1
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Ali A, Abdelhafiz AS, Saleh MM, Salem H, Rakha MA, Ezzat S. Monocyte to eosinophil ratio as a diagnostic biomarker for overlap syndrome and predictor of disease exacerbation. Int J Immunopathol Pharmacol 2023; 37:3946320231216321. [PMID: 37977558 PMCID: PMC10657538 DOI: 10.1177/03946320231216321] [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: 07/01/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023] Open
Abstract
Objectives: Chronic Obstructive Pulmonary Disease (COPD) is one of the most common pulmonary diseases. The concomitant association of Obstructive Sleep Apnea (OSA) and COPD is known as the Overlap Syndrome (OS). This study aimed to identify markers for predicting OS, among routine laboratory tests, including differential blood counts.Methods: One hundred twenty-five patients with exacerbated COPD were enrolled in the study and screened for OSA using the Epworth Sleepiness Scale (ESS). Those with a positive ESS score underwent polysomnography (PSG) for confirmation. All patients were followed for 90 days to monitor for subsequent exacerbations.Results: Out of the 125 patients with exacerbated COPD, 25 were confirmed to have OSA. Those with OS had a significantly higher body mass index (BMI) (p < 0.001). The monocyte to eosinophil ratio (MER) was significantly higher in the OS group, while the neutrophil to monocyte (NMR) ratio and platelets to monocyte (PMR) ratio were significantly lower. Younger age, male sex, and higher body mass index (BMI) were all associated with OS. During the 90-day follow-up period after hospital discharge, 60% of patients with OS were re-admitted due to acute exacerbations. The hazard ratio for a second exacerbation increased by two-fold for every one-unit increase MER. The MER demonstrated excellent utility in predicting a second exacerbation, with an area under the curve (AUC) of 83% and a p-value of .005.Conclusion: The monocyte to eosinophil ratio (MER) was independent predictors of OS among exacerbated COPD patients and had a very good prognostic utility for predicting the next exacerbation episodes. Long term follow up is recommended to evaluate the severity of exacerbations and the effect of complications of OS on the morbidity and mortality of these patients.
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Affiliation(s)
- Asmaa Ali
- Department of Pulmonary Medicine, Abbassia Chest Hospital, Egypt Ministry of Health and Population, Cairo, Egypt
| | - Ahmed Samir Abdelhafiz
- Department of Clinical Pathology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Mai M Saleh
- Department of Chest Disease, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Heba Salem
- Department of Chest Disease, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Mohammed A Rakha
- Department of Chest Disease, Faculty of Medicine, Alazhar University, Cairo, Egypt
| | - Seham Ezzat
- Department of Chest Disease, Faculty of Medicine, Tanta University, Tanta, Egypt
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2
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Hu J, Lv S, Zhou T, Chen H, Xiao L, Huang X, Wang L, Wu P. Identification of Pulmonary Hypertension Animal Models Using a New Evolutionary Machine Learning Framework Based on Blood Routine Indicators. JOURNAL OF BIONIC ENGINEERING 2022; 20:762-781. [PMID: 36466726 PMCID: PMC9703443 DOI: 10.1007/s42235-022-00292-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 06/17/2023]
Abstract
Pulmonary Hypertension (PH) is a global health problem that affects about 1% of the global population. Animal models of PH play a vital role in unraveling the pathophysiological mechanisms of the disease. The present study proposes a Kernel Extreme Learning Machine (KELM) model based on an improved Whale Optimization Algorithm (WOA) for predicting PH mouse models. The experimental results showed that the selected blood indicators, including Haemoglobin (HGB), Hematocrit (HCT), Mean, Platelet Volume (MPV), Platelet distribution width (PDW), and Platelet-Large Cell Ratio (P-LCR), were essential for identifying PH mouse models using the feature selection method proposed in this paper. Remarkably, the method achieved 100.0% accuracy and 100.0% specificity in classification, demonstrating that our method has great potential to be used for evaluating and identifying mouse PH models.
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Affiliation(s)
- Jiao Hu
- Department of Computer Science and Artificial Intelligence, Wenzhou University, Wenzhou, 325035 People’s Republic of China
| | - Shushu Lv
- Department of Dermatology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730 People’s Republic of China
| | - Tao Zhou
- The First Clinical College, Wenzhou Medical University, Wenzhou, 325000 People’s Republic of China
| | - Huiling Chen
- Department of Computer Science and Artificial Intelligence, Wenzhou University, Wenzhou, 325035 People’s Republic of China
| | - Lei Xiao
- Department of Computer Science and Artificial Intelligence, Wenzhou University, Wenzhou, 325035 People’s Republic of China
| | - Xiaoying Huang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000 People’s Republic of China
| | - Liangxing Wang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000 People’s Republic of China
| | - Peiliang Wu
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000 People’s Republic of China
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3
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Gómez-Rosero JA, Cáceres-Galvis C, Ascuntar J, Atencia C, Vallejo CE, Jaimes F. Biomarkers as a Prognostic Factor in COPD Exacerbation: A Cohort Study. COPD 2021; 18:325-332. [PMID: 33970730 DOI: 10.1080/15412555.2021.1922370] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The acute exacerbations of COPD (AECOPD) are one of the main causes of hospitalization and morbimortality in the adult population. There are not many tools available to predict the clinical course of these patients during exacerbations. Our goal was to estimate the clinical utility of C Reactive Protein (CRP), Mean Platelet Volume (MPV), eosinophil count and neutrophil/lymphocyte ratio (NLR) as in-hospital prognostic factors in patients with AECOPD. A prospective cohort study was conducted in patients who consulted three reference hospitals in the city of Medellín for AECOPD and who required hospitalization between 2017 and 2020. A multivariate analysis was performed to estimate the effect of biomarkers in the two primary outcomes: the composite outcome of in-hospital death and/or admission to the ICU and hospital length-of-stay. A total of 610 patients with a median age of 74 years were included; 15% were admitted to the ICU and 3.9% died in the hospital. In the multivariate analysis adjusted for confounding variables, the only marker significantly associated with the risk of dying or being admitted to the ICU was the NLR > 5 (OR: 3; CI95%: 1.5; 6). Similarly, the NLR > 5 was also associated to a lower probability of being discharged alive from the institution (SHR: 0.73; CI95%: 0.57; 0.94) and, therefore, a longer hospital stay. It was found that a neutrophil/lymphocyte ratio greater than 5 is a strong predictor of mortality or ICU admissions and a longer hospital stay in patients hospitalized with AECOPD.
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Affiliation(s)
- Jaime A Gómez-Rosero
- Internal Medicine Department, Medical School, University of Antioquia, Medellín, Colombia.,Medical Division, Hospital Pablo Tobón Uribe, Medellín, Colombia
| | - Camilo Cáceres-Galvis
- Internal Medicine Department, Medical School, University of Antioquia, Medellín, Colombia.,Medical Division, Hospital Universitario San Vicente Fundación, Medellín, Colombia
| | - Johana Ascuntar
- GRAEPIC - Clinical Epidemiology Academic Group (Grupo Académico de Epidemiología Clínica), University of Antioquia, Medellín, Colombia
| | - Carlos Atencia
- Internal Medicine Department, Medical School, University of Antioquia, Medellín, Colombia.,Medical Division, Hospital Universitario San Vicente Fundación, Medellín, Colombia
| | - Carlos E Vallejo
- Internal Medicine Department, Medical School, University of Antioquia, Medellín, Colombia.,Medical Division, IPS Universitaria León XIII, Medellín, Colombia
| | - Fabián Jaimes
- Internal Medicine Department, Medical School, University of Antioquia, Medellín, Colombia.,GRAEPIC - Clinical Epidemiology Academic Group (Grupo Académico de Epidemiología Clínica), University of Antioquia, Medellín, Colombia
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4
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Zinellu A, Paliogiannis P, Sotgiu E, Mellino S, Fois AG, Carru C, Mangoni AA. Platelet Count and Platelet Indices in Patients with Stable and Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis. COPD 2021; 18:231-245. [PMID: 33929925 DOI: 10.1080/15412555.2021.1898578] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Platelets play an important role in the pathophysiology of chronic obstructive pulmonary disease (COPD) by mediating thrombotic, inflammatory, and immune processes in the lung. We conducted a systematic review and meta-analysis of studies investigating the platelet count and three platelet indices, mean platelet volume (MPV), platelet distribution width (PDW), and platelet to lymphocyte ratio (PLR) in stable COPD vs. non-COPD patients and in stable COPD vs. acute exacerbation of COPD (AECOPD) patients (PROSPERO registration number: CRD42021228263). PubMed, Web of Science, Scopus and Google Scholar were searched from inception to December 2020. Twenty-seven studies were included in the meta-analysis, 26 comparing 4,455 stable COPD patients with 7,128 non-COPD controls and 14 comparing 1,251 stable COPD with 904 AECOPD patients. Stable COPD patients had significantly higher platelet counts (weighted mean difference, WMD = 13.39 x109/L, 95% CI 4.68 to 22.11 x109/L; p < 0.001) and PLR (WMD = 59.52, 95% CI 29.59 to 89.44; p < 0.001) than non-COPD subjects. AECOPD patients had significantly higher PLR values than stable COPD patients (WMD = 46.03, 95% CI 7.70 to 84.35; p = 0.02). No significant differences were observed in MPV and PDW. Between-study heterogeneity was extreme. In sensitivity analysis, the effect size was not modified when each study was sequentially removed. The was no evidence of publication bias. In our meta-analysis, specific platelet biomarkers were associated with stable COPD (platelet count and PLR) and AECOPD (PLR). However, the observed heterogeneity limits the generalizability of the findings. Further studies are required to determine their prognostic utility and the effects of targeted interventions in COPD.
