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Lange LJ, Ames SC, Ames GE, Heckman MG, White LJ, Roy V, Foran JM. Loneliness, immunological recovery patterns, and health-related quality of life (HRQOL) outcomes in patients receiving hematopoietic stem cell transplantation. BMC Psychol 2024; 12:40. [PMID: 38243338 PMCID: PMC10797957 DOI: 10.1186/s40359-024-01535-w] [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: 08/18/2023] [Accepted: 01/11/2024] [Indexed: 01/21/2024] Open
Abstract
PURPOSE Loneliness may compromise health-related quality of life (HRQOL) outcomes and the immunological impacts of loneliness via neuroendocrinological mechanisms likely have consequences for patients who have undergone a hematopoietic stem cell transplantation (HSCT). RESEARCH APPROACH AND MEASURES Loneliness (pre-transplant), immunological recovery (Day 30, Day 100, 1-year post-transplant), and HRQOL (Day 100, 1 year) were measured in a sample of 205 patients completing a HSCT (127 autologous, 78 allogenic). RESULTS Greater levels of pre-transplant loneliness predicted poorer HRQOL at Day 100 and 1-year follow-up. Loneliness also was associated with higher absolute neutrophil to absolute lymphocyte (ANC/ALC) ratios in the entire sample at Day 30, which in turn was associated with Day 100 HRQOL. CONCLUSIONS Findings demonstrate that pretransplant loneliness predicts HRQOL outcomes and associates with inflammatory immunological recovery patterns in HSCT patients. The balance of innate neutrophils to adaptive lymphocytes at Day 30 present a distinct profile in lonely individuals, with this immunity recovery profile predicting reduced HRQOL 100 days after the transplant. Addressing perceptions of loneliness before HSCT may be an important factor in improving immunological recovery and HRQOL outcomes.
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Affiliation(s)
- Lori J Lange
- Department of Psychology, University of North Florida, 1 UNF Drive, 32224, Jacksonville, FL, USA.
| | - Steven C Ames
- Division of Hematology and Oncology, Mayo Clinic Florida, 4500 San Pablo Road South, 32224, Jacksonville, FL, USA
| | - Gretchen E Ames
- Department of Surgery, Mayo Clinic Florida, 4500 San Pablo Road South, 32224, Jacksonville, FL, USA
| | - Michael G Heckman
- Division of Clinical Trials and Biostatistics, Mayo Clinic Florida, 4500 San Pablo Road South, 32224, Jacksonville, FL, USA
| | - Launia J White
- Division of Clinical Trials and Biostatistics, Mayo Clinic Florida, 4500 San Pablo Road South, 32224, Jacksonville, FL, USA
| | - Vivek Roy
- Division of Hematology and Oncology, Mayo Clinic Florida, 4500 San Pablo Road South, 32224, Jacksonville, FL, USA
| | - James M Foran
- Division of Hematology and Oncology, Mayo Clinic Florida, 4500 San Pablo Road South, 32224, Jacksonville, FL, USA
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Khoshbakht S, Başkurt D, Vural A, Vural S. Behçet's Disease: A Comprehensive Review on the Role of HLA-B*51, Antigen Presentation, and Inflammatory Cascade. Int J Mol Sci 2023; 24:16382. [PMID: 38003572 PMCID: PMC10671634 DOI: 10.3390/ijms242216382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/04/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
Behçet's disease (BD) is a complex, recurring inflammatory disorder with autoinflammatory and autoimmune components. This comprehensive review aims to explore BD's pathogenesis, focusing on established genetic factors. Studies reveal that HLA-B*51 is the primary genetic risk factor, but non-HLA genes (ERAP1, IL-10, IL23R/IL-12RB2), as well as innate immunity genes (FUT2, MICA, TLRs), also contribute. Genome-wide studies emphasize the significance of ERAP1 and HLA-I epistasis. These variants influence antigen presentation, enzymatic activity, and HLA-I peptidomes, potentially leading to distinct autoimmune responses. We conducted a systematic review of the literature to identify studies exploring the association between HLA-B*51 and BD and further highlighted the roles of innate and adaptive immunity in BD. Dysregulations in Th1/Th2 and Th17/Th1 ratios, heightened clonal cytotoxic (CD8+) T cells, and reduced T regulatory cells characterize BD's complex immune responses. Various immune cell types (neutrophils, γδ T cells, natural killer cells) further contribute by releasing cytokines (IL-17, IL-8, GM-CSF) that enhance neutrophil activation and mediate interactions between innate and adaptive immunity. In summary, this review advances our understanding of BD pathogenesis while acknowledging the research limitations. Further exploration of genetic interactions, immune dysregulation, and immune cell roles is crucial. Future studies may unveil novel diagnostic and therapeutic strategies, offering improved management for this complex disease.
