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Sahin R, Tanacan A, Serbetci H, Karagoz B, Agaoglu Z, Kara O, Sahin D. First-trimester neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and systemic immune-response index (SIRI) as predictors of composite adverse outcomes in pregnant women with Familial Mediterranean fever. Z Geburtshilfe Neonatol 2024; 228:156-160. [PMID: 37591287 DOI: 10.1055/a-2125-0973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
OBJECTIVE To evaluate the utility of the neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and systemic immune-response index (SIRI) in the prediction of adverse pregnancy outcomes in pregnant women with Familial Mediterranean fever (FMF) MATERIAL AND METHODS: This retrospective case-control study was conducted between 2019-2023. First-trimester NLR, SII (NLR X platelet count), and SIRI (NLR X monocyte count) values were compared between pregnant women with FMF (n=85) and without FMF (n=105). Thereafter, pregnant women with FMF were divided into two groups: 1) FMF with perinatal complications (n=30), and 2) FMF without perinatal complications (n=55). NLR, SII, and SIRI values were compared between the two subgroups. Finally, an ROC analysis was performed to determine optimal cut-off values for NLR, SII, and SIRI in the prediction of composite adverse pregnancy outcomes. RESULTS The FMF group had significantly higher first-trimester NLR, SII, and SIRI values compared to the controls. The FMF with perinatal complications group had significantly higher NLR, SII, and SIRI values than the FMF group without perinatal complications (p<0.05). Optimal cut-off values were 4.89 (80% sensitivity, 78.2% specificity), 1180.6 (76.7% sensitivity, 72.7% specificity), and 1.9 (83.3% sensitivity,72.7% specificity) for NLR, SII, and SIRI, respectively. CONCLUSION SII, SIRI, and NLR may be used to predict adverse pregnancy outcomes in pregnant women with FMF.
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Affiliation(s)
- Refaettin Sahin
- Division of Perinatology, Department of Obstetric and Gynecology, Ankara Bilkent City Hospital, Cankaya, Turkey
| | - Atakan Tanacan
- Division of Perinatology, Department of Obstetric and Gynecology, Ankara Bilkent City Hospital, Cankaya, Turkey
| | - Hakki Serbetci
- Division of Perinatology, Department of Obstetric and Gynecology, Ankara Bilkent City Hospital, Cankaya, Turkey
| | - Busra Karagoz
- Obstetrics and Gynecology, Ankara Bilkent City Hospital, Cankaya, Turkey
| | - Zahid Agaoglu
- Division of Perinatology, Department of Obstetric and Gynecology, Ankara Bilkent City Hospital, Cankaya, Turkey
| | - Ozgur Kara
- Division of Perinatology, Department of Obstetric and Gynecology, Ankara Bilkent City Hospital, Cankaya, Turkey
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, Division of Perinatology, Ankara City Hospital, Cankaya, Turkey
- Department of Obstetrics and Gynecology, Division of Perinatology, University of Health Sciences, Istanbul, Turkey
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Hao S, Yuan Y, Ye W, Fang X. Association Between Neutrophil-Lymphocyte Ratio and All-Cause Mortality in Critically Ill Patients with Chronic Obstructive Pulmonary Disease: A Retrospective Cohort Study. Med Sci Monit 2023; 29:e938554. [PMID: 36785492 PMCID: PMC9938631 DOI: 10.12659/msm.938554] [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] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Neutrophil-lymphocyte ratio (NLR) is related to increased mortality risk in many diseases. However, there is limited research on critically ill patients with chronic obstructive pulmonary disease (COPD). A retrospective cohort study was performed to investigate whether NLR can be used as a biomarker to predict the mortality of critically ill COPD patients. MATERIAL AND METHODS In the research, the data were gathered from the database of the Medical Information Mart for Intensive Care-IV. The 28-day mortality was defined as the primary outcome, while the secondary outcomes were in-hospital and 90-day mortality. Through the application of the Kaplan-Meier curves and the multivariate Cox regression analysis, the potential association between NLR and mortality for critically ill patients with COPD was evaluated. For subgroup analysis, age, sex, ethnicity, mean blood pressure, and comorbidities were considered. RESULTS We extracted data on 2650 patients, of which 53.7% were male. A higher level of NLR was correlated with higher 28-day mortality risk. Compared to the lower quartile (NLR<4.56), HR (95% CI) of the upper quartile (NLR>16.86) was 1.75 (1.21-2.52) in the multivariate Cox regression model when adjusted for confounders (P=0.003). A similar tendency was found in the 90-day mortality (HR=1.59, 95% CI=1.16-2.19, P=0.004) and the in-hospital mortality (HR=1.71, 95% CI=1.22-2.42, P=0.002). Subgroup analyses showed that the correlation between NLR and 28-day mortality was stable. CONCLUSIONS The higher level of NLR is likely to be correlated with the increase of the all-cause mortality risk in critically ill patients with COPD, but this needs to be validated in future prospective research.
