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Vučić M, Milenkovic J, Djindjic B, Stojiljkovic V, Stojanovic D, Djordjevic B, Milojkovic M, Velickovic S. Indicators of stress hematopoiesis in the blood predict COVID-19 progression in patients over 65 years old. Hematology 2024; 29:2311006. [PMID: 38305411 DOI: 10.1080/16078454.2024.2311006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 01/23/2024] [Indexed: 02/03/2024] Open
Abstract
OBJECTIVES Advanced age is a well-established risk factor for severe coronavirus disease 2019 (COVID-19). Exacerbated inflammation affects multiple organs, among which hematopoiesis responds by increased output of various cells. We aimed to determine the association between COVID-19 progression and large immature cell (LIC) counts, changes in erythrocyte and platelet distribution widths (RDW, PDW) with reference to patients' age. METHODS A total of 755 patients with complete blood cell (CBC) analysis in the first 24 h of hospitalization were enrolled. Patients were divided into two groups: under and above 65 years of age. RESULTS The LIC counts were different in both groups (p < 0.003). However, only the senior patients had markedly different values of RDW and PDW (p < 0.001). The receiver operating characteristic (ROC) curve analysis provided increased LIC (AUC = 0.600), RDW (AUC = 0.609), PDW (AUC = 0.556), and platelet to LIC ratio (AUC = 0.634) as significant in discriminating outcome in the older group. Importantly, these results were not repeated in the younger patients. In the elderly, the progression was predicted with LIC cut-off at ≥ 0.305 × 109/L (OR = 3.166) and RDW over 12.15% (OR = 2.081). DISCUSSION Aging is characterized by a decline in immunological competence with a compromised control of inflammation leading to a proinflammatory state. This background together with the actions of pathogens may lead to emergency myelopoiesis. CONCLUSION Our results point to the important differences between age groups regarding CBC-related parameters of stress hematopoiesis during severe infection. Higher LIC, RDW and PDW levels were reliable in the early identification of COVID-19 progression only in the elderly.
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Affiliation(s)
- Miodrag Vučić
- Department of Internal medicine and patient care, Faculty of Medicine, University of Nis, Niš, Serbia
- Clinic of hematology, allergology and clinical immunology, University Clinical Center in Nis, Niš, Serbia
| | - Jelena Milenkovic
- Department of Pathophysiology, Faculty of Medicine, University of Nis, Niš, Serbia
| | - Boris Djindjic
- Department of Pathophysiology, Faculty of Medicine, University of Nis, Niš, Serbia
- Clinic of Cardiology, University Clinical Center of Nis, Niš, Serbia
| | - Vladana Stojiljkovic
- Department of Biochemistry, Faculty of Medicine, University of Nis, Niš, Serbia
- Medical Biochemistry Center, University Clinical Center of Nis, Niš, Serbia
| | - Dijana Stojanovic
- Department of Pathophysiology, Faculty of Medicine, University of Nis, Niš, Serbia
| | - Branka Djordjevic
- Department of Biochemistry, Faculty of Medicine, University of Nis, Niš, Serbia
| | - Maja Milojkovic
- Department of Pathophysiology, Faculty of Medicine, University of Nis, Niš, Serbia
| | - Sanja Velickovic
- Clinic of hematology, allergology and clinical immunology, University Clinical Center in Nis, Niš, Serbia
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Botros L, Qayyum R. Association of platelet distribution width with all-cause and cause-specific mortality in US adults. Int J Cardiol 2024; 407:132100. [PMID: 38663809 DOI: 10.1016/j.ijcard.2024.132100] [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: 12/18/2023] [Revised: 03/31/2024] [Accepted: 04/22/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Platelet distribution width (PDW) indicates heterogeneity in circulating platelet sizes. Studies reporting PDW association with mortality were limited by small sample sizes. Therefore, we examined the relationship between PDW and all-cause and cause-specific mortality in a large representative cohort. METHODS The NHANES III data were linked to mortality files to examine the association between PDW and mortality. We excluded participants <18 years old and had a history of myocardial infarction. Since the hazards violated the proportionality assumption, we used piece-wise spline with 5-year time intervals in Cox models without and with adjustment for age, gender, race, smoking history, diabetes mellitus, hypertension, eGFR and total cholesterol. RESULTS Of 15,688 participants, 53.2% were females, 36.2% had a history of hypertension, and 6368(40.6%) died during follow-up (range 0 to 31 years). The mean (SD) age of the participants was 47(20) years, platelet count was 275.0(71.7) 109/L, and PDW 16.5(0.5). In multivariable analyses, PDW was associated with all-cause mortality at 0-5 years (HR = 1.44; 95%CI = 1.21, 1.72; P < 0.001) and at 5-10 years (HR = 1.23; 95%CI =1.03, 1.46; P = 0.02). Similarly, PDW association was significant for the first 0-5 years in cardiovascular mortality (HR = 1.58, 95%CI = 1.10, 2.25; P = 0.013) and for cancer mortality (HR = 1.48 (1.15, 95%CI = 1.15, 1.91, P = 0.003). For other-cause mortality, PDW remained significantly associated for 0-5 years (HR = 1.35, 95%CI =1.05, 1.74; P = 0.02) and for 5-10 years (HR = 1.38, 95%CI = 1.05, 1.83; P = 0.023). CONCLUSIONS PDW is an independent, but time-dependent, predictor of all-cause, cardiovascular, cancer and other-cause mortality up to 5 years. The mechanisms underlying this association need further study.