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Affiliation(s)
- Saba Khoshbakht
- Koç University Research Center for Translational Medicine, Istanbul 34010, Turkey; (S.K.); (A.V.)
| | - Defne Başkurt
- School of Medicine, Koç University, Istanbul 34010, Turkey;
| | - Atay Vural
- Koç University Research Center for Translational Medicine, Istanbul 34010, Turkey; (S.K.); (A.V.)
- Department of Neurology, Koç University School of Medicine, Istanbul 34010, Turkey
| | - Seçil Vural
- Koç University Research Center for Translational Medicine, Istanbul 34010, Turkey; (S.K.); (A.V.)
- Department of Dermatology and Venereology, Koç University School of Medicine, Istanbul 34010, Turkey
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Ban TH, Choi BS, Yoon SA, Kim Y, Jin K, Kim GH, Lee YK, Oh KH, Lee SH, Jung JY, Park HC, Ahn SY, Ko GJ, Kwon YJ, Hong YA. Clinical significance of neutrophil-to-lymphocyte ratio on the risk of abdominal aortic calcification and decreased bone mineral density in patients with end-stage kidney disease. PLoS One 2023; 18:e0286612. [PMID: 37878613 PMCID: PMC10599515 DOI: 10.1371/journal.pone.0286612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/06/2023] [Indexed: 10/27/2023] Open
Abstract
Inflammation plays a major role in the pathogenesis of chronic kidney disease (CKD), but the relationship between systemic inflammation and CKD-mineral bone disease is unclear. We aimed to investigate whether the neutrophil-to-lymphocyte ratio (NLR) is related to abdominal aortic calcification (AAC) and bone mineral density (BMD) in dialysis patients. In this cross-sectional analysis using baseline data of a multicenter cohort, a total of 759 patients were divided into three groups according to NLR level, and the associations between NLR and Kauppila AAC score (AACS) and BMD were assessed. The highest tertile NLR group had more males, alcohol consumers, higher diabetes prevalence, and higher comorbidity index than the lowest tertile NLR group. Fasting glucose and C-reactive protein levels were higher, while serum albumin, serum iron, and lipid profiles except triglycerides were lower in the highest tertile group. AACS was significantly higher in the highest tertile group than in the lowest and middle tertile groups (p = 0.017), but the mean areal BMD and T-score of the lumbar spine and femur were not different between groups. NLR level was positively correlated with AACS in all aortic wall segments except L1 and L3 anterior. In multivariable logistic regression analysis, the highest tertile NLR group was independently associated with AAC (odds ratio 2.876, 95% confidence interval 1.250-6.619, p = 0.013) but was not associated with osteoporosis in the lumbar spine and femur after adjusting for confounding factors. The NLR can be used as a potential indicator of AAC in dialysis patients.