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Affiliation(s)
- Shujie Hao
- College of Nursing, Anhui University of Chinese Medicine, Hefei, Anhui, PR China
| | - Yamei Yuan
- College of Nursing, Anhui University of Chinese Medicine, Hefei, Anhui, PR China
| | - Weidong Ye
- College of Traditional Chinese Medicine, Anhui University of Chinese Medicine, Hefei, Anhui, PR China
| | - Xiangming Fang
- College of Traditional Chinese Medicine, Anhui University of Chinese Medicine, Hefei, Anhui, PR China
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Soori H, Rezapoor P, Najafimehr H, Alirezaei T, Irilouzadian R. Comparative analysis of anthropometric indices with serum uric acid in Iranian healthy population. J Clin Lab Anal 2022; 36:e24246. [PMID: 35037318 DOI: 10.1002/jcla.24246] [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: 11/23/2021] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The relationship between elevated serum uric acid (SUA) levels and hypertension, metabolic syndrome and cardiovascular disease has been established. In this study, the relation of SUA levels to anthropometric indices, blood cell count and lipid profile was examined. METHODS Anthropometric parameters including body-mass index, waist circumference, waist to height ratio, waist to hip ratio, waist to pelvic ratio, neck circumference (NC), body fat mass (BFM), basal metabolic rate (BMR), visceral fat level (VFL) and percent body fat (PBF), along with complete blood cell count, lipid profile and SUA were obtained from 2921 young and middle-aged Iranian healthy subjects. To assess the normality of data, the Kolmogorov-Smirnov test was used. Mann-Whitney, Kruskal-Wallis, Chi-square and Spearman correlation tests were used for evaluating the association between variables. Simple and multiple regression analyses were also performed. RESULTS The results of data analysis showed all studied factors were correlated with SUA level except VFL, BFM, and platelet-to-lymphocyte ratio. The highest correlation was with NC, BMR, hematocrits (HCT) and triglycerides (TG). The backward method revealed that TG, LDL, HDL, neutrophil, lymphocyte, platelet, HCT, BMR and skinfold fat thickness were factors related to SUA. CONCLUSIONS According to the finding of this study, SUA level is related to anthropometric indices, lipid profile and neutrophil to lymphocyte ratio in healthy population. SUA measurement might be advisable to identify those at increased risk of health problems whom might benefit from further evaluation.
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Affiliation(s)
- Hamid Soori
- Safety Promotion and Injury prevention of research Center, Cohort Health Employees Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parinaz Rezapoor
- Safety Promotion and Injury prevention of research Center, Cohort Health Employees Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hadis Najafimehr
- Safety Promotion and Injury prevention of research Center, Cohort Health Employees Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Toktam Alirezaei
- Cardiology Department of Shohadaye-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rana Irilouzadian
- Faculty of medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Mondal S, Guha S, Saha A, Ghoshal L, Bandyopadhyay D. Evaluation of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Chronic Plaque Psoriasis. Indian J Dermatol 2022; 67:477. [PMID: 36578726 PMCID: PMC9792043 DOI: 10.4103/ijd.ijd_935_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Psoriasis is a common inflammatory dermatological condition and affects 2-3% population worldwide. Psoriasis area and severity index (PASI) and body surface area (BSA) are two commonly used scales used to measure disease severity in psoriasis patients. However, these scales are plagued by weaknesses as inter-observer variation and insufficient evaluation of micro-vascular inflammation. Thus, it is necessary to have an objective and simple measure of the severity of inflammation. The ratio of neutrophils-to-lymphocytes (NLR) and platelets-to-lymphocytes (PLR) are simple and inexpensive markers of systemic inflammatory response that can be measured as part of a complete blood count and are already used in the setting of inflammatory diseases. The utility of the NLR and PLR in psoriasis however, remains relatively unexplored. Aims and Objectives The present study was undertaken to assess if NLR, PLR and C-reactive protein were altered in chronic plaque psoriasis patients as compared to controls and also to determine correlation of NLR and PLR values with disease severity as measured by PASI. Methods This case control study consisted of equal numbers (45 each) chronic plaque psoriasis patients and control subjects. The subjects were evaluated by way of history taking, clinical and blood examination. Thereafter, the results were tabulated and examined statistically. Results Our study results indicate that psoriasis patients tended to have a higher neutrophil count, lymphocyte count, NLR and C-reactive protein in comparison the control subjects (P < 0.05). Conclusion We concluded that such easily available and low cost indices of systemic inflammation are raised in psoriasis patients and are positively correlated with the severity of involvement. They can thus not only be used to monitor the effect of systemic drugs in psoriasis.