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Affiliation(s)
- Liza Botros
- Department of Medicine, Eastern Virginia Medical School, Norfolk, USA; Department of Pulmonary Disease, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Rehan Qayyum
- Department of Medicine, Eastern Virginia Medical School, Norfolk, USA.
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Ligi D, Della Franca C, Notarte KI, Goldrich N, Kavteladze D, Henry BM, Mannello F. Platelet distribution width (PDW) as a significant correlate of COVID-19 infection severity and mortality. Clin Chem Lab Med 2024; 62:385-395. [PMID: 37725416 DOI: 10.1515/cclm-2023-0625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/01/2023] [Indexed: 09/21/2023]
Abstract
SARS-CoV-2 infection may cause a wide spectrum of symptoms, from asymptomatic, to mild respiratory symptoms and life-threatening sepsis. Among the clinical laboratory biomarkers analyzed during COVID-19 pandemic, platelet indices have raised great interest, due to the critical involvement of platelets in COVID-19-related thromboinflammation. Through an electronic literature search on MEDLINE, CINAHL, PubMed, EMBASE, Web of Science, and preprint servers we performed and updated a systematic review aimed at providing a detailed analysis of studies addressing the potential clinical utility of platelet distribution width, platelet distribution width (PDW), in laboratory medicine, exploring the possible association between increased PDW levels, disease severity, and mortality in COVID-19. Our systematic review revealed a wide heterogeneity of COVID-19 cohorts examined and a lack of homogenous expression of platelet indices. We found that 75 % of studies reported significantly elevated PDW values in COVID-19 infected cohorts compared to healthy/non-COVID-19 controls, and 40 % of studies reported that patients with severe COVID-19 showed increased PDW values than those with less-than-severe illness. Interestingly, 71.4 % of studies demonstrated significant increased PDW values in non survivors vs. survivors. Overall, these results suggest that platelets are critically involved as major players in the process of immunothrombosis in COVID-19, and platelet reactivity and morphofunctional alterations are mirrored by PDW, as indicator of platelet heterogeneity. Our results confirm that the use of PDW as prognostic biomarkers of COVID-19 sepsis still remains debated due to the limited number of studies to draw a conclusion, but new opportunities to investigate the crucial role of platelets in thrombo-inflammation are warranted.
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Affiliation(s)
- Daniela Ligi
- Laboratories of Clinical Biochemistry, Section of Biochemistry and Biotechnology, Department of Biomolecular Sciences - DISB, University of Urbino Carlo Bo, Urbino, Italy
| | - Chiara Della Franca
- Laboratories of Clinical Biochemistry, Section of Biochemistry and Biotechnology, Department of Biomolecular Sciences - DISB, University of Urbino Carlo Bo, Urbino, Italy
| | - Kin Israel Notarte
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - David Kavteladze
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Brandon Michael Henry
- Clinical Laboratory, Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Ferdinando Mannello
- Laboratories of Clinical Biochemistry, Section of Biochemistry and Biotechnology, Department of Biomolecular Sciences - DISB, University of Urbino Carlo Bo, Urbino, Italy
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Malladi N, Alam MJ, Maulik SK, Banerjee SK. The role of platelets in non-alcoholic fatty liver disease: From pathophysiology to therapeutics. Prostaglandins Other Lipid Mediat 2023; 169:106766. [PMID: 37479133 DOI: 10.1016/j.prostaglandins.2023.106766] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/29/2023] [Accepted: 07/17/2023] [Indexed: 07/23/2023]
Abstract
Platelets are one of the key mediators in thrombosis as well as in the progression of many diseases. An increase in platelet activation and a decrease in platelet count is associated with a plethora of liver diseases. In non-alcoholic fatty liver disease (NAFLD), platelets are highly activated and participate in the disease progression by enhancing the pro-thrombotic and pro-inflammatory state. Some altered platelet parameters such as mean platelet volume, plateletcrits, and platelet distribution width, aspartate transaminase to platelet ratio index, liver stiffness to platelet ratio and red cell distribution width to platelet ratio were found to be associated with NAFLD disease. Further, platelet contributes to the progression of cardiovascular complications in NAFLD is gaining the researcher's attention. An elevated mean platelet volume is known to enhance the risk of stroke, atherosclerosis, thrombosis, and myocardial infarction in NAFLD. Evidence also suggested that modulation in platelet function using aspirin, ticlopidine, and cilostazol help in controlling the NAFLD progression. Future research should focus on antiplatelet therapy as a treatment strategy that can control platelet activation in NAFLD as well as its cardiovascular risk. In the present review, we have detailed the role of platelets in NAFLD and its cardiovascular complications. We further aimed to highlight the growing need for antiplatelet therapy in NAFLD.
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Affiliation(s)
- Navya Malladi
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, Guwahati 781101, Assam, India
| | - Md Jahangir Alam
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, Guwahati 781101, Assam, India; Cell Biology and Physiology Division, CSIR-Indian Institute of Chemical Biology, Kolkata, India
| | - Subir K Maulik
- Indian Council of Medical Research, Ministry of Health, New Delhi 110029, India
| | - Sanjay K Banerjee
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research, Guwahati 781101, Assam, India.