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Affiliation(s)
- Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | | | - Elisabetta Sotgiu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Sabrina Mellino
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Alessandro G Fois
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Arduino A Mangoni
- Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Adelaide, Australia
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5
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Mallah H, Ball S, Sekhon J, Parmar K, Nugent K. Platelets in chronic obstructive pulmonary disease: An update on pathophysiology and implications for antiplatelet therapy. Respir Med 2020; 171:106098. [PMID: 32777683 DOI: 10.1016/j.rmed.2020.106098] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 06/14/2020] [Accepted: 07/26/2020] [Indexed: 12/18/2022]
Abstract
Platelets are essential mediators of inflammation and thrombosis. Chronic obstructive pulmonary disease (COPD) is a heterogeneous multisystem disease, causing significant morbidity and mortality worldwide. Recent evidence suggests that the lung is an important organ for platelet biogenesis. Cigarette smoking has been shown to induce platelet aggregation and decrease the capacity of mitochondrial electron transport system in platelets. Preclinical and clinical studies have suggested that platelets may contribute to the development of COPD through the breakdown of lung elastin by platelet factor 4, platelet activation and formation of platelet aggregates, and modulation of hypoxia signaling pathways. Recent large population studies have produced encouraging results indicating a potential role for aspirin in preventing exacerbations and delaying disease progression in patients with COPD. This review summarizes the information about the lung as an organ for platelet production, pathophysiological functions of platelets and platelet mediators in the development of COPD, and the most updated evidence on the utility of aspirin in patients with COPD.
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Affiliation(s)
- Haneen Mallah
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Somedeb Ball
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
| | - Jasmine Sekhon
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Kanak Parmar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Kenneth Nugent
- Division of Pulmonary and Critical Care Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
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6
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Handtke S, Thiele T. Large and small platelets-(When) do they differ? J Thromb Haemost 2020; 18:1256-1267. [PMID: 32108994 DOI: 10.1111/jth.14788] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 02/24/2020] [Accepted: 02/25/2020] [Indexed: 02/06/2023]
Abstract
Platelets are most important in providing cellular hemostasis but also take part in inflammation and immune processes. Increased platelet size has been regarded as a feature describing a young and more reactive subpopulation until studies were published which questioned this concept. Moreover, changes of platelet size given by the mean platelet volume (MPV) were described for immune thrombocytopenia, cardiovascular disease, atherosclerosis, venous thromboembolism, chronic lung disease, sepsis, cancer-associated thrombosis, autoimmune disorders, and others. This review summarizes the literature on what is known about platelets with different size and describes controversies of studies with large and small platelets putting a focus on their thrombogenicity, age, and on the association of MPV with the mentioned diseases.
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Affiliation(s)
- Stefan Handtke
- Institut für Immunologie und Transfusionsmedizin, Abteilung Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Thomas Thiele
- Institut für Immunologie und Transfusionsmedizin, Abteilung Transfusionsmedizin, Universitätsmedizin Greifswald, Greifswald, Germany
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7
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Hafez MR, Eid HA, Elsawy SB, Eldin NE, El Madbouly AA. Assessment of bronchial asthma exacerbation: the utility of platelet indices. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2019. [DOI: 10.4103/ejb.ejb_69_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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8
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Ma Y, Zong D, Zhan Z, Li H, Dai Z, Cui Y, Luo L, Zeng Z, He C, Chen Y. Feasibility of mean platelet volume as a biomarker for chronic obstructive pulmonary disease: A systematic review and meta-analysis. J Int Med Res 2019; 47:5937-5949. [PMID: 31774003 PMCID: PMC7045686 DOI: 10.1177/0300060519887886] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Objective To evaluate the feasibility of mean platelet volume (MPV) as a biomarker for
chronic obstructive pulmonary disease (COPD). Methods A systematic search for studies published up to March 2019 was performed in
the PubMed and Web of Science databases. Three independent investigators
screened the titles and abstracts of including studies according to
eligibility criteria. The Newcastle–Ottawa Scale was used to assess the
quality of eligible studies, and statistical analyses were performed using
Review Manager version 5.3. Results A total of eight studies with 1230 COPD patients and 443 healthy controls
were included in our meta-analysis. No significant differences in MPV level
were identified in pairwise comparisons of the acute exacerbations of COPD
(AECOPD), stable COPD, and control groups. Furthermore, no significant
correlation was observed between MPV level and systemic inflammatory
biomarkers. Conclusions MPV does not appear to represent a suitable biomarker of disease phase or
inflammatory burden in COPD. However, future large-scale studies should be
performed to further investigate the relationship between MPV and COPD.
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Affiliation(s)
- Yiming Ma
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Dandan Zong
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zijie Zhan
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Herui Li
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhongshang Dai
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yanan Cui
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lijuan Luo
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zihang Zeng
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Chenjie He
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yan Chen
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
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9
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Chen J, Dai L, Wang T, He J, Wang Y, Wen F. The elevated CXCL5 levels in circulation are associated with lung function decline in COPD patients and cigarette smoking-induced mouse model of COPD. Ann Med 2019; 51:314-329. [PMID: 31269827 PMCID: PMC7877878 DOI: 10.1080/07853890.2019.1639809] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Introduction: C-X-C motif chemokine 5 is primarily chemotactic for neutrophils and previously shown to increase in the bronchoalveolar lavage fluid of patients with chronic obstructive pulmonary disease. However, whether C-X-C motif chemokine 5 levels correlate with lung function decline in patients or mouse model of chronic obstructive pulmonary disease was not clear. Methods: The mouse model was induced by cigarette smoke exposure. Plasma/serum and bronchoalveolar lavage fluid were obtained from patients and mouse model of chronic obstructive pulmonary disease; C-X-C motif chemokine 5 levels were assessed and correlated with lung functions and granulocyte-colony stimulating factor levels, respectively. Results: The C-X-C motif chemokine 5 levels increased and correlated to granulocyte-colony stimulating factor levels in both plasma/serum and bronchoalveolar lavage fluid obtained from patients and mouse model of chronic obstructive pulmonary disease. Circulating levels of C-X-C motif chemokine 5 correlated to lung functions decline in patients and mouse model. Conclusions: Granulocyte-colony stimulating factor might coordinate with C-X-C motif chemokine 5 in the pathogenesis of neutrophilic inflammation in chronic obstructive pulmonary disease. Circulating C-X-C motif chemokine 5 might serve as a potential blood-based biomarker to add additional modest predictive value on the preliminary screening and diagnosis of chronic obstructive pulmonary disease. Key messages Circulating C-X-C motif chemokine 5 might serve as a potential blood-based biomarker to add additional modest predictive value on the preliminary screening and diagnosis of COPD. Granulocyte-colony stimulating factor might coordinate with C-X-C motif chemokine 5 in the pathogenesis of neutrophilic inflammation in chronic obstructive pulmonary disease.
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Affiliation(s)
- Jun Chen
- Division of Pulmonary Diseases, State Key Laboratory of Biotherapy, West China Hospital, West China School of Medicine, Sichuan University , Chengdu , China.,Department of Respiratory and Critical Care Medicine, West China Hospital, West China School of Medicine, Sichuan University , Chengdu , China
| | - Luqi Dai
- Division of Pulmonary Diseases, State Key Laboratory of Biotherapy, West China Hospital, West China School of Medicine, Sichuan University , Chengdu , China.,Department of Respiratory and Critical Care Medicine, West China Hospital, West China School of Medicine, Sichuan University , Chengdu , China
| | - Tao Wang
- Division of Pulmonary Diseases, State Key Laboratory of Biotherapy, West China Hospital, West China School of Medicine, Sichuan University , Chengdu , China.,Department of Respiratory and Critical Care Medicine, West China Hospital, West China School of Medicine, Sichuan University , Chengdu , China
| | - Junyun He
- Department of Respiratory Medicine, Hospital of Chengdu office of People's Government of Tibetan Autonomous Region of China , Chengdu , China
| | - Yashu Wang
- Department of Clinical Laboratory, Xinjiang Provincial Corps Hospital Chinese People's Armed Police Forces , Urumqi , China
| | - Fuqiang Wen
- Division of Pulmonary Diseases, State Key Laboratory of Biotherapy, West China Hospital, West China School of Medicine, Sichuan University , Chengdu , China.,Department of Respiratory and Critical Care Medicine, West China Hospital, West China School of Medicine, Sichuan University , Chengdu , China
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10
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Lei S, Sun Z, He X, Li C, Zhang Y, Luo X, Wu S. Clinical characteristics of pulmonary hypertension patients living in plain and high-altitude regions. CLINICAL RESPIRATORY JOURNAL 2019; 13:485-492. [PMID: 31095884 DOI: 10.1111/crj.13049] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 03/01/2019] [Accepted: 04/28/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The demographic characteristics, ratio of aetiologies and biochemical parameters of adult patients with pulmonary hypertension (PH) living in plain and high-altitude regions were investigated and analysed. METHODS In total, 2846 adult patients with PH hospitalized from 2010 to 2015 in the Second Xiangya Hospital of Central South University and Qinghai Red Cross Hospital were retrospectively investigated. RESULTS (1) In the present study, the numbers of patients with PH in both the plain and high-altitude regions increased annually (P < 0.05), and the in-hospital prevalence of PH significantly increased over time in the high-altitude region. PH was more common in women in the plain region. Furthermore, compared with PH patients living in the plain region, those living in the high-altitude region were older (P < 0.05) and had higher smoking rates (P < 0.05). In the plain region, the greatest proportion of patients with PH belonged to group 2 (PH because of left heart disease), while in the high-altitude region, group 3 (PH because of lung diseases and/or hypoxia) was the most common (P < 0.05). (2) Haemoglobin levels, red blood cell counts, mean platelet volumes and platelet volume distribution widths were lower in PH patients living in the plain region than in those living in the high-altitude region. Furthermore, platelet counts were higher in patients living in the plain region than in those living in the high-altitude region (P < 0.05). The BNP/NT-proBNP levels were higher in PH patients living in the plain region (45.5%), which were mostly in group 4, than in those living the high-altitude region (P < 0.05). CONCLUSIONS The data from the hospitals in both the plain and high-altitude regions show a tendency towards increased in-hospital prevalence of PH over the last 6 years. The most common aetiologies of PH in patients living in the plain region and high-altitude regions were left heart disease and lung disease, respectively. Compared with PH patients living in the plain region, those living in the high-altitude region had better cardiac function and less severe PH.
