 studies) and short-term (<30 days) mortality (OR 3.18; 95% CI, 1.90-5.30; 7 studies). One study reported the association of elevated postoperative NLR with long-term mortality (HR 8.58; 95% CI, 2.55-28.85). There was considerable between-study heterogeneity for the analysis of long-term mortality (I2 statistic 94.39%), which mostly was explained by study-level variables, such as the number of variables adjusted for by included studies and how many of these significantly increased the risk of long-term mortality, high risk of bias, and number of study centers, as well as participant level factors, such as average participant age and hypertension prevalence. CONCLUSIONS Perioperative NLR is an independent predictor of short-term and long-term postoperative mortality following cardiac surgery. Further research is required to determine which patient-level factors modify the prognostic value of NLR and to evaluate its role in routine clinical practice.
Collapse
Affiliation(s)
- Luke A Perry
- Department of Anaesthesia, Royal Melbourne Hospital, Parkville, Australia.
| | - Zhengyang Liu
- Department of Anaesthesia, Royal Melbourne Hospital, Parkville, Australia
| | - Joel Loth
- Department of Anaesthesia, Royal Melbourne Hospital, Parkville, Australia
| | - Jahan C Penny-Dimri
- Department of Surgery, Monash University, Clayton, Australia; School of Clinical Sciences, Monash Health, Clayton, Australia
| | - Mark Plummer
- Intensive Care Unit, Royal Melbourne Hospital, Parkville, Australia; Department of Critical Care, University of Melbourne, Parkville, Australia
| | - Reny Segal
- Department of Anaesthesia, Royal Melbourne Hospital, Parkville, Australia; Department of Medicine, University of Melbourne, Parkville, Australia
| | - Julian Smith
- Department of Surgery, Monash University, Clayton, Australia; School of Clinical Sciences, Monash Health, Clayton, Australia
| |
Collapse
|
147
|
Chen M, Zhu Y, Wang J, Wang G, Wu Y. The Predictive Value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Levels of Diabetic Peripheral Neuropathy. J Pain Res 2021; 14:2049-2058. [PMID: 34267549 PMCID: PMC8275189 DOI: 10.2147/jpr.s304595] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 06/20/2021] [Indexed: 12/14/2022] Open
Abstract
Objective This study was designed to assess the levels of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in diabetes patients to determine their prognostic value in predicting the disease of diabetic peripheral neuropathy (DPN). Methods We recruited 225 diabetes cases from the department of endocrinology of Anhui Provincial Hospital from August 2018 to October 2019. A total of 103 patients without diabetic peripheral neuropathy (DPN) were followed up for 18 months, and the number of patients of newly diagnosed DPN was counted. According to the results of neuroelectrophysiological examination, these patients were divided into the diabetes mellitus (DM) without DPN group and the DM with DPN group. The general information and results of blood samples were collected. The collected data were compared between groups, and the receiver operating characteristic curve (ROC) was drawn. The follow-up data were compared between groups and Binary Logistic regression analysis was performed. Results Patients with DPN shared distinct characteristics. For example, the patients were older, and had higher levels of inflammatory indicators (ie, levels of PLR and NLR), and lower level of indirect bilirubin, compared with patients without DPN. According to the receiver operating characteristic curve analysis, for type 1 diabetes, PLR showed the highest area under the curve (0.753). For type 2 diabetes, NLR showed the highest AUC of 0.602. For the follow-up results, patients with newly diagnosed DPN bad higher NLR level. Conclusion If patients of type 1 and type 2 diabetes are combined with elevated level of PLR and NLR, respectively, they are more likely complicated with DPN. NLR and PLR could be used as predictors to help clinicians screening for DPN in different types of diabetes. For type 1 diabetes, if patients who were without DPN had higher NLR level, the risk of developing DPN in the future will be greatly increased.
Collapse
Affiliation(s)
- Meiqiao Chen
- Department of Geriatrics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, People's Republic of China.,Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province, 230001, People's Republic of China
| | - Yuyou Zhu
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province, 230001, People's Republic of China
| | - Jumei Wang
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province, 230001, People's Republic of China
| | - Guoping Wang
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province, 230001, People's Republic of China
| | - Yuanbo Wu
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province, 230001, People's Republic of China
| |
Collapse
|
148
|
Li X, Xu J, Zhu L, Yang S, Yu L, Lv W, Hu J. A novel nomogram with preferable capability in predicting the overall survival of patients after radical esophageal cancer resection based on accessible clinical indicators: A comparison with AJCC staging. Cancer Med 2021; 10:4228-4239. [PMID: 34128338 PMCID: PMC8267131 DOI: 10.1002/cam4.3878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/24/2021] [Accepted: 03/14/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Esophageal cancer (EC) is a malignant tumor with high mortality. Nomogram is an important tool used in clinical prognostic assessment. We aimed to establish a novel nomogram to predict the overall survival (OS) of EC patients after radical esophagectomy. METHODS Data pertaining to the survival, demography, and clinicopathology of 311 EC patients who underwent radical esophagectomy were retrospectively investigated. The nomogram was established based on Cox hazard regression analysis. The calibration curves and Harrell's concordance index (C-index) were used to verify the predictive accuracy and ROC curves were used to assess the efficacy of the nomogram. Kaplan-Meier curves showed the prognostic value of the related risk classification system. Pearson correlation test was performed to determine the correlation between the risk classification system and TNM staging. RESULTS The median OS and 5-year survival rates in the primary and validation cohorts were 44 months and 29.8%, and 52 months and 27.1%, respectively. We used six independent prognostic factors-age, Sex, AGR, PRL, N stage, and PNI-in the nomogram. The C-index of nomogram was 0.75 and 0.70 in the primary and validation cohorts, respectively. Calibration curves indicated high consistency between actual and predicted OS. ROC curves showed that nomogram has a better efficacy compared with TNM staging in both cohorts. Patients were divided into three risk groups according to the total nomogram score, the median OS in each group was significantly different in both cohorts. Furthermore, the risk classification system was strongly correlated with the T and N staging system and exhibited a better OS prediction capability. CONCLUSIONS We established a novel and practical nomogram with a subordinate risk classification system to predict the OS of patients after radical esophagectomy. Compared with AJCC staging, this nomogram had preferable clinical capability in terms of individual prognosis assessment.