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Yang A, Yang YT, Zhao XM. An augmented Mendelian randomization approach provides causality of brain imaging features on complex traits in a single biobank-scale dataset. PLoS Genet 2023; 19:e1011112. [PMID: 38150468 PMCID: PMC10775988 DOI: 10.1371/journal.pgen.1011112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 01/09/2024] [Accepted: 12/12/2023] [Indexed: 12/29/2023] Open
Abstract
Mendelian randomization (MR) is an effective approach for revealing causal risk factors that underpin complex traits and diseases. While MR has been more widely applied under two-sample settings, it is more promising to be used in one single large cohort given the rise of biobank-scale datasets that simultaneously contain genotype data, brain imaging data, and matched complex traits from the same individual. However, most existing multivariable MR methods have been developed for two-sample setting or a small number of exposures. In this study, we introduce a one-sample multivariable MR method based on partial least squares and Lasso regression (MR-PL). MR-PL is capable of considering the correlation among exposures (e.g., brain imaging features) when the number of exposures is extremely upscaled, while also correcting for winner's curse bias. We performed extensive and systematic simulations, and demonstrated the robustness and reliability of our method. Comprehensive simulations confirmed that MR-PL can generate more precise causal estimates with lower false positive rates than alternative approaches. Finally, we applied MR-PL to the datasets from UK Biobank to reveal the causal effects of 36 white matter tracts on 180 complex traits, and showed putative white matter tracts that are implicated in smoking, blood vascular function-related traits, and eating behaviors.
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Affiliation(s)
- Anyi Yang
- Department of Neurology, Zhongshan Hospital and Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, People’s Republic of China
- MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, People’s Republic of China
| | - Yucheng T. Yang
- Department of Neurology, Zhongshan Hospital and Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, People’s Republic of China
- MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, People’s Republic of China
| | - Xing-Ming Zhao
- Department of Neurology, Zhongshan Hospital and Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, People’s Republic of China
- MOE Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, People’s Republic of China
- State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, People’s Republic of China
- International Human Phenome Institutes (Shanghai), Shanghai, People’s Republic of China
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Kelem A, Adane T, Shiferaw E. Insulin Resistance-Induced Platelet Hyperactivity and a Potential Biomarker Role of Platelet Parameters: A Narrative Review. Diabetes Metab Syndr Obes 2023; 16:2843-2853. [PMID: 37744701 PMCID: PMC10516192 DOI: 10.2147/dmso.s425469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 09/05/2023] [Indexed: 09/26/2023] Open
Abstract
Background Insulin has an inhibitory effect on platelets; however, this is compromised in circumstances of Insulin Resistance (IR), leading to platelet hyperactivity. Platelet parameters such as mean platelet volume, platelet count, and platelet distribution width are simple and accessible potential biomarkers for the early diagnosis and prognosis of IR. Therefore, the aim of this review is to provide insight on the current status of knowledge regarding IR-induced platelet hyperactivation and the potential biomarker role of platelet parameters. Methods This narrative review included articles published in the English language. Searches were carried out at the electronic databases PubMed and Google Scholar. The search strategy was done by combining key words and related database-specific subject terms (Mesh terms) with the appropriate Boolean operators. Conclusion Increasing insulin sensitivity in insulin resistant patients would possibly cause substantial reduction in platelet activation, which in turn reduce complications related with platelet hyperactivation. The standard methods to measure IR are not frequently employed in clinical practice due to their expensiveness and complexity. Thus, early detection of IR using a simple and more widely available biomarkers such as mean platelet volume, platelet count and platelet distribution width would be beneficial. Particularly in developing countries where resource scarcity is a major constraint of the health sector, utilizing such easy and affordable biomarkers may have a crucial role.
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Affiliation(s)
- Amanuel Kelem
- Department of Medical Laboratory Sciences, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Tiruneh Adane
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Elias Shiferaw
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Zhu HM, Xiong YY, Chen YB, Xiao J. Serum platelet distribution width predicts cardiovascular and all-cause mortality in patients undergoing peritoneal dialysis. Postgrad Med 2023; 135:394-401. [PMID: 36749999 DOI: 10.1080/00325481.2023.2178755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND Platelet distribution width (PDW) is a predictor for all-cause mortality in patients with cardiovascular diseases (CVD). This study aimed to evaluate the prognostic implication of PDW in predicting cardiovascular and all-cause mortality in patients undergoing peritoneal dialysis (PD). METHODS In total, 762 PD patients from a single center were recruited retrospectively from 2005 to 2017 and followed up until 2021. The primary and secondary outcomes were cardiovascular and all-cause mortality, respectively. Survival analysis was conducted using Kaplan-Meier estimates and Cox regression analysis. RESULTS During a median of 52.2 months of follow-up, 135 (17.7%) cases of CVD and 253 (33.2%) cases of all-cause mortality were reported. After multivariate adjustment, high levels of PDW were associated with an increased risk of death from CVD (HR: 1.583; 95% CI: 1.109-2.258; P = 0.011) and all-cause mortality (HR: 1.313; 95% CI: 1.006-1.758; P = 0.045). Subgroup analysis indicated a stronger association between PDW and all-cause mortality among female participants (P-value for interaction = 0.033). Higher levels of PDW predicted an increased risk of all-cause mortality in female patients (HR: 1.986; 95% CI,1.261-3.127). CONCLUSION High levels of PDW are independently associated with cardiovascular and all-cause mortality in the PD population, and differences by sex exist in the association of PDW with all-cause mortality.