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Affiliation(s)
- Sudeshna Mondal
- From the Department of Dermatology, Medical College, Kolkata, West Bengal, India
| | - Samudra Guha
- Biochemistry, Medical College, Kolkata, West Bengal, India
| | - Abanti Saha
- From the Department of Dermatology, Medical College, Kolkata, West Bengal, India
| | - Loknath Ghoshal
- Department of Dermatology, Malda Medical College, Malda, West Bengal, India,Address for correspondence: Dr. Loknath Ghoshal, 18, Shibpur Main Road, P.O. Tribeni, District: Hooghly, West Bengal - 712 503, India. E-mail:
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Lijuan W, Yuting Z, Chaoyang L, Ju Y. Neutrophil-lymphocyte, platelet-lymphocyte and lymphocyte-monocyte ratios may not be useful markers to assess disease activity in rheumatoid arthritis: A STROBE-compliant article. Medicine (Baltimore) 2021; 100:e27631. [PMID: 34766563 PMCID: PMC8589242 DOI: 10.1097/md.0000000000027631] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 10/08/2021] [Indexed: 01/05/2023] Open
Abstract
The associations among the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) and disease activity in rheumatoid arthritis remains unclear.To evaluate these indicators as potential markers of disease activity in patients with rheumatoid arthritis (RA).This cross-sectional study included 547 adult patients with RA. The patients were divided into two groups according to the disease activity score (DAS) system: remission and disease activity. Differences in the NLR, PLR and LMR of the two groups were assessed. Correlations were analyzed using Spearman analysis, and receiver operating characteristic (ROC) curves were used to identify the sensitivity, specificity, and optimal cutoff values to differentiate active RA patients from inactive RA patients.There was a statistically significant difference in the NLR (4.2 ± 3.2 vs 3.4 ± 2.4, P = .034) and PLR (222.3 ± 136.4 vs 176.9 ± 89.8, P = .006) between the two groups, but not for the LMR (3.0 ± 1.8 vs 3.4 ± 2.4, P = .115). In addition, the DAS28 and traditional inflammatory markers, including ESR and CRP, were weakly positively correlated with the NLR and PLR. Based on the ROC curves, the NLR (sensitivity 31.8%, specificity 77.8%) and PLR (sensitivity 57.3%, specificity 63.9%) were less valuable than the ESR (sensitivity 67.2%, specificity 91.7%) and CRP (sensitivity 76.2%, specificity 91.7%) for differentiating inactive RA patients from active RA patients due to low sensitivity and specificity and combining NLR or PLR also cannot significantly improved the diagnostic value of ESR and CRP.NLR, PLR and LMR may not be an useful independent diagnostic or complementary marker for disease activity in RA patients.