Collapse
Affiliation(s)
- Xinye Li
- Department of Thoracic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jinming Xu
- Department of Thoracic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Linhai Zhu
- Department of Thoracic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Sijia Yang
- Department of Thoracic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Li Yu
- Department of Thoracic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Wang Lv
- Department of Thoracic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jian Hu
- Department of Thoracic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| |
Collapse
|
149
|
Chen L, Qi L, Zhang J, Ma Q, Chai X. Neutrophil-lymphocyte ratio as a prognostic factor for minute clear cell renal cell carcinoma diagnosed using multi-slice spiral CT. Medicine (Baltimore) 2021; 100:e26292. [PMID: 34115033 PMCID: PMC8202639 DOI: 10.1097/md.0000000000026292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 05/19/2021] [Indexed: 11/22/2022] Open
Abstract
Minute clear cell renal cell carcinoma (MccRCC) has a diameter of <1.5 cm and can be diagnosed using multi-slice spiral CT (MSCT). Recently, the role of the neutrophil-lymphocyte ratio (NLR) in the development of MccRCC has attracted attention. This study aimed to further explore the relationship between the NLR and MccRCC.This was a prospective study of 100 patients who were diagnosed with MccRCC using MSCT at Urumqi Friendship Hospital, China. The study investigated a series of pretreatment factors, including NLR and patients' general clinical data. Statistical methods employed included Pearson's chi-square test, Spearman-rho correlation test, Cox regression analysis, and receiver operator characteristic curve analysis.Based on Pearson's χ2, Spearman-rho test, and univariate/multivariate Cox regression analysis, the overall survival of patients with MccRCC was shown to be significantly related to NLR (P < .001). NLR (hazard ratio = 50.676, 95%CI, 17.543-146.390, P < .001) is a significant independent risk-factor for MccRCC. A receiver operator characteristic curve was plotted to examine specificity and sensitivity between NLR and MccRCC (area under curve = 0.958, P < .001).The level of the NLR plays a crucial role in the survival of patients with MccRCC, as diagnosed with MSCT. The higher the NLR, the worse the prognosis for patients with MccRCC.
Collapse
|
150
|
Li S, Luo Y, Wang W, Lu J, Hu M, Sun Q, Yang X, Han J, Zhong L. A Novel Multiparameter Scoring Model for Noninvasive Early Prediction of Ischemic Colitis: A Multicenter, Retrospective, and Real-World Study. Clin Transl Gastroenterol 2021; 12:e00370. [PMID: 34106095 PMCID: PMC8189633 DOI: 10.14309/ctg.0000000000000370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 04/20/2021] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Ischemic colitis (IC) is a common gastrointestinal ischemic disease caused by hypoperfusion or reperfusion injury. However, there are few studies on risk factors associated with poor prognoses of the disease. This study aimed to determine the predictors of poor prognoses in patients with IC and establish a prognostic scoring method with good internal and external validity for identifying severe cases in an early stage. METHODS We established a prognosis model by conducting a multicenter, retrospective study of patients hospitalized with IC between November 2008 and May 2020. Predictive power was tested using 5-fold internal cross-validation and external validation. RESULTS The following 6 factors were included in the prognostic model: neutrophil count, D-dimer level, ischemia of the distal ileum, ischemia of the hepatic flexure, ulceration, and luminal stenosis. The area under the receiver-operating characteristic curve for internal cross-validation of the prediction model was 86%, and that for external validation was 95%. During internal validation, our model correctly identified 88.08% of the patients. It was further found that patients younger than 65 years with a higher neutrophil-to-lymphocyte ratio and higher heart rate had poor prognoses. Patients aged 65 years and older with ischemia of terminal ileum, hepatic flexure, splenic flexure, and intestinal stenosis had poor prognoses. DISCUSSION Patients with ischemia in the hepatic flexure and the distal ileum, endoscopic evidence of ulcer or stenosis, higher neutrophil counts, and higher D-dimer levels have worse prognoses. This information could aid in the selection of timely and appropriate treatment.
Collapse
Affiliation(s)
- Shan Li
- Department of Gastroenterology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Yiwei Luo
- Department of Gastroenterology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Wei Wang
- Department of Gastroenterology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Jinlai Lu
- Department of Gastroenterology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Miao Hu
- Department of Gastroenterology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Qinjuan Sun
- Department of Gastroenterology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Xiaoqing Yang
- Department of Gastroenterology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Junyi Han
- Department of Gastroenterology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
| | - Lan Zhong
- Department of Gastroenterology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
| |
Collapse
|