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Affiliation(s)
- Heng-Mei Zhu
- Department of Nephrology, First Affiliated Hospital of Nanchang University, Nanchang, China.,Department of Nephrology, South China Hospital, Medical School, Shenzhen University, Shenzhen, China
| | - Yi-Yi Xiong
- Medical College of Nanchang University, Nanchang, China
| | - Yan-Bing Chen
- Department of Nephrology, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jun Xiao
- Department of Nephrology, First Affiliated Hospital of Nanchang University, Nanchang, China
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Liu B, Xu G, Sun B, Wu G, Chen J, Gao Y. Clinical and biochemical indices of people with high-altitude experience linked to acute mountain sickness. Travel Med Infect Dis 2023; 51:102506. [PMID: 36410656 DOI: 10.1016/j.tmaid.2022.102506] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/02/2022] [Accepted: 11/15/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Acute mountain sickness (AMS) is a major health issue for people travelling to high altitudes. This study was designed to comprehensively evaluate the changes in clinical characteristics and biochemical indices of high-altitude travelers and determine whether these changes were associated with AMS. METHODS A total of 14 clinical indices and 52 biochemical indices were determined in 22 subjects before and during acute high-altitude exposure. Six hours after passive ascent to 3648 m (Lhasa, China), the Lake Louise Scoring (LLS) system 2018 was used to assess AMS, which was defined as headache with a total LLS ≥3. RESULTS Before travelling to high altitudes, uric acid (UA), platelet distribution width (PDW), mitral peak E velocity (MVE), and ejection fraction (EF) were significantly higher in AMS-resistant individuals than in AMS-susceptible ones (all p < 0.05). A good predictive value of UA (0.817, 95% CI: 0.607-1.000) and PDW (0.844, 95% CI: 0.646-1.000) for AMS-susceptible subjects was found. With high-altitude experience, 14 subjects were diagnosed as having AMS. Compared with non-AMS, the changes in UA and number of neutrophils in AMS presented a significant difference (all p < 0.05). The high-altitude-induced changes in UA, area under the curve, specificity, and sensitivity for identifying AMS were 0.883 (95% CI: 0.738-1.000), 83.30%, and 90.00%, respectively. CONCLUSION Human presents a compensatory physiological and biochemical response to high-altitude travel at early phase. The UA concentration before travel and its trend with high-altitude experience exhibited good performance for identifying AMS.
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Affiliation(s)
- Bao Liu
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, 400038, China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, 400038, China.
| | - Gang Xu
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, 400038, China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, 400038, China.
| | - Bingda Sun
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, 400038, China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, 400038, China.
| | - Gang Wu
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, 400038, China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, 400038, China.
| | - Jian Chen
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, 400038, China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, 400038, China.
| | - Yuqi Gao
- Institute of Medicine and Equipment for High Altitude Region, College of High Altitude Military Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China; Key Laboratory of Extreme Environmental Medicine, Ministry of Education of China, Chongqing, 400038, China; Key Laboratory of High Altitude Medicine, PLA, Chongqing, 400038, China.
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Platelet Indices Are the Promising Biomarkers in Monitoring Disease Activities in Patients with Syphilis. Int J Infect Dis 2022; 118:230-235. [PMID: 35301100 DOI: 10.1016/j.ijid.2022.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 02/25/2022] [Accepted: 03/09/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To uncover the role of the platelet indices in patients with syphilis. METHODS A total of 2061 syphilis patients and 528 healthy controls were enrolled in this retrospective cohort study. The data of platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW) and indicators of syphilis activities were collected. The correlations between the platelet indices and disease activities were analyzed. RESULTS 425 (20.6%) of all the 2061 patients were of primary and secondary syphilis, 433 (21.0%) latent, 463 (22.5%) serofast, 350 (17.0%) asymptomatic neurosyphilis and 390 (18.9%) symptomatic neurosyphilis. Compared with the healthy controls, PLT was significantly increased in the primary and secondary syphilis group. Whereas, MPV and PDW were significantly decreased in all stages of syphilis. These changes of platelets indices were reversed after anti-treponemal therapy. Further correlation analysis showed PLT was positively associated with the syphilis activity indicators [rapid plasma reagin (RPR) titer, cerebrospinal fluid white blood cell (CSF-WBC), CSF-protein, and CSF-VDRL (venereal disease research laboratory)] and inflammatory markers [WBC, C-reaction protein (CRP), and erythrocyte sedimentation rate (ESR)]. Conversely, PDW was negatively correlated with all of these parameters. MPV had an inverse relationship with RPR, ESR, and CRP. CONCLUSIONS Platelet indices are associated with syphilis activities.