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Affiliation(s)
- Wang Lijuan
- Chengdu Medical College, Chengdu, China
- Department of Rheumatology, The First People's Hospital of Yibin, Yibin, China
| | - Zhou Yuting
- North Sichuan Medical College, Nanchong, China
- Department of Rheumatology, The First People's Hospital of Yibin, Yibin, China
| | - Liang Chaoyang
- Department of Rheumatology, The First People's Hospital of Yibin, Yibin, China
| | - Yang Ju
- Department of Rheumatology, The First People's Hospital of Yibin, Yibin, China
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Emami Ardestani M, Alavi-Naeini N. Evaluation of the relationship of neutrophil-to lymphocyte ratio and platelet-to-lymphocyte ratio with in-hospital mortality in patients with acute exacerbation of chronic obstructive pulmonary disease. CLINICAL RESPIRATORY JOURNAL 2020; 15:382-388. [PMID: 33210811 DOI: 10.1111/crj.13312] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 10/13/2020] [Accepted: 11/13/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has the highest mortality rate and medical costs. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte (PLR) ratio are inflammatory markers that have been recently linked to the AECOPD severity and patient outcome. OBJECTIVE Therefore, the present study aimed at evaluating the diagnostic value of NLR and PLR in the prognosis of the in-hospital mortality in AECOPD patients. METHODS The present retrospective study was performed on 829 AECOPD patients. Age, gender and laboratory results of CBC tests including lymphocyte count, neutrophil count, platelet count, hemoglobin count, white blood cell count (WBC), eosinophil cell count, NLR, PLR and CRP as well as the mortality data were collected from the patients' records and subsequently recorded. RESULTS The results of the present study revealed that NLR with the cut-off value of 6.90, sensitivity of 60.87%, and specificity of 73.29% had a significant diagnostic value in the prognosis of in-hospital mortality in AECOPD patients (P < 0.05). A similar significant finding regarding the diagnostic value in the prognosis of in-hospital mortality in AECOPD patients was obtained for CRP with the cut-off value of 30, sensitivity of 73.08%, and specificity of 60.26% (P < 0.05). However, the diagnostic value of PLR in the prognosis of in-hospital mortality in AECOPD patients was found to be insignificant (P = 0.18). CONCLUSION According to the results of the present study, NLR > 6.90 can be considered as a valuable and accurate marker in the prognosis of in-hospital mortality in AECOPD patients.
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Affiliation(s)
- Mohammad Emami Ardestani
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nooshin Alavi-Naeini
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Evaluation of hematological parameters in children with FMF. Clin Rheumatol 2018; 38:701-707. [DOI: 10.1007/s10067-018-4338-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 09/23/2018] [Accepted: 10/12/2018] [Indexed: 10/28/2022]
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Kholoussi S, Kholoussi N, Zaki ME, El-Bassyouni HT, Elnady H, Morcos B, Abo-Shanab A. Immunological Evaluation in Patients with Familial Mediterranean fever. Open Access Maced J Med Sci 2018. [PMID: 29531594 PMCID: PMC5839438 DOI: 10.3889/oamjms.2018.079] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE: This study aimed to investigate T & B lymphocyte subsets and Natural Killer (NK) cells patterns in children with FMF versus normal control subjects, to estimate the immunoglobulins IgG, IgM, and IgA levels, and to scrutinize the possible use of Neutrophil / Lymphocyte ratio (NLR) as a marker for subclinical inflammation in FMF patients. PATIENTS AND METHODS: A group of 42 patients with FMF attending the Genetics Clinic at National Research Centre were included in this study. They were 13 males and 19 females; their age ranged from 2 to 17 years old. Normal healthy subjects within the same age and sex range were included as a control group. Complete blood picture was done for all cases, and neutrophil/ lymphocyte ratio was calculated. Flow cytometer analysis was done for CD3, CD4, CD8, CD19 and CD16 using monoclonal antibodies. Immunoglobulins IgG, IgA and IgM were estimated in serum using nephelometry. RESULTS: Positive consanguinity was present in 20 patients (47.6%). Abdominal pain was the most common manifestation followed by fever, arthritis, and red rash. CD3, CD4 and CD8 were statistically increased in patients group as compared to normal control group, while CD16 was statistically decreased. CONCLUSION: The study suggests that quantitative measurement of CD expressions of CD3, CD4 and CD8 as well as NLR might be used as valuable markers for subclinical inflammation in FMF.