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Affiliation(s)
- Si Lei
- Department of Respiratory Medicine, Second Xiangya Hospital of Central South University, Changsha, P.R. China.,Research Unit of Respiratory Disease, Central South University, Changsha, P.R. China.,Hunan Evidence-based Medicine Center, Changsha, P.R. China
| | - Zhina Sun
- Department of Respiratory Medicine, Qinghai Red Cross Hospital, Xining, P.R. China
| | - Xiuqin He
- Department of Respiratory Medicine, Qinghai Red Cross Hospital, Xining, P.R. China
| | - Cheng Li
- Department of Respiratory Medicine, Second Xiangya Hospital of Central South University, Changsha, P.R. China.,Research Unit of Respiratory Disease, Central South University, Changsha, P.R. China.,Hunan Evidence-based Medicine Center, Changsha, P.R. China
| | - Yiqing Zhang
- Department of Respiratory Medicine, Second Xiangya Hospital of Central South University, Changsha, P.R. China.,Research Unit of Respiratory Disease, Central South University, Changsha, P.R. China.,Hunan Evidence-based Medicine Center, Changsha, P.R. China
| | - Xihong Luo
- Department of Respiratory Medicine, Second Xiangya Hospital of Central South University, Changsha, P.R. China.,Research Unit of Respiratory Disease, Central South University, Changsha, P.R. China.,Hunan Evidence-based Medicine Center, Changsha, P.R. China
| | - Shangjie Wu
- Department of Respiratory Medicine, Second Xiangya Hospital of Central South University, Changsha, P.R. China.,Research Unit of Respiratory Disease, Central South University, Changsha, P.R. China.,Hunan Evidence-based Medicine Center, Changsha, P.R. China
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11
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Brassington K, Selemidis S, Bozinovski S, Vlahos R. New frontiers in the treatment of comorbid cardiovascular disease in chronic obstructive pulmonary disease. Clin Sci (Lond) 2019; 133:885-904. [PMID: 30979844 PMCID: PMC6465303 DOI: 10.1042/cs20180316] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 03/26/2019] [Accepted: 04/01/2019] [Indexed: 02/06/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is a disease characterised by persistent airflow limitation that is not fully reversible and is currently the fourth leading cause of death globally. It is now well established that cardiovascular-related comorbidities contribute to morbidity and mortality in COPD, with approximately 50% of deaths in COPD patients attributed to a cardiovascular event (e.g. myocardial infarction). Cardiovascular disease (CVD) and COPD share various risk factors including hypertension, sedentarism, smoking and poor diet but the underlying mechanisms have not been fully established. However, there is emerging and compelling experimental and clinical evidence to show that increased oxidative stress causes pulmonary inflammation and that the spill over of pro-inflammatory mediators from the lungs into the systemic circulation drives a persistent systemic inflammatory response that alters blood vessel structure, through vascular remodelling and arterial stiffness resulting in atherosclerosis. In addition, regulation of endothelial-derived vasoactive substances (e.g. nitric oxide (NO)), which control blood vessel tone are altered by oxidative damage of vascular endothelial cells, thus promoting vascular dysfunction, a key driver of CVD. In this review, the detrimental role of oxidative stress in COPD and comorbid CVD are discussed and we propose that targeting oxidant-dependent mechanisms represents a novel strategy in the treatment of COPD-associated CVD.
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Affiliation(s)
- Kurt Brassington
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC 3083, Australia
| | - Stavros Selemidis
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC 3083, Australia
| | - Steven Bozinovski
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC 3083, Australia
| | - Ross Vlahos
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC 3083, Australia
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12
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Platelet Indices for Predicting Patient Outcomes in Post-Neurosurgical Meningitis. ARCHIVES OF NEUROSCIENCE 2019. [DOI: 10.5812/ans.82911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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Karataş M, Gündüzöz M, Öziş TN, Özakıncı OG, Ergün D. Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as haematological indices of inflammatory response in ceramic workers' silicosis. CLINICAL RESPIRATORY JOURNAL 2019; 13:159-165. [PMID: 30664328 DOI: 10.1111/crj.12997] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 12/28/2018] [Accepted: 01/15/2019] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Occupational exposure to crystalline silica over time may result in silicosis: a fatal, irreversible occupational disease leading to lung function impairment. A complex inflammatory process, excessive accumulation of mesenchymal cells and collagen production are the primary mechanisms underlying silicosis. Neutrophil to lymphocyte ratio (NLR) and the platelet to lymphocyte ratio (PLR) have emerged as representative indices of systemic inflammation. OBJECTIVES The purpose of the present study was to investigate the relationship between NLR, PLR and silicosis. METHODS We retrospectively analysed the demographic and laboratory data of ceramic workers who were referred to our Hospital between 2010 and 2018. Five hundred and seventy-three patients with silicosis and 222 ceramic workers without silicosis (controls) were included in the study. RESULTS The radiographic ILO classification of silicosis patients was as follows: category 1 (71.5%), category 2 (19.2%), category 3 (7.5%). NLR and PLR in categories 2 and 3 were significantly higher when compared with the control group (P < .005). FEV1 , FEV1 %, FVC, FVC % and PEF were significantly lower in all silicosis patients and also in patients with subcategories (all P < .005). NLR showed a poor positive correlation with CRP (r = 0.095, P < .05) and ESR (r = 0.207, P = .000) while PLR only with ESR (r = 0.317, P = .000) in patients with silicosis. NLR and PLR showed negative correlations with FEV1 , FVC and PEF (all P < .005). CONCLUSION We conclude that NLR and PLR have significant but poor correlations with pulmonary functions and severity of silicosis, especially in late radiographic profusion categories.
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Affiliation(s)
- Mevlüt Karataş
- Department of Chest Diseases, Occupational and Environmental Diseases Hospital, Ankara, Turkey
| | - Meşide Gündüzöz
- Department of Family Medicine, Occupational and Environmental Diseases Hospital, Ankara, Turkey
| | - Türkan Nadir Öziş
- Department of Chest Diseases, Occupational and Environmental Diseases Hospital, Ankara, Turkey
| | - Osman Gökhan Özakıncı
- Department of Public Health, Occupational and Environmental Diseases Hospital, Ankara, Turkey
| | - Dilek Ergün
- Department of Chest Diseases, Occupational and Environmental Diseases Hospital, Ankara, Turkey
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Implications of mean platelet volume in health and disease: A large population study on data from National Health and Nutrition Examination Survey. Thromb Res 2019; 175:90-94. [PMID: 30731389 DOI: 10.1016/j.thromres.2019.01.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 12/25/2018] [Accepted: 01/16/2019] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Mean platelet volume (MPV) is a measure of platelet size and activity. We conducted a population study with National Health and Nutrition Examination Survey (NHANES) data to understand the relationship of MPV with health and diseases. MATERIALS AND METHODS The NHANES is a cross-sectional survey of non-institutionalized adult population, administered every 2 years by the Centers for Disease Control and Prevention. Participants answer a questionnaire, receive a physical examination, and undergo laboratory tests. Values of MPV were collected over 6 years (2011-2016). Logistic regression was used to predict likelihood of being in categories with MPV < 10th percentile or >90th percentile. Statistical analysis was performed using Stata/SE 15.1. RESULTS In our study with 17,969 individuals, the mean MPV was 8.40 [SD = 0.92] femtoliter. Individuals with male sex, age 45-64 years, and recent hospital-stay were more likely to have MPV < 10th percentile. Obese, Blacks and Mexican Americans had higher odds of having MPV > 90th percentile. Individuals with emphysema had significantly higher adjusted Odds [OR 1.92, 95% CI: 1.11-3.31, p = 0.021] of MPV < 10th percentile. Individuals with cancer were less likely to have MPV > 90th percentile [OR 0.74, 95% CI: 0.55-0.99, p = 0.042]. A diagnosis of coronary artery disease, asthma, and chronic obstructive pulmonary disease did not have significant associations with MPV. CONCLUSIONS Obese individuals are more likely to have higher MPV. Individuals with emphysema had higher odds of having MPV < 10th percentile and those with cancer were less likely to have MPV > 90th percentile.