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Dubey A, Kumar S, Acharya S, Wanjari AK, Bawankule S, Agrawal S, Shukla A. Impact of Red Cell and Platelet Distribution Width in Patients of Medical Intensive Care Unit. J Lab Physicians 2022; 13:309-316. [PMID: 34975248 PMCID: PMC8714314 DOI: 10.1055/s-0041-1730883] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Introduction The red blood cell distribution width (RDW) is a measurement of variations in the size of red blood cells. As the width increases, the rate of mortality also increases, although the reason for it is still not known. On the other hand, platelet distribution width (PDW) is also useful in predicting morbidity and mortality in sepsis and other critically ill patients. In our study, we planned to study the impact of both RDW and PDW and evaluate their prognostic importance with outcome in patients admitted in medicine intensive care unit (MICU). Material and Method In these cross-sectional observational studies, 1,300 patients were included who were admitted in MICU. Critically ill patients were defined on the basis of qSOFA score greater than 2. PDW and RDW were obtained from Coulter report of complete blood count. Parameters included in Acute Physiology and Chronic Health Evaluation (APACHE) IV scores were taken and APACHE IV score was calculated. Correlation of RDW and PDW with outcomes such as length of ICU stay, use of mechanical ventilator, and discharge/death was done. Result The mean RDW (%) for the entire study population was 15.17 ± 3.01. The RDW (%) was significantly on the higher side in patients who succumbed to the disease as compared with the patients who were discharged. The correlation between the length of ICU stay (days) and RDW (%) was moderately positive and was significant (rho = 0.37, p ≤ 0.001). The correlation between the length of ICU stay (days) and PDW (%) was moderately positive and was significant (rho = 0.5, p ≤ 0.001). Conclusion RDW and PDW were found as significant indicators for period of stay in ICU, requirement for mechanical ventilation, and mortality rate in patients admitted to ICUs. As these are simple, easy to conduct, universally available tests, they can be regularly incorporated in patients admitted in ICUs.
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Affiliation(s)
- Ayush Dubey
- Department of Medicine, Datta Meghe Institute of Medical Sciences, Jawahar Lal Nehru Medical College (deemed to be university), Wardha, Maharashtra, India
| | - Sunil Kumar
- Department of Medicine, Datta Meghe Institute of Medical Sciences, Jawahar Lal Nehru Medical College (deemed to be university), Wardha, Maharashtra, India
| | - Sourya Acharya
- Department of Medicine, Datta Meghe Institute of Medical Sciences, Jawahar Lal Nehru Medical College (deemed to be university), Wardha, Maharashtra, India
| | - Anil K Wanjari
- Department of Medicine, Datta Meghe Institute of Medical Sciences, Jawahar Lal Nehru Medical College (deemed to be university), Wardha, Maharashtra, India
| | - Shilpa Bawankule
- Department of Medicine, Datta Meghe Institute of Medical Sciences, Jawahar Lal Nehru Medical College (deemed to be university), Wardha, Maharashtra, India
| | - Sachin Agrawal
- Department of Medicine, Datta Meghe Institute of Medical Sciences, Jawahar Lal Nehru Medical College (deemed to be university), Wardha, Maharashtra, India
| | - Ashlesha Shukla
- Department of Medicine, Institute of Medical Sciences and SUM Hospital (deemed to be university), Bhubaneswar, Odisha, India
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Li L, Yu J, Zhou Z. Platelet-associated parameters in patients with psoriasis: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e28234. [PMID: 34918687 PMCID: PMC10545373 DOI: 10.1097/md.0000000000028234] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 11/16/2021] [Accepted: 11/24/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The relationship between platelet-associated parameters and psoriasis has been controversial. The purpose of our meta-analysis was to assess whether platelet count, platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), and platelet distribution width (PDW) are associated with psoriasis. METHODS We performed a thorough documentation retrieval via PubMed, EMBASE, and Web of Science until June 2021. Pooled standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated using a random-effects model. RESULTS Overall, 22 studies involving 1749 patients with psoriasis and 1538 healthy controls were selected for the meta-analysis. The outcomes showed that platelet count presented non-significant differences between psoriatic patients and normal individuals (SMD = 0.12, 95% CI = -0.07 to 0.32, P = .210), while PLR (SMD = 0.28, 95% CI = 0.03-0.53, P = .031), MPV (SMD = 0.55, 95% CI = 0.30-0.79, P < .001), and PDW (SMD = 0.29, 95% CI = 0.03-0.55, P = .027) were remarkably greater in the psoriatic patients than in the healthy individuals, and similar results were found in subgroup analyses. The analytical results of susceptibility revealed that the outcomes were robust, and no evidence of substantial publication bias was identified. CONCLUSION Patients with psoriasis present significantly higher PLR, MPV, and PDW than healthy individuals, suggesting that psoriasis is accompanied by low-grade systemic inflammation and platelet activation.
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Affiliation(s)
- Li Li
- Department of Clinical Laboratory, Binhai County People's Hospital, Binhai, Jiangsu, China
| | - Jianxiu Yu
- Department of Clinical Laboratory, Binhai County People's Hospital, Binhai, Jiangsu, China
| | - Zhongwei Zhou
- Department of Clinical Laboratory, Yancheng Third People's Hospital (The Affiliated Yancheng Hospital of Southeast University Medical College, The Sixth Affiliated Hospital of Nantong University, The Yancheng School of Clinical Medicine of Nanjing Medical University), Yancheng, Jiangsu, China
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van Dijk WEM, Nijdam JS, Haitjema S, de Groot MCH, Huisman A, Punt MC, Evers ACC, Schutgens REG, Lely AT, van Galen KPM. Platelet count and indices as postpartum hemorrhage risk factors: a retrospective cohort study. J Thromb Haemost 2021; 19:2873-2883. [PMID: 34339085 PMCID: PMC9292153 DOI: 10.1111/jth.15481] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 07/27/2021] [Accepted: 07/29/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Severe postpartum hemorrhage (SPPH) is the leading cause of maternal mortality and morbidity worldwide. Platelet anomalies frequently occur during pregnancy. However, their role in the etiology of SPPH is largely unknown. OBJECTIVE To study the relation between platelet parameters and SPPH. METHODS This retrospective single-center cohort included deliveries between 2009 and 2017. SPPH was defined as ≥1000 ml blood loss within 24 h after delivery. Platelet parameters were measured within 72 h before delivery. Multiple imputation was performed for missing data. Odds ratios were adjusted (aORs) for maternal age, multiple gestation, macrosomia, induction of labor, preeclampsia, and hemolysis, elevated liver enzymes, and low platelets syndrome. RESULTS A total of 23 205 deliveries were included. Of the 2402 (10.4%) women with thrombocytopenia (<150 × 109 /L), 10.3% developed SPPH, compared with 7.6% of women with a normal platelet count (aOR: 1.34, 95% CI: 1.14-1.59). Women with a platelet count of <50 × 109 /L were most at risk (aOR of 2.24 [1.01-4.94]) compared with the reference group with normal platelet counts; the aOR was 1.22 (0.77-1.93) for the 50-99 × 109 /L platelet count group and 1.31 (1.10-1.56) for the 100-149 × 109 /L platelet count group. Plateletcrit was associated with SPPH (aOR 1.15 [1.08-1.21] per 0.05% decrease), and, although rarely present, a platelet distribution width (PDW) ≥23% (n = 22) also increased the odds of SPPH (aOR 6.05 [2.29-16.20]). CONCLUSION Different degrees of thrombocytopenia were independently associated with the occurrence of SPPH. Despite their relation to SPPH, plateletcrit and a PDW of ≥23% have limited additional value in addition to platelet count.
