Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio among Patients with Vestibular Neuritis

Clinical Significance of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Acute Unilateral Vestibulopathy

BACKGROUND AND PURPOSE

The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been identified as useful biomarkers for assessing the inflammatory response and for predicting the prognosis of various diseases. This study aimed to determine the clinical significance and effects on prognostic prediction of NLR and PLR in acute unilateral vestibulopathy (AUV).

METHODS

We retrospectively recruited 128 patients who were diagnosed with AUV from July 2016 to April 2021, and compared NLR and PLR values between these patients with AUV and age- and sex-matched healthy subjects. We also analyzed the correlations of various clinical parameters with NLR and PLR.

RESULTS

NLR and PLR in the AUV group were 3.41±2.80 (mean±standard deviation) and 128.86±67.06, respectively, with only NLR being significantly higher than that in the control group (1.55±0.60, p<0.001). The gain asymmetry of the horizontal vestibulo-ocular reflex (VOR) was slightly larger in patients with high NLR (n=52) than in those with normal NLR (n=76) (41.9%±20.2% vs. 33.6%±17.4%, p=0.048). However, the hospitalization period, preceding infection, canal paresis, and absolute horizontal VOR gain did not differ between patients with high and normal NLR and PLR values. The correlation analyses also revealed that none of the clinical parameters were significantly correlated with NLR or PLR. At 3-month follow-up examinations, NLR and PLR did not differ significantly between patients with and without function recovery of the horizontal VOR.

CONCLUSIONS

This study found a high NLR in AUV, suggesting an acute inflammatory status in the vestibular organ. However, the usefulness of NLR and PLR as prognostic markers remains unclear.

Vestibular function is associated with immune inflammatory response

Association between vestibular function and immune inflammatory response has garnered increasing interest. Immune responses can lead to anatomical or functional alterations of the vestibular system, and inflammatory reactions may impair hearing and balance. Vestibular disorders comprise a variety of conditions, such as vestibular neuritis, benign paroxysmal positional vertigo, Meniere's disease, vestibular migraine, posterior circulation ischemia, and bilateral vestibular disease. Moreover, some patients with autoimmune diseases develop vestibulocochlear symptom. This paper offers an overview of prevalent vestibular diseases and discusses associations between vestibular dysfunction and immune diseases.

Association of Dry Eye Diseases and Auditory Sensitivity

This study aimed to evaluate the association between dry eye and inner ear diseases in a Korean population. Methods: Data from the Korean National Health and Nutrition Survey (KNHANES V, 2010−2012), a national cross-sectional health examination and survey, were collected by the Korea Centers for Disease Control and Prevention. The association between dry eye and inner ear disease was determined using the chi-square test and logistic regression analysis. The individuals were divided into two age groups (<60 and ≥60 years). Results: In total, 17,542 individuals (n = 11,932 in the <60 years group and n = 5610 in the ≥60 years group) were enrolled. After adjusting for confounding factors, the logistic regression model revealed that the associated factors were dizziness and loss of balance experience (OR, 1.315; 95% CI, 1.143−1.513), self-awareness of abnormal voice (OR, 1.372; 95% CI, 1.120−1.679), subjective hearing discomfort (OR, 1.278; CI, 1.084−1.506), and tinnitus (OR, 1.265; 95% CI, 1.101−1.453). The inversely associated factor for dry eye was bilateral hearing loss (OR, 0.497; 95% CI, 0.367−0.672). The hearing threshold was lower in the dry eye group than in the non-dry eye group (p < 0.05). Conclusions: Tinnitus was associated with dry eye and bilateral hearing loss was inversely associated with dry eye. These results suggest that hypersensitivity of the senses and nerves, which is neuropathic hyperesthesia, is one of the main mechanisms of dry eye. Treatment of neuropathy may help in treating dry eye associated with dizziness or tinnitus.

Predictive Performances of Blood Parameter Ratios for Liver Inflammation and Advanced Liver Fibrosis in Chronic Hepatitis B Infection

OBJECTIVE

Blood parameter ratios, including neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and monocyte to lymphocyte ratio (MLR), have been reported that they are correlated to the progression of liver disease. This study is aimed at evaluating the predictive value of PLR, NLR, and MLR for liver inflammation and fibrosis in patients with chronic hepatitis B (CHB).

METHODS

We recruited 457 patients with CHB who underwent a liver biopsy and routine laboratory tests. Liver histology was assessed according to the Scheuer scoring system. The predictive accuracy for liver inflammation and fibrosis was assessed by receiver operating characteristics (ROC) analysis.

RESULTS

PLR and NLR presented significantly reverse correlation to liver inflammation and fibrosis. However, these correlations were not observed for MLR and liver histology. The AUROCs of PLR for assessing G2-3 and G3 were 0.676 and 0.705 with cutoffs 74.27 and 68.75, respectively. The AUROCs of NLR in predicting inflammatory scores G2-3 and G3 were 0.616 and 0.569 with cutoffs 1.36 and 1.85, respectively. The AUROCs of PLR for evaluating fibrosis stages S3-4 and S4 were 0.723 and 0.757 with cutoffs 79.67 and 74.27, respectively. The AUROCs of NLR for evaluating fibrosis stages S3-4 and S4 were 0.590 with cutoff 1.14.

CONCLUSION

Although PLR has similar predictive power of progressive liver fibrosis compared with APRI, FIB-4, and GPR in CHB patients, it has the advantage of less cost and easy application with the potential to be widely used in clinical practice.