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Uysal P. Evaluation of relationship between disease severity, mean platelet volume, and platelet distribution width in stable chronic obstructive pulmonary disease. ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE 2018. [DOI: 10.25000/acem.444456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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16
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Aksoy E, Güngör S, Ağca MÇ, Özmen İ, Duman D, Koçak ND, Aktürk ÜA, Tunçay E, Saltürk C, Yalçınsoy M, Ocaklı B, Karakurt Z. A Revised Treatment Approach for Hospitalized Patients with Eosinophilic and Neutrophilic Exacerbations of Chronic Obstructive Pulmonary Disease. Turk Thorac J 2018; 19:193-200. [PMID: 30322438 DOI: 10.5152/turkthoracj.2018.18004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 05/20/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The choice of treatment according to the inflammation type in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has been of recent interest. This study investigated the role of novel biomarkers, hospital outcomes, and readmission rates in the first month in patients with eosinophilic or neutrophilic AECOPD. MATERIALS AND METHODS We conducted a retrospective observational cohort study in a Chest Teaching Hospital with hospitalized AECOPD patients. Subjects' characteristics, hemogram results, C-reactive protein (CRP), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), platelet/mean platelet volume (PLT/MPV), length of hospital stay, mortality, and steroid use were recorded. Eosinophilic AECOPD defined as peripheral blood eosinophilia (PBE) was >2% and neutrophilic AECOPD as PBE ≤2%. Readmission within 28 days of discharge was recorded. RESULTS Of 2727(31.5% females) patients, eosinophilic AECOPD was found in 510 (18.7%) patients. Leucocytes, CRP, NLR, and PLR were significantly higher in neutrophilic AECOPD than in eosinophilic AECOPD (p<0.001). Steroid use and mortality rate were 45% and 0.6% in eosinophilic AECOPD and 71%, and 1.4% in neutrophilic AECOPD, respectively (p=0.001, p=0.19). Age >75 years, albumin <2.5 g/dL, CRP >50 mg/dL, and PLT/MPV <20×103 were found to be risks factors for hospital mortality (p<0.05 each). Readmission rates within 28 days of discharge were 5% (n=136), and this rate was higher in eosinophilic AECOPD patients not taking steroids (p<0.001). CONCLUSION NLR, PLR, and CRP levels were higher in neutrophilic AECOPD compared with eosinophilic AECOPD. These markers decreased with treatment in neutrophilic AECOPD. A PLT/MPV ratio of <20×103 resulted in an increased mortality rate. Thus, appropriate steroid therapy may reduce readmission rates in the first 28 days after discharge in eosinophilic AECOPD.
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Affiliation(s)
- Emine Aksoy
- Clinic of Chest Diseases, Health Sciences University, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Sinem Güngör
- Clinic of Chest Diseases, Health Sciences University, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Meltem Çoban Ağca
- Clinic of Chest Diseases, Health Sciences University, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - İpek Özmen
- Clinic of Chest Diseases, Health Sciences University, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Dildar Duman
- Clinic of Chest Diseases, Health Sciences University, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Nagihan Durmuş Koçak
- Clinic of Chest Diseases, Health Sciences University, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Ülkü Aka Aktürk
- Clinic of Chest Diseases, Health Sciences University, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Eylem Tunçay
- Clinic of Chest Diseases, Health Sciences University, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Cüneyt Saltürk
- Clinic of Chest Diseases, Health Sciences University, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Murat Yalçınsoy
- Department of Chest Diseases, İnönü University School of Medicine, Malatya, Turkey
| | - Birsen Ocaklı
- Clinic of Chest Diseases, Health Sciences University, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Zuhal Karakurt
- Clinic of Chest Diseases, Health Sciences University, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
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Archontogeorgis K, Voulgaris A, Papanas N, Nena E, Froudarakis M, Mikhailidis DP, Steiropoulos P. Mean Platelet Volume and Platelet Distribution Width in Patients With Obstructive Sleep Apnea Syndrome and Concurrent Chronic Obstructive Pulmonary Disease. Clin Appl Thromb Hemost 2018; 24:1216-1222. [PMID: 30016881 PMCID: PMC6714785 DOI: 10.1177/1076029618788178] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Evidence suggests that there is platelet activation in obstructive sleep apnea syndrome (OSAS) and chronic obstructive pulmonary disease (COPD). Our objective is to evaluate mean platelet volume (MPV) and platelet distribution width (PDW) in patients with overlap syndrome (OS), that is, concurrent COPD with OSAS. Mean platelet volume and PDW were assessed in consecutive patients who had undergone polysomnography and pulmonary function testing. They were divided into the following groups: controls (apnea-hypopnea index [AHI] <5/hour, and forced expiratory volume in 1st second [FEV1]/forced vital capacity [FVC] >70%), OSAS group (AHI ≥5/hour and FEV1/FVC >70%), and OS group (AHI ≥5/hour and FEV1/FVC <70%). A total of 485 patients (360 males and 125 females) were included. Mean platelet volume in controls was lower compared with the other groups: 10 ± 0.9 fL for controls versus 10.3 ± 1.2 fL for OSAS ( P = .006), versus 10.7 ± 1 fL for OS ( P < .001). Additionally, MPV was higher in OS group than OSAS: 10.7 ± 1 fL versus 10.3 ± 1.2 fL, respectively ( P = .002). Platelet distribution width was lower in controls compared with the other groups: 12.9 ± 2 fL for controls versus 13.6 ± 1.9 fL for OSAS ( P = .007), versus 13.8 ± 2.3 fL for OS ( P = .008), while there was no difference between OS and OSAS groups. Mean platelet volume and PDW are increased in patients with OS compared with healthy controls, with respiratory function being the major contributor in platelet activation in this series.
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Affiliation(s)
| | - Athanasios Voulgaris
- 1 Medical School, Democritus University of Thrace, Alexandroupolis, Greece.,2 Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Nikolaos Papanas
- 3 Second Department of Internal Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Evangelia Nena
- 4 Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Marios Froudarakis
- 2 Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Dimitri P Mikhailidis
- 5 Department of Clinical Biochemistry, Royal Free Hospital, University College London, London, United Kingdom
| | - Paschalis Steiropoulos
- 1 Medical School, Democritus University of Thrace, Alexandroupolis, Greece.,2 Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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Hudzik B, Korzonek-Szlacheta I, Szkodziński J, Liszka R, Lekston A, Zubelewicz-Szkodzińska B, Gąsior M. Association between multimorbidity and mean platelet volume in diabetic patients with acute myocardial infarction. Acta Diabetol 2018; 55:175-183. [PMID: 29189913 PMCID: PMC5816096 DOI: 10.1007/s00592-017-1079-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 11/08/2017] [Indexed: 01/05/2023]
Abstract
AIMS Diabetes mellitus (DM) is one of the most frequently detected conditions in multimorbid disease clusters. Platelet activation is one of the key mechanisms underlying atherothrombosis in acute myocardial infarction. Available data link mean platelet volume (MPV) to poor prognosis not only in cardiovascular and non-cardiovascular disease. Given the lack of research data on the association between disease clusters and MPV, we have set out to investigate the link between multimorbidity and MPV in diabetic patients with acute myocardial infarction. METHODS A total of 277 patients with DM and STEMI undergoing primary percutaneous coronary intervention were enrolled. Based on the number of comorbidities the study population was divided into two groups: group 1 (N = 58) with ≤ 1 comorbidity and group 2 (N = 219) with ≥ 2 comorbidities. A subanalysis was performed within the multimorbidity group: group 2A with two or three comorbidities (N = 156) and group 2B with at least four comorbidities (N = 63). RESULTS In the study population, 15.9% of patients had one comorbidity, and 22.0, 34.3, and 22.7% of patients had two, three, or at least four comorbid conditions, respectively. Both MPV and PDW were elevated in multimorbid patients (9.3 vs 10.8 fl and 9.5 vs 10.3 fl, respectively). The highest platelet volume indices were observed in patients with at least four comorbid conditions. There was a moderate positive correlation between MPV and the total number of comorbidities, the number of CVD comorbidities, and the number of non-CVD comorbidities. CONCLUSIONS These findings indicate that multimorbidity is associated with an increase in platelet volume indices. MPV values increased with the increasing number of comorbid conditions. Importantly, MPV values were elevated in some, but not all CVD and non-CVD conditions.
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Affiliation(s)
- Bartosz Hudzik
- Third Department of Cardiology, Silesian Center for Heart Disease, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.
- Department of Nutrition-Related Disease Prevention, School of Public Health in Bytom, Medical University of Silesia, Katowice, Poland.
| | - Ilona Korzonek-Szlacheta
- Department of Nutrition-Related Disease Prevention, School of Public Health in Bytom, Medical University of Silesia, Katowice, Poland
| | - Janusz Szkodziński
- Third Department of Cardiology, Silesian Center for Heart Disease, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Radosław Liszka
- Third Department of Cardiology, Silesian Center for Heart Disease, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Andrzej Lekston
- Third Department of Cardiology, Silesian Center for Heart Disease, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Barbara Zubelewicz-Szkodzińska
- Department of Nutrition-Related Disease Prevention, School of Public Health in Bytom, Medical University of Silesia, Katowice, Poland
| | - Mariusz Gąsior
- Third Department of Cardiology, Silesian Center for Heart Disease, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
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19
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Can mean platelet volume and neutrophil-to-lymphocyte ratio be biomarkers of acute exacerbation of bronchiectasis in children? Cent Eur J Immunol 2017; 42:358-362. [PMID: 29472813 PMCID: PMC5820978 DOI: 10.5114/ceji.2017.72808] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 12/12/2016] [Indexed: 12/24/2022] Open
Abstract
Introduction Bronchiectasis (BE) is a parenchymal lung disease evolving as a result of recurrent lung infections and chronic inflammation. Although it has been shown in adult studies that mean platelet volume (MPV) and neutrophil-to-lymphocyte ratio (NLR) can be used as biomarkers of airway inflammation, knowledge is limited in the paediatric age group. The aim of our study is to investigate the potential of MPV and NLR as biomarkers that may indicate acute exacerbations of non-cystic fibrosis BE in children. Material and methods Children with non-cystic fibrosis BE (n = 50), who were followed in the division of Paediatric Pulmonology of our hospital between June 2010 and July 2015, were involved in the present retrospective cross-sectional study. Haemogram values during acute exacerbations and non-exacerbation periods, and a control group were compared. Results In children with bronchiectasis, the average leukocyte count (p < 0.001), platelet count (p = 0.018), absolute neutrophil count (p < 0.001), and NLR (p < 0.001) were higher, as expected, when compared with the control group. NLR values, in the period of acute exacerbation were significantly higher than the values of both the non-exacerbation periods (p = 0.02) and the control group (p < 0.001). In contrast, MPV values in the period of acute exacerbation did not exhibit a significant difference from those of non-exacerbation periods (p = 0.530) and the control group (p = 0.103). Conclusions It was concluded that leukocyte count, platelet count, absolute neutrophil count, and NLR can be used to show chronic inflammation in BE, but only NLR and absolute neutrophil count can be used as biomarkers to show acute exacerbations.