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Affiliation(s)
- Shams Kholoussi
- National Research Centre - Immunogenetics Department, Cairo, Egypt
| | - Naglaa Kholoussi
- National Research Centre - Immunogenetics Department, Cairo, Egypt
| | | | | | - Hala Elnady
- National Research Centre - Child Health, Cairo, Egypt
| | - Botros Morcos
- National Research Centre - Immunogenetics Department, Cairo, Egypt
| | - Asem Abo-Shanab
- National Research Centre - Immunogenetics Department, Cairo, Egypt
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Chandrashekara S, Mukhtar Ahmad M, Renuka P, Anupama KR, Renuka K. Characterization of neutrophil-to-lymphocyte ratio as a measure of inflammation in rheumatoid arthritis. Int J Rheum Dis 2017; 20:1457-1467. [PMID: 28952205 DOI: 10.1111/1756-185x.13157] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The neutrophil to lymphocyte ratio (NLR) is one of the well-recognized sensitive measures of inflammation. This cross-sectional observational study was aimed at characterizing the relationship of NLR with the inflammatory markers erythrocyte sedimentation rate (ESR), C-reative protein (CRP), Disease Activity Score of 28 joints (DAS28)-CRP(3), joint counts and quality measures of rheumatoid arthritis (RA). MATERIALS AND METHODS Patients with RA were recruited in two phases. The following were assessed for all patients: joint count, pain by visual analogue scale (VAS), complete blood count, ESR, CRP and quality index assessment using the Short Form health survey (SF-36) questionnaire. A subgroup analysis was also performed to evaluate the association between NLR and cytokines. RESULTS Four hundred and eighty-nine subjects were recruited. Distribution of NLR values corresponded with DAS28-CRP(3) rather than CRP and ESR. A significant difference in VAS, swollen joint counts (SJC-28), inflammatory parameters and general health outcome measures was observed among the NLR groups. A weak correlation was observed between NLR and RA disease measures. It had least bias at lower ranges with DAS28-CRP(3) than CRP and ESR. The NLR cut-off value of 1.4 classified the patients in deep remission with 90% specificity, 24% sensitivity, likelihood ratio positive (LR+) 2.46 and likelihood ratio negative (LR-) 0.84. CRP was a significant baseline predictor of NLR. A significant influence of interleukin-6 on CRP was noted. CONCLUSION In contrast to the traditional markers, NLR may serve as a less expensive and effective measure of inflammation in RA. Its efficacy is comparable to that of CRP and it is not impacted by the cytokines influencing CRP and ESR.
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Affiliation(s)
| | | | | | - K R Anupama
- ChanRe Rheumatology and Immunology Centre, Bangalore, India
| | - K Renuka
- ChanRe Rheumatology and Immunology Centre, Bangalore, India
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Basaran O, Uncu N, Celikel BA, Aydın F, Cakar N. Assessment of neutrophil to lymphocyte ratio and mean platelet volume in pediatric familial Mediterranean fever patients. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2017; 22:35. [PMID: 28461821 PMCID: PMC5390538 DOI: 10.4103/1735-1995.202140] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 11/19/2016] [Accepted: 12/28/2016] [Indexed: 01/07/2023]
Abstract
Background: Blood neutrophil to lymphocyte ratio (NLR) and mean platelet volume (MPV) both have been used as a simple marker of inflammation in many disorders. Here, we aimed to investigate the relationship between NLR, MPV, and familial Mediterranean fever (FMF). Materials and Methods: In this retrospective study, the files of FMF patients in pediatric rheumatology outpatient clinic were reviewed. There were 160 participants (68.4%) in the FMF patient group and 74 participants (31.6%) in the control group. Ninety of patients were in attack-free period, and 70 were in attack period. Results: The highest values of NLR were found in the patients at attack period. Patients in attack-free period and the participants in control group had similar levels of NLR (1.71 ± 0.83 and 1.91 ± 1.86 respectively) (P = 0.457), and they had lower ratios than the patients did at attack period (4.10 ± 3.11) (P < 0.001 for both). There was no significant difference between MPV values of attack patients (8.35 ± 4.91) and attack-free patients (8.43 ± 1.15) (P = 0.074). MPV values of attack patients and attack-free patients were significantly higher than control group (7.99 ± 0.81) (P < 0.001 for both). Conclusion: NLR ratio may indicate FMF attack period. Since there was no significant difference between attack-free patients and control groups, NLR ratio cannot be used as a subclinical inflammation marker. However, NLR could be a useful predictor of inflammation in FMF patients. On the other hand, since our attack and attack-free patients have similar MPV values and both had greater MPV values than control group, we suggest that MPV may be used to show subclinical inflammation.