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Affiliation(s)
- Tae Hyun Ban
- Division of Nephrology, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Bum Soon Choi
- Division of Nephrology, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sun Ae Yoon
- Division of Nephrology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yaerim Kim
- Division of Nephrology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Kyubok Jin
- Division of Nephrology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Gheun-Ho Kim
- Division of Nephrology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Young-Ki Lee
- Division of Nephrology, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
| | - Kook-Hwan Oh
- Division of Nephrology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sang-Ho Lee
- Division of Nephrology, Department of Internal Medicine, Kyunghee University Hospital at Gangdong, College of Medicine, Kyunghee University, Seoul, Republic of Korea
| | - Ji Yong Jung
- Division of Nephrology, Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Hyeong Cheon Park
- Division of Nephrology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Shin Young Ahn
- Division of Nephrology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Gang-Jee Ko
- Division of Nephrology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Young Joo Kwon
- Division of Nephrology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yu Ah Hong
- Division of Nephrology, Department of Internal Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Juchnowicz D, Dzikowski M, Rog J, Waszkiewicz N, Karakuła KH, Zalewska A, Maciejczyk M, Karakula-Juchnowicz H. The usefulness of a complete blood count in the prediction of the first episode of schizophrenia diagnosis and its relationship with oxidative stress. PLoS One 2023; 18:e0292756. [PMID: 37824542 PMCID: PMC10569548 DOI: 10.1371/journal.pone.0292756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 09/27/2023] [Indexed: 10/14/2023] Open
Abstract
A complete blood count (CBC) is a routinely performed blood examination. Only a few studies assess the relationship between CBC and oxidative stress (OS) in schizophrenia (SZ). The aim of the study was to assess the utility of CBC in the prediction of SZ diagnosis, and the relationship between CBC and OS. The study included: 47 individuals with the first episode of psychosis (26 drug-naive: FEP-nt; 21 patients under antipsychotic treatment: FEP-t) and 30 healthy persons (control group, HC). CBC and oxidative stress-related parameters were assessed in blood samples. The FEP group had higher levels of WBC, MCHC, NEU, MONO, EOZ, BASO, and %EOZ compared to HC (p<0.05). Various relationships between OS and CBC were found, and this connection was significantly different between healthy individuals and patients. The most promising C&RT model for discriminating FEP from HC was combining monocytes, eosinophils, and neutrophils (accuracy: 77%, 95%CI = 0.67-0.87). The analysis singled out WBC and HT (accuracy: 74%, 95%CI = 0.64-0.90) as the most promising to distinguish FEP-nt from HC; WBC and %Neu to allocate to FEP-t or HC group (accuracy: 87%, 95%CI = 0.64-0.90); RDW-SD and LYMPH (accuracy: 86%, 95% CI = 0.75-97) for distinguishing FEP-nt from FEP-t. CBC could be a promising, cheap tool to determine abnormalities related to schizophrenia. However, more studies with larger sample sizes are required.
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Affiliation(s)
- Dariusz Juchnowicz
- Department of Psychiatric Nursing, Medical University of Lublin, Lublin, Poland
| | - Michał Dzikowski
- 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Lublin, Poland
| | - Joanna Rog
- Laboratory of Human Metabolism Research, Department of Dietetics, Warsaw University of Life Sciences, Warsaw, Poland
| | | | - Kaja Hanna Karakuła
- 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Lublin, Poland
| | - Anna Zalewska
- Department of Restorative Dentistry and Experimental Dentistry Laboratory, Medical University of Bialystok, Bialystok, Poland
| | - Mateusz Maciejczyk
- Department of Hygiene, Epidemiology and Ergonomics, Medical University of Bialystok, Bialystok, Poland
| | - Hanna Karakula-Juchnowicz
- 1st Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Lublin, Poland
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Abushouk A, Agrawal A, Hariri E, Dykun I, Kansara T, Saad A, Abdelfattah O, Badwan O, Jaggi C, Farwati M, Harb SC, Puri R, Reed GW, Krishnaswamy A, Yun J, Kapadia S. Association between haematological parameters and outcomes following transcatheter aortic valve implantation at mid-term follow-up. Open Heart 2022; 9:openhrt-2022-002108. [PMID: 36600647 PMCID: PMC9748985 DOI: 10.1136/openhrt-2022-002108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 11/14/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Patients undergoing transcatheter aortic valve implantation (TAVI) often have multiple comorbidities, such as anaemia and chronic inflammatory disorders. We sought to investigate the association between preoperative and postoperative haematological parameters and clinical outcomes in TAVI patients at mid-term follow-up. METHODS In the present study, consecutive patients (N=908) who underwent TAVI at the Cleveland Clinic between 2017 and 2019 with available complete blood counts were studied. Data were collected on preoperative and postoperative anaemia and elevations in neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). Survival analysis was used to study the association of haematologic parameters with all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE). RESULTS We found that preoperative anaemia and elevated NLR were significantly associated with a higher risk of all-cause mortality (aHR=1.6 (95% CI: 1.1 to 2.0) and 1.4 (95% CI: 1.1 to 1.6), respectively) and MACCE (aHR=1.9 (95% CI: 1.3 to 2.8) and 1.6 (95% CI: 1.1 to 2.4), respectively). While an elevated preoperative PLR was not associated with increased mortality risk, it had a significant association with MACCE risk (aHR: 1.6 (95% CI: 1.1 to 2.4)). Further, postoperative anaemia, elevated NLR and PLR were associated with increased risks of all-cause mortality and MACCE. CONCLUSION Pathological alterations in haematological parameters were associated with higher risks of post-TAVI mortality and MACCE at mid-term follow-up. Our findings advocate for further incorporating haematological parameters in the preoperative evaluation of TAVI candidates.