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20
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Białas AJ, Pedone C, Piotrowski WJ, Antonelli Incalzi R. Platelet distribution width as a prognostic factor in patients with COPD - pilot study. Int J Chron Obstruct Pulmon Dis 2017; 12:2261-2267. [PMID: 28814854 PMCID: PMC5546588 DOI: 10.2147/copd.s131868] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Platelets may actively participate in inflammation in COPD. Platelet distribution width (PDW), a measure of platelets’ volume heterogeneity, may increase in platelets’ activation. We hypothesized that PDW may be a marker of hypercoagulation, which plays a significant role in conditions associated with worse survival of patients with COPD, eg, acute myocardial infarction and other forms of ischemic heart disease. Methods Retrospective analysis of 79 patients. Variables were compared after grouping patients according to the upper normal limit of PDW, using Welch’s t-tests or Mann–Whitney U, and chi-square tests. Survival in the two groups was compared using the Kaplan–Meier method and Cox proportional hazards regression. Results Ten patients presented values of PDW above 16 fL, which was the upper limit of normality for our laboratory. Compared to patients with normal PDW, they had lower forced expiratory flow between 25% and 75% of vital capacity (FEF 25–75) – 35% of reference value vs 57% (P=0.003) and peak expiratory flow – 39% vs 54% (P<0.001). The median survival of patients with elevated PDW was 743 days compared to those with normal PDW (1,305 days) (P=0.025). The adjusted HR was 4.59 (95% CI: 1.1, 19.19; P=0.04). Conclusion Our analysis indicates that elevated PDW is associated with reduced survival of patients with COPD. If our data are to be confirmed, PDW may be used as an inexpensive and repeatable prognostic tool in COPD.
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Affiliation(s)
- Adam J Białas
- Department of Pneumology and Allergy, Medical University of Lodz, Łódź, Poland.,Healthy Aging Research Centre (HARC), Medical University of Lodz, Łódź, Poland
| | - Claudio Pedone
- Department of Geriatrics, Campus Bio-Medico University of Rome, Rome, Italy
| | - Wojciech J Piotrowski
- Department of Pneumology and Allergy, Medical University of Lodz, Łódź, Poland.,Healthy Aging Research Centre (HARC), Medical University of Lodz, Łódź, Poland
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Malerba M, Nardin M, Radaeli A, Montuschi P, Carpagnano GE, Clini E. The potential role of endothelial dysfunction and platelet activation in the development of thrombotic risk in COPD patients. Expert Rev Hematol 2017; 10:821-832. [PMID: 28693343 DOI: 10.1080/17474086.2017.1353416] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Despite lack of knowledge in the field, several studies have underlined the role of endothelium dysfunction and platelet activation as significant players in the development and progression of chronic obstructive pulmonary disease (COPD). Indeed, endothelium plays a crucial role in vascular homeostasis and impairment, due to the inflammation process enhanced by smoking. Chronic inflammation and endothelial dysfunction have been proved to drive platelet activity. Consequently, thrombotic risk is enhanced in COPD, and might explain the higher percentage of cardiovascular death in such patients. Areas covered: This review aims to clarify the role of endothelium function and platelet hyper-activity as the pathophysiological mechanisms of the increased thrombotic risk in COPD. Expert commentary: In COPD patients, chronic inflammation does not impact only on lung parenchyma, but potentially involves all systems, including the endothelium of blood vessels. Impaired endothelium has several consequences, such as reduced vasodilatation capacity, enhanced blood coagulation, and increased platelet activation resulting in higher risk of thrombosis in COPD patients. Endothelium dysfunction and platelet activation are potential targets of therapy in patients with COPD aiming to reduce their risk of cardiovascular events.
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Affiliation(s)
- Mario Malerba
- a Department of Internal Medicine , University of Brescia and ASST Spedali Civili , Brescia , Italy
| | - Matteo Nardin
- a Department of Internal Medicine , University of Brescia and ASST Spedali Civili , Brescia , Italy
| | | | - Paolo Montuschi
- c Department of Pharmacology, Faculty of Medicine , University Hospital Agostino Gemelli Catholic University of the Sacred Heart, Pharmacology , Rome , Italy
| | - Giovanna E Carpagnano
- d Department of Medical and Surgical Sciences , Institute of Respiratory Diseases, University of Foggia , Foggia , Italy
| | - Enrico Clini
- e Department of Medical and Surgical Sciences , University of Modena-Reggio Emilia , Modena , Italy
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Karadeniz G, Aktoğu S, Erer OF, Kır SB, Doruk S, Demir M, Sonat K. Predictive value of platelet-to-lymphocyte ratio in exacerbation of chronic obstructive pulmonary disease. Biomark Med 2016; 10:701-10. [PMID: 27339097 DOI: 10.2217/bmm-2016-0046] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM We aimed to assess the platelet-to-lymphocyte ratio (PLR) and platelet parameters in patients with chronic obstructive pulmonary disease (COPD). METHODS A total of 60 stable COPD patients, 50 acute exacerbation COPD patients and 50 healthy controls were enrolled in this study. RESULTS The platelet distribution width and PLR were higher and the mean platelet volume was lower in the COPD patients during acute exacerbation compared with the stable patients and controls. The PLR was negatively correlated with the forced expiratory volume in 1 s. CONCLUSION The PLR may be used as a useful and easily accessible tool for evaluating the ongoing inflammation during stable period and the disease severity during acute exacerbations in COPD patients.
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Affiliation(s)
- Gülistan Karadeniz
- Dr Suat Seren Chest Disease & Surgery Training & Research Hospital, Department of Pulmonology, Izmir, Turkey
| | - Serir Aktoğu
- Dr Suat Seren Chest Disease & Surgery Training & Research Hospital, Department of Pulmonology, Izmir, Turkey
| | - Onur Fevzi Erer
- Dr Suat Seren Chest Disease & Surgery Training & Research Hospital, Department of Pulmonology, Izmir, Turkey
| | - Serpil Bulaç Kır
- Sifa University School of Medicine, Department of Pulmonology, Izmir, Turkey
| | - Sibel Doruk
- Sifa University School of Medicine, Department of Pulmonology, Izmir, Turkey
| | - Melike Demir
- Dicle University School of Medicine, Department of Pulmonology, Diyarbakır, Turkey
| | - Kübra Sonat
- Dokuz Eylul University Faculty of Health Sciences, Department of Nursing, Izmir, Turkey
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Mean Platelet Volume Decreases in Adult Patients With Obstructive Sleep Apnea After Uvulopalatal Flap Surgery. J Craniofac Surg 2016; 26:2152-4. [PMID: 26468800 DOI: 10.1097/scs.0000000000001954] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
AIM The main purpose of the study was to investigate changes in mean platelet volume (MPV) values in patients with obstructive sleep apnea syndrome (OSAS) who had undergone uvulopalatal flap (UPF) surgery. METHOD The study included a review of the medical records of 37 adult patients who had undergone UPF surgery after being diagnosed with OSAS. The baseline blood parameters of patients, including the MPV and platelet distribution width (PDW) values, were measured and repeated 3 months after treatment. Polysomnographic evaluations of the patients were also performed during admission and the 3rd month control. Comparisons of MPV values and their correlation with polysomnographic parameters were the main outcomes measured. RESULTS The blood parameters of all patients were similar except for MPV values, which were significantly lower after treatment (P < 0.001). Patients' apnea hypopnea index (AHI) and apnea episodes were significantly reduced after the UPF surgery, whereas their oxygen saturation significantly increased (P < 0.001). The MPV values were not correlated with polysomnographic parameters (P > 0.05). CONCLUSION The UPF surgery, which is a relatively simple surgical intervention to treat OSAS, alleviates nocturnal hypoxic episodes and lowers platelet volume. These may both be important predictors of adverse cardiovascular outcomes related to OSAS.
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Demir M, Acet H, Kaya H, Taylan M, Yüksel M, Yılmaz S, Sezgi C, Karadeniz G, Yenibertiz D. Relationship between metabolic syndrome and epicardial fat tissue thickness in patients with chronic obstructive pulmonary disease. Anatol J Cardiol 2016; 16:405-411. [PMID: 27025203 PMCID: PMC5331372 DOI: 10.14744/anatoljcardiol.2016.6566] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2015] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE An increase in epicardial fat tissue (EFT) thickness was found to be associated with metabolic syndrome (MS) and ischemic heart disease. MS is a comorbidity of chronic obstructive pulmonary disease (COPD) resulting from the accompanying systemic inflammation. The aim of our study was to investigate the usefulness of EFT thickness to predict MS in COPD patients. METHODS COPD patients admitted to our clinic during January-December 2014 and healthy controls were included in this prospective case control study. Patients with comorbidities, COPD exacerbation, and malignancies were excluded. Patients and controls were compared in terms of anthropometric measurements, MS-related examination and laboratory findings, pulmonary function tests, and EFT thickness. The correlations between EFT thickness and markers of MS in COPD were evaluated using the Student's t-test and logistic regression analysis. RESULTS COPD patients and controls were composed of 82 and 84 individuals, respectively. MS was diagnosed in 31 (37.8%) COPD patients. The EFT thickness was significantly higher in COPD patients than in the controls and was also higher in COPD patients with MS than in those without MS (all p<0.001). Each 1-mm increment of EFT raised the risk of MS two-fold (p=0.011, OR=2.08, 95% CI: 1.18-3.68). Increase in triglyceride level (p=0.004, OR=1.02, 95% CI: 1.01-1.03) and reduction in forced vital capacity (p=0.025, OR=0.26, 95% CI: 0.08-0.84) were found to be associated with increased MS risk. The cut-off value for EFT thickness in the prediction of MS in COPD patients was 6.75 mm (sensitivity: 83%, specificity: 65%). CONCLUSION EFT thickness is a non-invasive and easily available parameter, which is valuable in the prediction of increased MS risk in COPD patients. Early diagnosis of patients at risk of MS may help to prevent ischemic heart disease in these patients.