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Affiliation(s)
- Ozge Basaran
- Department of Pediatric Rheumatology, Ankara Child Health Hematology, Oncology Education and Research Hospital, Ankara, Turkey
| | - Nermin Uncu
- Department of Pediatric Rheumatology, Ankara Child Health Hematology, Oncology Education and Research Hospital, Ankara, Turkey
| | - Banu Acar Celikel
- Department of Pediatric Rheumatology, Ankara Child Health Hematology, Oncology Education and Research Hospital, Ankara, Turkey
| | - Fatma Aydın
- Department of Pediatric Rheumatology, Ankara Child Health Hematology, Oncology Education and Research Hospital, Ankara, Turkey
| | - Nilgun Cakar
- Department of Pediatric Rheumatology, Ankara Child Health Hematology, Oncology Education and Research Hospital, Ankara, Turkey
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Ayna AB, Ermurat S, Coşkun BN, Harman H, Pehlivan Y. Neutrophil to Lymphocyte Ratio and Mean Platelet Volume as Inflammatory Indicators in Systemic Lupus Erythematosus Nephritis. Arch Rheumatol 2017; 32:21-25. [PMID: 30375538 PMCID: PMC6190939 DOI: 10.5606/archrheumatol.2017.5886] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Accepted: 04/05/2016] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES This study aims to evaluate the role of neutrophil to lymphocyte ratio (NLR) and mean platelet volume (MPV) as activation and inflammatory markers in systemic lupus erythematosus (SLE) patients with nephritis. PATIENTS AND METHODS A total of 108 SLE patients (8 males, 100 females; mean age 35.3±10.2 years; range 16 to 64 years) including 78 patients with renal involvement (8 males, 70 females; mean age 33.9±10.6 years; range 16 to 64 years) (SLEn+ group) and 30 patients without renal involvement (30 females; mean age 39.1±8.2 years; range 22 to 55 years) (SLEn- group) were included in this retrospective study. All patients' clinical characteristics and laboratory data which include erythrocyte sedimentation rate, C-reactive protein, white blood counts, neutrophil counts, lymphocyte counts, platelet counts, and MPV levels were obtained from medical records. The laboratory data at the highest proteinuria periods of the patients with renal involvement were recorded. RESULTS Mean MPV (SLEn+ =9.1±2.2, SLEn- =7.9±1.2, p=0.001) and NLR (SLEn+ =5.9±5.9, SLEn- =2.6±2.5, p<0.001) values were significantly higher in lupus nephritis group. Besides, a positive correlation between NLR and C-reactive protein was found in lupus nephritis group (r=1.97, p=0.045). Based on receiver operating characteristic curve with area under the curve of 0.76, cutoff NLR value of 1.93 had 83% sensitivity and 54% specificity [95% confidence interval, 0.66-0.85] in differentiating SLE patients with or without nephritis. CONCLUSION Neutrophil to lymphocyte ratio and MPV may be discriminative for lupus nephritis. Also, NLR may be a predictor of lupus nephritis. Both MPV and NLR values may be affected by a great number of factors; therefore, further prospective studies are needed to evaluate the use of these parameters in SLE.
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Affiliation(s)
- Ata Bora Ayna
- Department of Physical and Rehabilitation, Division of Rheumatology, Medical Faculty of Uludağ University, Bursa, Turkey
| | - Selime Ermurat
- Department of Internal Medicine, Division of Rheumatology, Medical Faculty of Uludağ University, Bursa, Turkey
| | - Belkis Nihan Coşkun
- Department of Internal Medicine, Division of Rheumatology, Medical Faculty of Uludağ University, Bursa, Turkey
| | - Halil Harman
- Department of Physical and Rehabilitation, Division of Rheumatology, Medical Faculty of İzzet Baysal Training and Research Hospital, Bolu, Turkey
| | - Yavuz Pehlivan
- Department of Internal Medicine, Division of Rheumatology, Medical Faculty of Uludağ University, Bursa, Turkey
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Mukhin NA, Bogdanova MV, Rameev VV, Kozlovskaya LV. Autoinflammatory diseases and kidney involvement. TERAPEVT ARKH 2017; 89:4-20. [DOI: 10.17116/terarkh20178964-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Albayrak S, Zengin K, Tanik S, Atar M, Unal SH, Imamoglu MA, Gurdal M. Can the neutrophil-to-lymphocyte ratio be used to predict recurrence and progression of non-muscle-invasive bladder cancer? Kaohsiung J Med Sci 2016; 32:327-33. [PMID: 27377847 DOI: 10.1016/j.kjms.2016.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 03/12/2016] [Accepted: 03/23/2016] [Indexed: 02/09/2023] Open
Abstract
The aim of our study was to evaluate whether neutrophil-to-lymphocyte ratio (NLR) is a predictor of disease progression and recurrence in patients with primary non-muscle-invasive bladder cancer (NMIBC). This was a prospective study of 86 patients with newly diagnosed NMIBC. The patients were classified by the number of points assigned by the European Organization for Research and Treatment of Cancer risk tables. The correlation between progression score, recurrence score, age, mean platelet volume, red blood cell distribution width and NLR was assessed statistically. The same parameters were compared between the risk groups. A significant difference in NLR and age values was observed between recurrence and progression risk score groups. The relationships between NLR and recurrence and progression risk scores were no longer significant after correcting for the statistical effect of age on scores. Age was significantly different between groups after adjusting for NLR. Our study revealed that NLR and age were associated with patient age and bladder tumor progression and recurrence risk scores. After correcting for age, the significant relationship with NLR was lost, in contrast to some previous studies. We recommend that patient age should be corrected to avoid misleading results in NLR studies.