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Affiliation(s)
- Abdelrahman Abushouk
- Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Ankit Agrawal
- Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Essa Hariri
- Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Iryna Dykun
- Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Tikal Kansara
- Department of Internal Medicine, Cleveland Clinic Union Hospital, Dover, Ohio, USA
| | - Anas Saad
- Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Omar Abdelfattah
- Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Osamah Badwan
- Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Connor Jaggi
- Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Medhat Farwati
- Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Serge C Harb
- Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Rishi Puri
- Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Grant W Reed
- Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Amar Krishnaswamy
- Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - James Yun
- Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Samir Kapadia
- Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
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Lin CH, Li YH, Wang YY, Chang WD. Higher Neutrophil-To-Lymphocyte Ratio Was Associated with Increased Risk of Chronic Kidney Disease in Overweight/Obese but Not Normal-Weight Individuals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138077. [PMID: 35805736 PMCID: PMC9265888 DOI: 10.3390/ijerph19138077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 06/26/2022] [Accepted: 06/28/2022] [Indexed: 02/01/2023]
Abstract
Background: Inflammation has been proposed to play potential roles in the development and progression of chronic kidney disease (CKD). We evaluated the relationship of neutrophil-to-lymphocyte ratio (NLR), a systemic inflammation marker, with CKD in normal-weight and overweight/obese adults. Methods: This cross-sectional study included 2846 apparently healthy adults who underwent a health examination between August 2000 and April 2002. Normal-weight was defined as a body mass index (BMI, kg/m2) of 18.5−24, while overweight/obesity was defined as a BMI of ≥24. CKD was defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2. Logistic and linear regression analysis was performed to explore the NLR−CKD relationship. Results: Of the 2846 participants (1777 men and 1069 women), there were 348 CKD individuals (12.3%), with 262 (14.7%) men and 86 (8%) women. A total of 1011 men (56.9%) and 408 women (38.2%) were overweight or obese. Compared with the normal-weight participants, CKD prevalence was higher in the overweight/obese women (6.1% vs. 11.3%, p = 0.002), but not in the overweight/obese men (14.5% vs. 14.9%, p = 0.793). CKD percentages in the NLR quartile groups were 9.4%, 11.5%, 15.4%, and 22.7% in men (p < 0.0001) and 6.4%, 7.1%, 10.5%, and 8.2% in women (p = 0.2291). After adjustment for confounders, each increment of one unit of NLR was associated with a higher CKD risk in the overweight/obese men (adjusted odds ratio (OR) = 1.37, 95% confidence interval (CI) = 1.03−1.82, p = 0.03) and women (adjusted OR = 1.77, 95% CI = 1.08−2.90, p = 0.023), whereas NLR was not associated with CKD in normal-weight men or women. Further, in the overweight/obese participants with an eGFR of 50−70 mL/min/1.73 m2, univariable linear regression analysis revealed a significant negative correlation between NLR and eGFR for men (p = 0.004) and women (p = 0.009). Conclusions: It was found that higher NLR was associated with an increased CKD risk in overweight/obese but not in normal-weight men and women in an adult health examination dataset. Our study suggests a role of NLR for CKD prediction in overweight/obese individuals.