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Affiliation(s)
- Melike Demir
- Department of Chest Disease, Faculty of Medicine, Dicle University, Diyarbakır-Turkey.
| | - Halit Acet
- Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakır-Turkey
| | - Halide Kaya
- Department of Chest Disease, Faculty of Medicine, Dicle University, Diyarbakır-Turkey
| | - Mahsuk Taylan
- Department of Chest Disease, Faculty of Medicine, Dicle University, Diyarbakır-Turkey
| | - Murat Yüksel
- Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakır-Turkey
| | - Süreyya Yılmaz
- Department of Chest Disease, Faculty of Medicine, Dicle University, Diyarbakır-Turkey
| | - Cengizhan Sezgi
- Department of Chest Disease, Faculty of Medicine, Dicle University, Diyarbakır-Turkey
| | - Gülistan Karadeniz
- Department of Chest Disease, Faculty of Medicine, Şifa University, İzmir-Turkey
| | - Derya Yenibertiz
- Department of Chest Disease, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara-Turkey
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Yilmaz H, Yilmaz G, Menteşe A, Kostakoğlu U, Karahan SC, Köksal İ. Prognostic impact of platelet distribution width in patients with Crimean-Congo hemorrhagic fever. J Med Virol 2016; 88:1862-6. [PMID: 27089100 DOI: 10.1002/jmv.24547] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2016] [Indexed: 11/12/2022]
Abstract
Platelet distribution width (PDW) is a readily available blood test involving calculations performed by automated blood analyzers. Crimean-Congo hemorrhagic fever (CCHF) may exhibit a severe profile with fatal hemorrhaging or else present with a mild clinical process. The purpose of our study was to investigate the importance of PDW in CCHF patients and its clinical prognostic value. This study was conducted with patients with CCHF. Patients were divided into two groups on the basis of presence or absence of bleeding. Demographic characteristics, clinical findings, PDW, and other laboratory tests were recorded onto forms. A total of 423 patients were included. Hemorrhaging was observed in 27.9% during hospitalization. PDW on the first day of hospitalization was 17.2 ± 0.9% in the hemorrhagic patients and 17.1 ± 0.6% in the cases without hemorrhage (P = 0.290). On the third day of hospitalization, PDW was 17.6 ± 0.8% in the hemorrhagic patients and 17.0 ± 0.7% in the cases without hemorrhage (P < 0.001). At a third-day PDW level cut-off point of 17.1%, AUROC was 0.677, sensitivity 65.5%, specificity 54.6%, PPV 35.5%, and NPV 80.6%. A one-unit raise in third day PDW stepped up the probability of bleeding in patients with CCHF 3.45-fold at logistic regression analysis. This study shows that PDW is a parameter that may be used to determine disease severity. This parameter may be at least as useful as platelet count in helping clinicians identify severe cases. Early identification of cases with a severe course will make it possible to provide early planning of modalities such as intensive care support. J. Med. Virol. 88:1862-1866, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Hülya Yilmaz
- Department of Medical Biochemistry, Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Gürdal Yilmaz
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University, Trabzon, Turkey
| | - Ahmet Menteşe
- Faculty of Medicine, Department of Medical Biochemistry, Karadeniz Technical University, Trabzon, Turkey
| | - Uğur Kostakoğlu
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Süleyman Caner Karahan
- Faculty of Medicine, Department of Medical Biochemistry, Karadeniz Technical University, Trabzon, Turkey
| | - İftihar Köksal
- Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University, Trabzon, Turkey
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Makhlouf HA, Sadek SH, Nafady AAH. Platelet function in diabetic and nondiabetic patients with chronic obstructive pulmonary disease: a case control study. CLINICAL RESPIRATORY JOURNAL 2016; 12:48-56. [PMID: 27003100 DOI: 10.1111/crj.12477] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 10/04/2015] [Accepted: 03/18/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND The effect of association between chronic obstructive pulmonary disease (COPD) and diabetes (DM) on platelet function has not been studied before. OBJECTIVES To evaluate the effect of the association between COPD and DM on platelet function and C reactive protein (CRP). PATIENTS AND METHODS This case control study was carried out on 110 stable COPD patients who were classified into diabetic and nondiabetic groups. In addition, 40 apparently healthy, age and sex-matched individuals were included in this study as a control group. Chest X-ray, pulmonary function testing and arterial blood gases were done for COPD patients. CRP and complete blood count (CBC) were measured in both patient and control groups. RESULTS Mean platelet volume (MPV), platelet distribution width (PDW), platelet crit (PCT) and CRP were significantly higher in COPD patients either nondiabetic or diabetic compared to control group. Moreover, MPV and CRP markers were significantly higher in COPD diabetic patients compared to nondiabetic. There was no significant difference in various laboratory data among different stages of COPD either diabetic or nondiabetic (P > 0.05). In COPD patients, MPV was a significantly positively correlated with CRP and PDW (r = 0.346, P < 0.001; r = 0.510, P < 0.001, respectively) and negatively correlated with PLT count (r = -0.294, P = 0.002). CONCLUSION MPV, PDW, PCT and CRP were significantly higher in COPD patients either nondiabetic or diabetic. Platelet function may be modified by the systemic inflammation that associated with COPD. Platelet activation as a prothrombotic sequence of this disease may be used as novel therapeutic target.
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Affiliation(s)
- Hoda Ahmed Makhlouf
- Department of Chest, Faculty of Medicine, Assiut University Hospital, Assiut, Egypt
| | - Samiaa Hamdy Sadek
- Department of Chest, Faculty of Medicine, Assiut University Hospital, Assiut, Egypt
| | - Asmaa Abdel Hakim Nafady
- Department of Clinical Pathology, Faculty of Medicine, Assiut University Hospital, Assiut, Egypt
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Malerba M, Olivini A, Radaeli A, Ricciardolo FLM, Clini E. Platelet activation and cardiovascular comorbidities in patients with chronic obstructive pulmonary disease. Curr Med Res Opin 2016; 32:885-91. [PMID: 26824631 DOI: 10.1185/03007995.2016.1149054] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective Platelet activation in COPD patients is associated with an increased risk of cardiovascular events. We aimed at assessing the mean platelet volume (MPV), as an index of platelet activation, in COPD patients both when stable or during acute exacerbation (AE). Research design and methods A total of 478 patients (75 with AE) and 72 age-matched healthy controls were enrolled. Medical history, comorbidities, medications, pulmonary function tests, MPV and blood cell count, erythrocyte sedimentation rate (ERS) and C-reactive protein (CRP) were recorded. Results MPV was higher in COPD than in controls (8.7 ± 1.1 fL and 8.4 ± 0.8 fL respectively, p = 0.025) and increased with the severity of the disease as assessed by post-bronchodilator forced expiratory volume in the first second (FEV1) categorized I to IV (p > 0.05). MPV was higher in COPD patients during AE compared with stable condition (8.7 ± 1.0 fL and 8.9 ± 1.0 fL, p = 0.021). MPV ≥10.5 fL correlated with the presence of at least one co-existing cardiovascular disease (p = 0.008). No correlation was observed between MPV and CRP or ERS in patients or in controls. A negative correlation was found between platelet count and MPV in COPD patients. Limitations The retrospective design did not allow the assessment of a clear cause-effect relationship between MPV and all the pathophysiological factors considered. Conclusions Elevated MPV is associated with lower platelet count and with cardiovascular comorbidity in COPD patients. MPV is higher in more severe COPD and during AE. Present findings warrant future studies to confirm a possible clinically relevant role for platelet activation in cardiovascular risk in the COPD population.
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Affiliation(s)
- Mario Malerba
- a Department of Internal Medicine , University of Brescia and AOU Spedali Civili , Brescia , Italy
| | - Alessia Olivini
- a Department of Internal Medicine , University of Brescia and AOU Spedali Civili , Brescia , Italy
| | | | | | - Enrico Clini
- d Department of Medical and Surgical Sciences , Ospedale Villa Pineta, University of Modena-Reggio Emilia , Modena , Italy
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Helmy TA, Baess AI, Algarahi AA. Mean platelet volume as an inflammatory marker in acute exacerbation of chronic obstructive pulmonary disease. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2016. [DOI: 10.4103/1687-8426.176772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Zhang S, Cui YL, Diao MY, Chen DC, Lin ZF. Use of Platelet Indices for Determining Illness Severity and Predicting Prognosis in Critically Ill Patients. Chin Med J (Engl) 2016; 128:2012-8. [PMID: 26228211 PMCID: PMC4717961 DOI: 10.4103/0366-6999.161346] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background: Decreased platelet (PLT) count is one of the independent risk factors for mortality in intensive care unit (ICU) patients. This study was to investigate the relationship between PLT indices and illness severity and their performances in predicting hospital mortality. Methods: Adult patients who admitted to ICU of Changzheng Hospital from January 2011 to September 2012 and met inclusion criteria were included in this study. Univariate analysis was used to identify potential independent risk factors for mortality. Multiple logistic regression analysis was used to calculate adjusted odds ratio for mortality in patients with normal or abnormal PLT indices. The relationship between PLT indices and illness severity were assessed by the Acute Physiology and Chronic Health Evaluation II (APACHE II) scores or sequential organ failure assessment (SOFA) scores in patients with normal and abnormal PLT indices. The performances of PLT indices in predicting mortality were assessed by receiver operating curves and diagnostic parameters. The survival curves between patients with normal and abnormal PLT indices were compared using Kaplan–Meier method. Results: From January 2011 to September 2012, 261 of 361 patients (204 survivors and 57 nonsurvivors) met the inclusion criteria. After adjustment for clinical variables, PLT count <100 × 1012/L (P = 0.011), plateletcrit (PCT) <0.108 (P = 0.002), mean platelet volume (MPV) >11.3 fL (P = 0.023) and platelet distribution width (PDW) percentage >17% (P = 0.009) were identified as independent risk factors for mortality. The APACHE II and SOFA scores were 14.0 (9.0–20.0) and 7.0 (5.0–10.5) in the “low PLT” tertile, 13.0 (8.0–16.0) and 7.0 (4.0–11.0) in the “low PCT” tertile, 14.0 (9.3–19.0) and 7.0 (4.0–9.8) in the “high MPV” tertile, 14.0 (10.5–20.0) and 7.0 (5.0–11.0) in the “high PDW” tertile, all of which were higher than those in patients with normal indices. Patients with decreased PLT and PCT values (all P < 0.001), or increased MPV and PDW values (P = 0.007 and 0.003, respectively) had shortened length of survival than those with normal PLT indices. Conclusions: Patients with abnormally low PLT count, high MPV value, and high PDW value were associated with more severe illness and had higher risk of death as compared to patients with normal PLT indices.