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Affiliation(s)
| | - Kursad Zengin
- Department of Urology, Bozok University, School of Medicine, Yozgat, Turkey
| | - Serhat Tanik
- Department of Urology, Bozok University, School of Medicine, Yozgat, Turkey.
| | - Muhittin Atar
- Department of Urology, Bozok University, School of Medicine, Yozgat, Turkey
| | - Serhat Haluk Unal
- Department of Urology, Amasya Serafeddin Sabuncuoglu Education and Research Hospital, Amasya, Turkey
| | | | - Mesut Gurdal
- Department of Urology, Bozok University, School of Medicine, Yozgat, Turkey
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14
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Kucuk A, Erol MF, Senel S, Eroler E, Yumun HA, Uslu AU, Erol AM, Tihan D, Duman U, Kucukkartallar T, Solak Y. The role of neutrophil lymphocyte ratio to leverage the differential diagnosis of familial Mediterranean fever attack and acute appendicitis. Korean J Intern Med 2016; 31:386-91. [PMID: 26864298 PMCID: PMC4773722 DOI: 10.3904/kjim.2015.039] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 03/18/2015] [Accepted: 06/17/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND/AIMS Familial Mediterranean fever (FMF) is an autosomal recessive disorder characterized by attacks of fever and diffuse abdominal pain. The primary concern with this presentation is to distinguish it from acute appendicitis promptly. Thus, we aimed to evaluate the role of neutrophil lymphocyte ratio (NLR) to leverage the differential diagnosis of acute FMF attack with histologically proven appendicitis. METHODS Twenty-three patients with histologically confirmed acute appendicitis and 88 patients with acute attack of FMF were included in the study. NLR, C-reactive protein and other hematologic parameters were compared between the groups. RESULTS Neutrophil to lymphocyte ratio was significantly higher in patients with acute appendicitis compared to the FMF attack group (8.24 ± 6.31 vs. 4.16 ± 2.44, p = 0.007). The performance of NLR in diagnosing acute appendicitis with receiver operating characteristic analysis with a cut-off value of 4.03 were; 78% sensitivity, 62% specificity, and area under the curve 0.760 (95% confidence interval, 0.655 to 0.8655; p < 0.001). CONCLUSIONS This study showed that NLR, the simple and readily available inflammatory marker may have a useful role in distinguishing acute FMF attack from acute appendicitis.
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Affiliation(s)
- Adem Kucuk
- Division of Rheumatology, Department of Internal Medicine, Necmettin Erbakan University, Konya, Turkey
- Correspondence to Adem Kucuk, M.D. Division of Rheumatology, Department of Internal Medicine, Meram School of Medicine, Necmettin Erbakan University, Meram, Konya 42060, Turkey Tel: +90-332-223-6548 Fax: +90-332-223-6548 E-mail:
| | - Mehmet Fatih Erol
- Department of General Surgery, Bursa Sevket Yilmaz Research and Training Hospital, Bursa, Turkey
| | - Soner Senel
- Division of Rheumatology, Department of Internal Medicine, Cumhuriyet University, Sivas, Turkey
| | - Emir Eroler
- Department of General Surgery, Bursa Sevket Yilmaz Research and Training Hospital, Bursa, Turkey
| | - Havvanur Alparslan Yumun
- Department of General Surgery, Bursa Sevket Yilmaz Research and Training Hospital, Bursa, Turkey
| | - Ali Ugur Uslu
- Department of Internal Medicine, Cumhuriyet University, Sivas, Turkey
| | - Asiye Mukaddes Erol
- Department of Physical Medicine and Rehabilitation, Bursa Sevket Yilmaz Research and Training Hospital, Bursa, Turkey
| | - Deniz Tihan
- Department of General Surgery, Bursa Sevket Yilmaz Research and Training Hospital, Bursa, Turkey
| | - Ugur Duman
- Department of General Surgery, Bursa Sevket Yilmaz Research and Training Hospital, Bursa, Turkey
| | | | - Yalcin Solak
- Division of Nephrology, Department of Internal Medicine, Necmettin Erbakan University, Konya, Turkey
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15
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Duksal F, Alaygut D, Güven AS, Ekici M, Oflaz MB, Tuncer R, Cevit Ö. Neutrophil-lymphocyte ratio in children with familial Mediterranean fever: Original article. Eur J Rheumatol 2015; 2:20-23. [PMID: 27708915 DOI: 10.5152/eurjrheumatol.2015.0093] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 10/22/2014] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The aim of present study was (a) to evaluate the relationship between the neutrophil/lymphocyte (N/L) ratio and mutation types of familial Mediterranean fever (FMF) in children and (b) to evaluate the relationship between the N/L ratio and age. MATERIAL AND METHODS Three hundred forty-three children with familial Mediterranean fever in the attack-free period and 283 healthy control children were included in the