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Affiliation(s)
- Wobke E. M. van Dijk
- Benign Hematology, Van CreveldkliniekUniversity Medical CenterUtrechtThe Netherlands
| | | | - Saskia Haitjema
- Clinical Chemistry and HematologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Mark C. H. de Groot
- Clinical Chemistry and HematologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Albert Huisman
- Clinical Chemistry and HematologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Marieke C. Punt
- Benign Hematology, Van CreveldkliniekUniversity Medical CenterUtrechtThe Netherlands
| | | | - Roger E. G. Schutgens
- Benign Hematology, Van CreveldkliniekUniversity Medical CenterUtrechtThe Netherlands
| | - A. Titia Lely
- Obstetrics and GynecologyUniversity Medical Center UtrechtUtrechtNetherlands
| | - Karin P. M. van Galen
- Benign Hematology, Van CreveldkliniekUniversity Medical CenterUtrechtThe Netherlands
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Karatas KS, Bahceci I, Telatar TG, Bahceci B, Hocaoglu C. Relationship between disease and disease severity and semaphorin 5A and hemogram level in obsessive-compulsive disorder. Nord J Psychiatry 2021; 75:509-515. [PMID: 33771090 DOI: 10.1080/08039488.2021.1896779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Semaphorin 5A (SEMA 5A) is a neuroprotein that regulates the formation of excitatory synapses between neurons, important in autoimmunity, inflammatory processes and behaviors. This study aimed to investigate the SEMA 5A levels in patients with obsessive-compulsive disorder (OCD) diagnosed for the first time and evaluate the relationship of disease and disease severity with the blood SEMA 5A level and hemogram. METHODS More than 41,465 patients who applied to the psychiatry clinic from January 2018 to December 2020 were evaluated according to the DSM-5 criteria; 57 patients diagnosed with OCD for the first time, who met the inclusion criteria, were included in the study. Disease severity was investigated administering the Yale Brown Obsessive Compulsion Scale. The peripheral blood SEMA 5A level and hemogram were measured and evaluated in relation to platelet (PLT) activity, neutrophil-lymphocyte ratio (NLR), PLT-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), C-reactive protein (CRP), and compared with control group of 26 people. RESULTS The comparison of the groups revealed a significant difference in SEMA 5A and CRP level, neutrophil count and percentage, lymphocyte count, PLT activity. A significant correlation was found between disease and SEMA 5A level, NLR, PLR, and PLT parameters in diagnosis of OCD. As the severity of OCD increased, the SEMA 5A level and PLT count decreased, while the PDW and MLR values increased. CONCLUSION In patients with OCD, a relationship was found between plasma SEMA 5A, PLT activity, NLR, PLR, and MLR activity levels with disease and the disease severity.