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Affiliation(s)
| | | | | | | | - Zhao-Fen Lin
- Department of Emergency Medicine, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
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Blood parameters as indicators of upper airway obstruction in children with adenoid or adenotonsillar hypertrophy. J Craniofac Surg 2016; 26:e213-6. [PMID: 25933146 DOI: 10.1097/scs.0000000000001437] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
UNLABELLED Adenotonsillar hypertrophy (ATH) is the most common cause of obstructive sleep apnea in children. This study aimed to evaluate the blood parameters of children with ATH who underwent surgery. METHODS The study included a review of the medical records of 130 children who underwent adenoidectomy or adenotonsillectomy with a diagnosis of adenoid hypertrophy and/or chronic tonsillitis. Patients were classified into 3 groups: group 1 (n=69) underwent adenoidectomy, group 2 (n=61) underwent adenotonsillectomy, and group 3 consisted of 82 healthy children. White blood cell count, platelet count, hemoglobin levels, mean platelet volume, and platelet distribution width values were the primary outcome measures. RESULTS Mean platelet volume, platelet distribution width and hemoglobin values decreased in the groups that underwent surgery. Whereas the decrease in group 1 was insignificant, it was significant in group 2. White blood cell count values increased in both group 1 (adenoidectomy) and group 2 (adenotonsillectomy), but the increase in group 2 was significant. No significant difference in platelet count was detected before versus after the operation. CONCLUSIONS Upper airway obstruction caused by ATH remarkably changes the blood parameters related to chronic hypoxia. Significant improvement can be achieved after adenotonsillectomy rather than adenoidectomy alone.
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Ntolios P, Papanas N, Nena E, Boglou P, Koulelidis A, Tzouvelekis A, Xanthoudaki M, Tsigalou C, Froudarakis ME, Bouros D, Mikhailidis DP, Steiropoulos P. Mean Platelet Volume as a Surrogate Marker for Platelet Activation in Patients With Idiopathic Pulmonary Fibrosis. Clin Appl Thromb Hemost 2015; 22:346-50. [PMID: 26659450 DOI: 10.1177/1076029615618023] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Idiopathic pulmonary fibrosis (IPF) is associated with a prothrombotic state. AIM To study mean platelet volume (MPV) and Platelet Distribution Width (PDW) as markers of platelet activation and their potential association with lung function in patients with recently diagnosed IPF. MATERIALS AND METHODS This study included 56 patients with IPF (age 64.9±7.4 years) and 79 controls (age 64.2 ± 5.9 years). RESULTS An inverse relation was demonstrated between platelet count and MPV in the control group but not among patients with IPF. Platelet count was significantly lower in patients with IPF compared with controls (230 ± 60 vs 256 ± 75 × 10(3)/μL, P = .038). Conversely, MPV was higher in patients versus controls (10.3 ± 1.2 vs 9.8 ± 1.2 fl, P = .024), while there was no difference between the groups in PDW. Respiratory function was, as expected, significantly impaired in patients with IPF versus controls in terms of forced expiratory volume in first second (FEV1; 67.2 ± 23.1 vs 102.6 ± 15.9% of predicted value, P < .001), forced vital capacity (FVC; 65.3 ± 21 vs 95.2 ± 16.1% of predicted value, P < .001), FEV1/FVC (83.1 ± 15 vs 87.5 ± 6.4%, P = .041) and partial pressure of oxygen in arterial blood (PaO2; 67.1 ± 10.3 vs 81.5 ± 15.2 mm Hg, P < .001). No significant correlation was seen between MPV and FVC (r = -.1497, P = .275), MPV and lung diffusion capacity for carbon monoxide (r = .035, P = .798) and total lung capacity (r = .032, P = .820). CONCLUSIONS Patients with IPF exhibit higher MPV values and lower platelet count. Further studies are needed to assess the clinical implications of these findings.
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Affiliation(s)
- P Ntolios
- Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - N Papanas
- Second Department of Internal Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - E Nena
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - P Boglou
- Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - A Koulelidis
- Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - A Tzouvelekis
- Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - M Xanthoudaki
- Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - C Tsigalou
- Hematology Laboratory, University Hospital of Alexandroupolis, Greece
| | - M E Froudarakis
- Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - D Bouros
- Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - D P Mikhailidis
- Department of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital campus, University College London Medical School, University College London, London, United Kingdom
| | - P Steiropoulos
- Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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32
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Mean platelet volume is elevated in exacerbated and convalescent COPD patients. Clin Chim Acta 2015; 451:227-31. [DOI: 10.1016/j.cca.2015.10.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 09/20/2015] [Accepted: 10/01/2015] [Indexed: 11/18/2022]
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33
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Wang M, Zhang J, Ji Q, Yang Q, Zhao F, Li W, Chang HT, Xie X. Evaluation of platelet distribution width in chronic obstructive pulmonary disease patients with pulmonary embolism. Biomark Med 2015; 10:587-96. [PMID: 26567584 DOI: 10.2217/bmm.15.112] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Platelets play an important role in the pathogenesis of pulmonary embolism (PE). We aimed to investigate whether there is a correlation between platelet distribution width (PDW) and chronic obstructive pulmonary disease (COPD) patients with PE. METHODS We conducted a retrospective study using 126 COPD patients with PE and 51 COPD patients without PE. Blood biomarkers, including PDW and d-dimer, were included. Odds ratios (OR) associated with PDW and interactions with d-dimer, SpO2 were estimated for PE. RESULTS PDW was higher in the COPD patients with PE group (p = 0.007). A higher PDW had a significantly increased risk of PE than a lower PDW (adjusted OR 2.724, 95% CI: 1.290-5.753). CONCLUSION PDW are elevated in COPD patients with PE and are associated with the risk of PE.
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Affiliation(s)
- Maofeng Wang
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310000, China.,Department of Biomedical Sciences Laboratory, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, 322100, China
| | - Jun Zhang
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310000, China
| | - Qiaoying Ji
- Department of Respiratory, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, 322100, China
| | - Qiongfang Yang
- Department of Respiratory, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, 322100, China
| | - Fenhua Zhao
- Department of Radiology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, 322100, China
| | - Weimin Li
- Department of Cardiology, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, 322100, China
| | - Hao-Teng Chang
- Graduate Institute of Basic Medical Science, College of Medicine, China Medical University, Taichung City, 40402, Taiwan.,Department of Computer Science and Information Engineering, Asia University, Taichung City 41354, Taiwan
| | - Xinyou Xie
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310000, China
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Affiliation(s)
- N Papanas
- Second Department of Internal Medicine, Diabetes Clinic, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece
| | - E Maltezos
- Second Department of Internal Medicine, Diabetes Clinic, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece
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Faes C, Charrin E, Connes P, Pialoux V, Martin C. Chronic physical activity limits blood rheology alterations in transgenic SAD mice. Am J Hematol 2015; 90:E32-3. [PMID: 25382738 DOI: 10.1002/ajh.23896] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 11/04/2014] [Indexed: 11/10/2022]
Affiliation(s)
- Camille Faes
- CRIS EA 647, University Claude Bernard Lyon 1, University of Lyon; France
| | - Emmanuelle Charrin
- CRIS EA 647, University Claude Bernard Lyon 1, University of Lyon; France
| | - Philippe Connes
- CRIS EA 647, University Claude Bernard Lyon 1, University of Lyon; France
- Institut Universitaire de France; Paris France
| | - Vincent Pialoux
- CRIS EA 647, University Claude Bernard Lyon 1, University of Lyon; France
- Institut Universitaire de France; Paris France
| | - Cyril Martin
- CRIS EA 647, University Claude Bernard Lyon 1, University of Lyon; France
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36
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Affiliation(s)
- Paschalis Steiropoulos
- Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Nikolaos Papanas
- Second Department of Internal Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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Neutrophil-to-lymphocyte ratio in chronic obstructive pulmonary disease: a retrospective study. Inflammation 2014; 37:374-80. [PMID: 24078279 DOI: 10.1007/s10753-013-9749-1] [Citation(s) in RCA: 124] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is a common chronic inflammatory disease of the lung with a high mortality and morbidity rate. Some of the inflammatory markers such as C-reactive protein (CRP), leukocyte count are associated with COPD. In this study, we aimed to evaluate the role of neutrophil-to-lymphocyte ratio (NLR) in COPD patients comparing with the other well-known inflammatory markers. We retrospectively enrolled the laboratory results of 269 COPD patients of which 178 patients at stable period and 91 patients during acute exacerbation and 50 sex- and age- matched healthy controls. We found that NLR values of the stable COPD patients were significantly higher than those of the controls (P < 0.001). During acute exacerbation of the disease there was a further increase compared to stable period (P < 0.001). NLR values were also positively correlated with serum CRP levels and red cell distribution width (RDW) and negatively correlated with mean platelet volume (MPV) in both COPD groups. In conclusion, NLR could be considered as a new inflammatory marker for assessment of inflammation in COPD patients with its quick, cheap, easily measurable property with routine complete blood count analysis.