study. Patients were divided into subgroups according to mutation types. Neutrophil and lymphocyte counts were retrieved from medical records of patients and the N/L ratio was calculated from these parameters. RESULTS The N/L ratio of patients was found to be significantly higher than that of controls (p<0.001). Among 343 patients, homozygous, heterozygous, and compound mutations were observed in 39, 253, and 51 patients, respectively. The differences in the N/L ratio among patients with homozygous, heterozygous, and compound mutations were not statistically significant. The most common mutations were M694V (n=126), E148Q (n=70), M680I, (n=33), and V726A (n=28). Significant differences were not observed among these mutations in terms of the N/L ratio (p>0.05). In all subjects, there was a weak but significant relationship between age and the N/L ratio (r: 0.215, p<0.001). CONCLUSION The N/L ratio, which can be determined by simple methods in routine blood tests, may be used for the follow-up monitoring of chronic inflammation in patients. In addition, the N/L ratio may give an idea to clinicians regarding the early initiation of treatment in patients with typical clinical findings of FMF.
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Affiliation(s)
- Fatma Duksal
- Department of Pediatrics, Division of Pediatric Immunology and Allergy, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Demet Alaygut
- Department of Pediatrics, Division of Pediatric Nefrology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Ahmet Sami Güven
- Department of Pediatrics, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Mahmut Ekici
- Department of Pediatrics, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Mehmet Burhan Oflaz
- Department of Pediatrics, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Rukiye Tuncer
- Department of Pediatrics, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
| | - Ömer Cevit
- Department of Pediatrics, Division of Pediatric Immunology and Allergy, Cumhuriyet University Faculty of Medicine, Sivas, Turkey
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16
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Özer S, Yılmaz R, Sönmezgöz E, Karaaslan E, Taşkın S, Bütün İ, Demir O. Simple markers for subclinical inflammation in patients with Familial Mediterranean Fever. Med Sci Monit 2015; 21:298-303. [PMID: 25615955 PMCID: PMC4315639 DOI: 10.12659/msm.892289] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background In this study we investigated the potential of neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), mean platelet volume (MPV), and red cell width distribution (RDW) as new inflammatory markers to identify chronic inflammations during symptom-free periods in children diagnosed with Familial Mediterranean Fever (FMF). Material/Methods The study included 153 children diagnosed with FMF based on the Tel-Hashomer Criteria, and 90 healthy volunteers. Hospital records were obtained to collect NLR, PLR, MPV, RDW, and FMF scores and the FMF mutation analyses of the patients enrolled in the study. Data on proteinuria were also collected and defined as a protein/creatinine ratio >0.2. Results NLR, PLR, MPV, and RDW were significantly higher in symptom-free FMF patients than in the control group. C-reactive protein values also weakly correlated with NLR, PLR, MPV, and RDW, but the correlation was not statistically significant. NLR had the strongest correlation with CRP. The NLR cut-off point to indicate subclinical inflammation in symptom-free FMF patients was calculated to be 1.65. Conclusions NLR, PLR, MPV, and RDW are potential subclinical inflammation markers in patients with FMF. NLR, PLR, MPV, and RDW values are higher in patients with FMF during symptom-free periods. NLR was found to be the most reliable marker for subclinical inflammation when compared to PLR, MPV, and RDW. We also found that these markers are not significantly higher in proteinuric patients when compared with levels in non-proteinuric patients.
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Affiliation(s)
- Samet Özer
- Department of Pediatrics, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Resul Yılmaz
- Department of Pediatrics, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Ergün Sönmezgöz
- Department of Pediatrics, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Erhan Karaaslan
- Department of Pediatrics, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Semanur Taşkın
- Department of Pediatrics, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - İlknur Bütün
- Department of Biochemistry, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Osman Demir
- Department of Biostatistics, Gaziosmanpasa University School of Medicine, Tokat, Turkey
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