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Affiliation(s)
- Kader Semra Karatas
- Psychiatry Department, Recep Tayyip Erdoğan University Medical School, Rize, Turkey
| | - Ilkay Bahceci
- Medical Microbiology and Clinical Microbiology Department, Recep Tayyip Erdoğan University Medical School, Rize, Turkey
| | - Tahsin Gokhan Telatar
- Public Health Department, Recep Tayyip Erdoğan University Medical School, Rize, Turkey
| | - Bulent Bahceci
- Psychiatry Department, Recep Tayyip Erdoğan University Medical School, Rize, Turkey
| | - Cicek Hocaoglu
- Psychiatry Department, Recep Tayyip Erdoğan University Medical School, Rize, Turkey
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Köse A, Akdeniz A, Babus SB, Göçmen M, Temel GO. The Usefulness of Platelet Distribution Width and Platelet Distribution Width to Lymphocyte Ratio in Predicting Severity and Outcomes in Patients with Snakebite. Wilderness Environ Med 2021; 32:284-292. [PMID: 34172373 DOI: 10.1016/j.wem.2021.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 03/18/2021] [Accepted: 03/19/2021] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Tissue damage, inflammatory response, and hematologic abnormalities may occur in snakebite envenomation. This study aimed to evaluate the predictive ability of platelet distribution width (PDW) and platelet distribution width to lymphocyte ratio (PDWLR) in the severity and outcome of envenomation in patients with snakebites in the emergency department (ED). METHODS All adult patients admitted to the ED after a snakebite were retrospectively evaluated. Patients were classified according to the severity of envenomation. The relationship between the PDW and PDWLR and envenomation severity and patient outcomes was analyzed. Multivariate logistic regression analysis was performed to determine the predictors of severe envenomation. Results were presented as 95% CIs with odds ratios. Statistical significance was accepted at P<0.05. RESULTS Envenomation was classified as none/minimal in 42 patients and moderate/severe in 29. PDW and PDWLR were significantly higher in the moderate/severe group (P=0.016 and P<0.001, respectively). Cut-off values of 16.5 for PDW and 6.15 for PDWLR were related to more severe envenomation (area under the curve 0.67, 95% CI 0.55-0.78 and area under the curve 0.85, 95% CI: 0.74-0.92, respectively). Blood product replacement, thrombocytopenia, hematologic abnormality, advanced local findings, compartment syndrome/fasciotomy, antivenom dosing, and moderate/severe envenomation were associated with PDWLR >6.15 (P<0.05). In multivariate analysis, PDWLR (odds ratio 1.19 [95% CI 1-1.4]; P=0.04) was an independent predictor of severe envenomation. CONCLUSIONS Higher PDW and PDWLR were associated with severe envenomation in patients with snakebites in the ED. PDWLR may be used as a predictor of severe envenomation and adverse outcomes.
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Affiliation(s)
- Ataman Köse
- Faculty of Medicine, Department of Emergency Medicine, Mersin University, Mersin, Turkey.
| | - Aydan Akdeniz
- Faculty of Medicine, Department of Hematology, Mersin University, Mersin, Turkey
| | - Seyran Bozkurt Babus
- Faculty of Medicine, Department of Emergency Medicine, Mersin University, Mersin, Turkey
| | - Mert Göçmen
- Faculty of Medicine, Department of Emergency Medicine, Mersin University, Mersin, Turkey
| | - Gülhan Orekici Temel
- Faculty of Medicine, Department of Biostatistics and Medical Informatics, Mersin University, Mersin, Turkey
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Deineka V, Sulaieva O, Pernakov M, Korniienko V, Husak Y, Yanovska A, Yusupova A, Tkachenko Y, Kalinkevich O, Zlatska A, Pogorielov M. Hemostatic and Tissue Regeneration Performance of Novel Electrospun Chitosan-Based Materials. Biomedicines 2021; 9:biomedicines9060588. [PMID: 34064090 PMCID: PMC8224387 DOI: 10.3390/biomedicines9060588] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/13/2021] [Accepted: 05/19/2021] [Indexed: 12/16/2022] Open
Abstract
The application of chitosan (Ch) as a promising biopolymer with hemostatic properties and high biocompatibility is limited due to its prolonged degradation time, which, in turn, slows the repair process. In the present research, we aimed to develop new technologies to reduce the biodegradation time of Ch-based materials for hemostatic application. This study was undertaken to assess the biocompatibility and hemostatic and tissue-regeneration performance of Ch-PEO-copolymer prepared by electrospinning technique. Chitosan electrospinning membranes (ChEsM) were made from Ch and polyethylene oxide (PEO) powders for rich high-porous material with sufficient hemostatic parameters. The structure, porosity, density, antibacterial properties, in vitro degradation and biocompatibility of ChEsM were evaluated and compared to the conventional Ch sponge (ChSp). In addition, the hemostatic and bioactive performance of both materials were examined in vivo, using the liver-bleeding model in rats. A penetrating punch biopsy of the left liver lobe was performed to simulate bleeding from a non-compressible irregular wound. Appropriately shaped ChSp or ChEsM were applied to tissue lesions. Electrospinning allows us to produce high-porous membranes with relevant ChSp degradation and swelling properties. Both materials demonstrated high biocompatibility and hemostatic effectiveness in vitro. However, the antibacterial properties of ChEsM were not as good when compared to the ChSp. In vivo studies confirmed superior ChEsM biocompatibility and sufficient hemostatic performance, with tight interplay with host cells and tissues. The in vivo model showed a higher biodegradation rate of ChEsM and advanced liver repair.
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Affiliation(s)
- Volodymyr Deineka
- Medical Institute, Sumy State University, 40007 Sumy, Ukraine; (O.S.); (M.P.); (V.K.); (Y.H.); (A.Y.); (A.Y.); (Y.T.)
- Correspondence: (V.D.); (M.P.)
| | - Oksana Sulaieva
- Medical Institute, Sumy State University, 40007 Sumy, Ukraine; (O.S.); (M.P.); (V.K.); (Y.H.); (A.Y.); (A.Y.); (Y.T.)