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Loprinzi PD, Walker JF, Lee H. Association between Physical Activity and Inflammatory Markers among U.S. Adults with Chronic Obstructive Pulmonary Disease. Am J Health Promot 2014; 29:81-8. [DOI: 10.4278/ajhp.130510-quan-235] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. Chronic obstructive pulmonary disease (COPD) may cause not only inflammation in the lungs but also systemic effects. One potential strategy to reduce systemic inflammation and attenuate disease progression is physical activity (PA). However, no nationally representative studies, to our knowledge, have examined the association between objectively measured physical activity and inflammation among those with COPD. Design. Cross-sectional. Setting. National Health and Nutrition Examination Survey 2003–2006. Subjects. Two hundred thirty-eight former or current smokers with self-reported COPD who had complete data on study variables. Measures. Participants wore an accelerometer for ≥4 days to assess light-intensity PA (LPA), moderate-to-vigorous PA (MVPA), and total physical activity (TPA); completed questionnaires to assess self-reported COPD and smoking status; and had their blood taken to assess white blood cell (WBC) and neutrophil levels. Analysis. Multivariable linear regression analysis was used. Results. LPA (β = –.0004), MVPA (β = –.04), and TPA (β = –.0004) were significantly inversely associated with WBC level. Similarly, LPA (β = –.001) and TPA (β = –.001) were significantly inversely associated with neutrophils; however, MVPA was marginally associated with neutrophils (β = –.05; p =.06). Conclusion. These analyses demonstrate an inverse association between objectively measured PA and inflammation among current or former smokers with COPD. If these findings are confirmed elsewhere, then PA among those with COPD may serve as an anti-inflammatory strategy to possibly decrease cardiovascular and metabolic disease occurrence.
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Zhang Z, Xu X, Ni H, Deng H. Platelet indices are novel predictors of hospital mortality in intensive care unit patients. J Crit Care 2014; 29:885.e1-6. [PMID: 24895093 DOI: 10.1016/j.jcrc.2014.04.020] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 04/17/2014] [Accepted: 04/26/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND OBJECTIVE Platelet volume indices (PVIs) are inexpensive and readily available in intensive care units (ICUs). However, their association with mortality has never been investigated in a critical care setting. Our study aimed to investigate the association of PVI and mortality in unselected ICU patients. METHODS This was a retrospective study conducted in a mixed 24-bed ICU from September 2010 to December 2012. Platelet indices including mean platelet volume (MPV), platelet distribution width (PDW), platelet count, and plateletcrit were measured on ICU entry. Univariable analyses were performed to screen for variables that were associated with mortality. Variables with P < .1 were incorporated into a regression model to adjust for the odds ratio of platelet indices. RESULTS A total of 1556 patients were included during the study period, including 1113 survivors and 443 nonsurvivors (mortality rate: 28.47%). Platelet distribution width and MPV were significantly higher in nonsurvivors than in survivors. Platelet distribution width greater than 17% and MPV greater than 11.3 fL were independent risk factors for mortality (adjusted odds ratio: 1.92 and 1.84, respectively) and survival time (hazards ratio: 1.77 and 1.75, respectively). CONCLUSION Higher MPV and PDW are associated with increased risk of death, whereas the decrease in plateletcrit is associated with increased mortality risk.
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Affiliation(s)
- Zhongheng Zhang
- Department of critical care medicine, Jinhua municipal central hospital, Zhejiang, PR China.
| | - Xiao Xu
- Department of critical care medicine, Jinhua municipal central hospital, Zhejiang, PR China
| | - Hongying Ni
- Department of critical care medicine, Jinhua municipal central hospital, Zhejiang, PR China
| | - Hongsheng Deng
- Department of critical care medicine, Jinhua municipal central hospital, Zhejiang, PR China
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Sun WX, Zhang JR, Cao ZG, Li Y, Wang RT. A decreased mean platelet volume is associated with stable and exacerbated asthma. Respiration 2014; 88:31-7. [PMID: 24854778 DOI: 10.1159/000360296] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 01/29/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Systemic inflammation is related to disease progression in asthma. Activated platelets play a critical role in atherogenesis, inflammation, and atherothrombosis. The mean platelet volume (MPV) is an early marker of platelet activation. OBJECTIVES The aim of this study is to clarify the relevance of MPV levels in patients with stable and exacerbated asthma. METHODS We investigated the peripheral blood cell count parameters, C-reactive protein (CRP), lung function parameters, and arterial blood gas in patients with asthma and control subjects. Eighty-five stable asthma patients and 85 asthmatics with exacerbations were investigated. Eighty-five controls matched for age, gender, body mass index (BMI), and smoking status were recruited. RESULTS Patients with exacerbated asthma had lower MPV and higher CRP levels and white blood cell (WBC) counts compared to patients with stable asthma and control subjects. Furthermore, the MPV was reduced in patients with stable asthma compared to control subjects. Negative correlations between MPV and CRP were present in stable and exacerbated asthma. Although there was no relationship between MPV and WBC count in stable asthma, there was an inverse relationship between MPV and WBC count in exacerbated asthma. CONCLUSIONS These findings show that patients with stable asthma had a lower MPV compared to controls and the MPV levels in asthmatic patients with exacerbations were lower compared to those in patients with stable asthma. Further investigations regarding the role of MPV in asthma may be beneficial in the search for therapeutic targets.
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Affiliation(s)
- Wen-Xue Sun
- Department of Respiratory Medicine, The First Affiliated Hospital, Harbin Medical University, Harbin, PR China
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Yang SW, Cho SH, Kwon HS, Sohn IS, Hwang HS. Significance of the platelet distribution width as a severity marker for the development of preeclampsia. Eur J Obstet Gynecol Reprod Biol 2014; 175:107-11. [PMID: 24502873 DOI: 10.1016/j.ejogrb.2013.12.036] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 12/14/2013] [Accepted: 12/21/2013] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To evaluate the platelet distribution width (PDW) and other platelet indices as potential severity markers of preeclampsia (PE). STUDY DESIGN A total of 935 pregnant women who had received continuous prenatal care and had undergone delivery were included. The participants were classified into 3 groups: healthy pregnant women (n=816), pregnant women with mild PE (n=59), and pregnant women with severe PE (n=60). Blood samples were collected during antenatal care or at the time of admission, and the platelet indices were compared among the three groups. RESULTS Among the three groups, the platelet count and plateletcrit decreased as the disease progressed. The mean platelet volume and the PDW, however, increased as the disease progressed. When compared to the levels of other platelet indices, the PDW showed significant elevation in the severe PE group. In the mild and severe PE groups, the PDW was statistically correlated with the mean arterial pressure (MAP) (r=0.231, p<0.05), whereas other platelet indices were not. In the receiver operating characteristics curve analysis, the area under the curve of the PDW to predict severe PE was 0.74. CONCLUSIONS Among platelet indices, the PDW is significantly higher in women with severe PE than in women with mild PE, and is positively correlated with the MAP. Therefore, the PDW can serve as a candidate marker for predicting the severity of PE.
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Affiliation(s)
- Seung Woo Yang
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Soo Hyun Cho
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Han Sung Kwon
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - In Sook Sohn
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Han Sung Hwang
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea.
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Steiropoulos P, Bogiatzi C, Archontogeorgis K, Nena E, Xanthoudaki M, Boglou P, Tzouvelekis A, Papanas N, Tsivgoulis G, Bouros D. Is there evidence of early vascular disease in patients with obstructive sleep apnoea without known comorbidities? Preliminary findings. Open Cardiovasc Med J 2013; 7:61-8. [PMID: 24044028 PMCID: PMC3772567 DOI: 10.2174/1874192401307010061] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 06/05/2013] [Indexed: 12/30/2022] Open
Abstract
We evaluated early atherosclerotic lesions in 20 non-smokers with newly diagnosed Obstructive Sleep Apnoea (OSA) and without known comorbidities by measuring common carotid artery intima media thickness (CCA-IMT), transcranial Doppler ultrasound (TCD), and ankle brachial index (ABI). These were compared with 20 healthy age- and BMI-matched controls. In OSA patients, CCA-IMT was not significantly higher vs. controls (0.74±0.17 vs. 0.66±0.12 mm, p=0.201) and it was positively correlated with neck circumference (r=0.466, p=0.039), arousal index (r=0.663, p=0.001), gamma-glutamyl transpeptidase activity (r=0.474, p=0.035) while it was negatively correlated with Forced Expiratory Volume in 1 sec (r=-0.055, p=0.012). No difference was noted between patients and controls in terms of vascular stenosis on TCD examination, while asymptomatic peripheral artery disease was found in one patient with OSA. In conclusion, OSA patients without known comorbidities exhibit a non-significant increase in CCA-IMT without further evidence of vascular disease, but additional experience in a larger patient series is needed.
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Affiliation(s)
- P Steiropoulos
- Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - C. Bogiatzi
- Department of Neurology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - K. Archontogeorgis
- Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - E. Nena
- Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - M. Xanthoudaki
- Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - P. Boglou
- Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - A. Tzouvelekis
- Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - N. Papanas
- Second Department of Internal Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - G. Tsivgoulis
- Department of Neurology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - D. Bouros
- Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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