- Medical Laboratory CSD, 03148 Kyiv, Ukraine
| | - Mykola Pernakov
- Medical Institute, Sumy State University, 40007 Sumy, Ukraine; (O.S.); (M.P.); (V.K.); (Y.H.); (A.Y.); (A.Y.); (Y.T.)
| | - Viktoriia Korniienko
- Medical Institute, Sumy State University, 40007 Sumy, Ukraine; (O.S.); (M.P.); (V.K.); (Y.H.); (A.Y.); (A.Y.); (Y.T.)
| | - Yevheniia Husak
- Medical Institute, Sumy State University, 40007 Sumy, Ukraine; (O.S.); (M.P.); (V.K.); (Y.H.); (A.Y.); (A.Y.); (Y.T.)
| | - Anna Yanovska
- Medical Institute, Sumy State University, 40007 Sumy, Ukraine; (O.S.); (M.P.); (V.K.); (Y.H.); (A.Y.); (A.Y.); (Y.T.)
| | - Aziza Yusupova
- Medical Institute, Sumy State University, 40007 Sumy, Ukraine; (O.S.); (M.P.); (V.K.); (Y.H.); (A.Y.); (A.Y.); (Y.T.)
| | - Yuliia Tkachenko
- Medical Institute, Sumy State University, 40007 Sumy, Ukraine; (O.S.); (M.P.); (V.K.); (Y.H.); (A.Y.); (A.Y.); (Y.T.)
| | | | - Alena Zlatska
- Biotechnology Laboratory Ilaya Regeneration, Medical Company Ilaya, 03115 Kyiv, Ukraine;
- State Institute of Genetic and Regenerative Medicine of NAMS of Ukraine, 04114 Kyiv, Ukraine
| | - Maksym Pogorielov
- Medical Institute, Sumy State University, 40007 Sumy, Ukraine; (O.S.); (M.P.); (V.K.); (Y.H.); (A.Y.); (A.Y.); (Y.T.)
- NanoPrime, 39-200 Dębica, Poland
- Correspondence: (V.D.); (M.P.)
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Yu Z, Xiong J, Yang K, Huang Y, He T, Yu Y, Zhao J. The association between platelet indices and cardiovascular events in chronic kidney disease patients without dialysis. Int Urol Nephrol 2021; 53:961-971. [PMID: 33387224 DOI: 10.1007/s11255-020-02696-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 10/27/2020] [Indexed: 01/04/2023]
Abstract
PURPOSE Previous studies have indicated that platelet indices are related to the pathogenesis of cardiovascular diseases (CVD). However, it is unclear which platelet-related indicators are associated with CVD events in patients with chronic kidney disease (CKD) without dialysis. METHODS We performed a single-center prospective cohort study involved 1391 CKD patients to explore the relationship between platelet indices and CVD events in CKD patients. A nomogram was generated to predict CVD-free survival after 3 and 5 years of follow-up in terms of the fitted Cox regression model. And the time-dependent receiver-operating characteristic (ROC) curves were applied to evaluate the prediction accuracy of platelet indices on CVD events. RESULTS During a median follow-up of 3.41 years, 211 (15.2%) patients experienced CVD events. Results showed that platelet counts (PLT), plateletcrit (PCT), platelet-large cell ratio (P-LCR), and platelet distribution width (PDW) among 5 platelet indices were significantly lower in advanced CKD stages. Cox regression model showed that PLT, PDW, and PCT were associated with CVD events. However, after multivariable-adjusted, low level of PLT, hazard ratio (HR) 0.994 and 95% confidence interval (95% CI 0.989-1.000, p = 0.04), and PDW, HR 0.936 (95% CI 0.878-0.998, p = 0.044) predicted CVD events. The area under the ROC curve (AUC) of platelet indices assessed by time-dependent ROC curve analysis showed that only PLT and PDW were significant for predicting CVD events for 5 years. CONCLUSIONS We demonstrated that PLT and PDW among 5 platelet indices were independently associated with CVD events in patients with CKD.
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Affiliation(s)
- Zhikai Yu
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, People's Republic of China
| | - Jiachuan Xiong
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, People's Republic of China
| | - Ke Yang
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, People's Republic of China
| | - Yinhui Huang
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, People's Republic of China
| | - Ting He
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, People's Republic of China
| | - Yanlin Yu
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, People's Republic of China
| | - Jinghong Zhao
- Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Kidney Center of PLA, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, People's Republic of China.
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Platelet distribution width as a marker for predicting lupus nephritis. Int Immunopharmacol 2020; 85:106693. [PMID: 32559723 DOI: 10.1016/j.intimp.2020.106693] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 05/26/2020] [Accepted: 06/08/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Lupus nephritis (LN) is an important manifestation of systemic lupus erythematosus (SLE). The aim of this study was to investigate the predictive value of platelet distribution width (PDW) in LN. METHODS A retrospective study involving 212 SLE patients and 201 healthy controls were performed. All clinical characteristics and laboratory data were collected from their medical records. RESULTS The level of PDW was significantly decreased in SLE patients, which was negatively correlated with SLE disease activity index 2000 (SLEDAI-2K) score, disease duration, and 24-hour (24-h) urine protein, while positively correlated with serum IgG and IgM. There were more LN patients in low-PDW group than normal-PDW and high-PDW groups. In low-PDW group, SLEDAI-2K score, 24-h urine protein level, and anti-dsDNA antibody level was significantly higher, while serum IgG level was markedly lower. Moreover, PDW was negatively correlated with 24-h urine protein and disease duration, and it was positively correlated with serum IgG in LN patients. In addition, the area under the ROC curve of PDW was 0.87 and the optimal clinical cutoff level was 12.9, which provided a 87.41% sensitivity and a 74.63% specificity. Decreased PDW combined with high 24-h urine protein exhibited an excellent diagnostic value for LN. Importantly, 16.67% LN patients with negative 24-h urine protein can be detected in low PDW group. CONCLUSION PDW may be a potential marker for predicting LN. Low PDW accompanied with high 24-h urine protein may be a useful indicator for diagnosing LN.
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