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Affiliation(s)
- Chia-Ho Lin
- Department of Medical Education, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
| | - Yu-Hsuan Li
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan;
| | - Ya-Yu Wang
- Department of Family Medicine, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Section 4, Taichung 40705, Taiwan;
- Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing University, Taichung 402202, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
| | - Wen-Dau Chang
- Department of Family Medicine, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Section 4, Taichung 40705, Taiwan;
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 402202, Taiwan
- Correspondence:
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Comparative evaluation of serum high sensitivity C-reactive protein and complete hemogram indices in subjects with and without apical periodontitis: A prospective interventional study. J Endod 2022; 48:1020-1028. [DOI: 10.1016/j.joen.2022.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/05/2022] [Accepted: 05/07/2022] [Indexed: 01/08/2023]
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Balta I, Balta S. The Relation Between C-Reactive Protein-Albumin Ratio and Carotid Intima-Media Thickness in Psoriasis. Angiology 2022; 73:772-780. [PMID: 35189713 DOI: 10.1177/00033197211072599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Psoriasis vulgaris is associated with an increased risk of atherosclerosis. The C-Reactive Protein-to-Albumin Ratio (CAR) has received increasing attention as an independent prognostic factor for inflammatory diseases. The carotid intima-media thickness (cIMT) is a predictor of atherosclerosis. We assessed the correlation between CAR and cIMT in patients with psoriasis vulgaris. We enrolled 147 participants (72 with psoriasis vulgaris and 75 controls). Disease severity was assessed using the "Psoriasis Area Severity İndex (PASI)." Patient and control groups were similar with regard to gender, age, and body mass index (BMI). cIMT was measured in both the left and the right common carotid arteries. CAR values were higher in patients with psoriasis compared with controls (0.93 (0.06-4.32) vs 0.51 (0.10-2.99), p < .001). The patients with psoriasis had a significantly greater cIMT compared with control subjects. (0.53 (0.42-0.65) vs 0.50 (0.41-0.65) mm, p = .03). PASI scores were positively correlated with CAR values (r = 0.532, p < .001). A positive correlation between cIMT and CAR was found in patients with psoriasis vulgaris (r = 0.463, p < .001). CAR is an easily derived reproducible marker that could prove useful for assessing the inflammatory status of patients with psoriasis in clinical practice. CAR may also prove useful as a cardiovascular risk marker in these patients.
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Affiliation(s)
- Ilknur Balta
- Associate Professor of Dermatology, Department of Dermatology, Malatya Education and Research Hospital, 506082Turgut Ozal University, Malatya, Turkey
| | - Sevket Balta
- Specialist of Cardiology, Department of Cardiology, Hayat Hospital, Malatya, Turkey
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Wang Q, Sun Y, Xu Q, Liu W, Wang P, Yao J, Zhao A, Chen Y, Wang W. Higher dietary inflammation potential and certain dietary patterns are associated with polycystic ovary syndrome risk in China: A case–control study. Nutr Res 2022; 100:1-18. [DOI: 10.1016/j.nutres.2021.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/16/2021] [Accepted: 12/31/2021] [Indexed: 12/12/2022]
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10
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Brezinov OP, Sevilya Z, Yahud E, Rahkovich M, Kogan Y, Marincheva G, Kakzanov Y, Lev E, Laish-Farkash A. Comparison of Immature Platelet Fraction and Factors Associated with Inflammation, Thrombosis and Platelet Reactivity Between Left and Right Atria in Patients with Atrial Fibrillation. J Atr Fibrillation 2021; 13:2459. [PMID: 34950336 DOI: 10.4022/jafib.2459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 12/25/2020] [Accepted: 01/18/2021] [Indexed: 11/10/2022]
Abstract
Background Recent trials found poor temporal relationship between atrial fibrillation (AF) episodes and strokes. Thus, stroke in AF patients probably involves more mechanisms than cardiac embolism. We compared factors of inflammation, thrombosis and platelet reactivity between left (LA) and right atria (RA) and femoral vein (FV) in patients with AF. Methods Blood samples were collected from patients undergoing AF-ablation from the FV, RA and LA for neutrophil to lymphocyte ratio (NLR), immature platelet fraction (IPF) and count (IPC), CD40 ligand, P-selectin and E-Selectin. IPF was measured by an autoanalyzer; CD40 ligand, P-selectin, and E-Selectin were measured by ELISA and NLR was calculated from complete blood counts. Results Sixty-seven patients were included (age 65±10y, 63% male, CHA2DS2-VASc score 2.8±1.8, LA volume index 40±24 mL/m2, 63% paroxysmal AF). There was no difference between FV, RA and LA regarding NLR and CD40 ligand. Factors associated with platelets activity: P-selectin, IPC and IPF% were higher in RA vs LA (60.3 IQR 49.0-76.4 ng/ml vs. 59.3 IQR 49.0-74.7, respectively, p=0.03 for P-selectin, 7.5 IQR 5.2-10 103/μL vs. 7.1 IQR 5-9.8, p<0.01 for IPC, and 3.6 IQR 2.7-5.0 % vs. 3.6 IQR 2.6-4.8, p<0.01 for IPF%). Similar trends were for E-selectin (41.2 IQR 31.1-51.2 ng/mL vs. 38.7 IQR 27.9-50.4 p=0.09). Similar significant differences were found in patients with CHA2DS2-VASC≥2 but not in patients with low score. Conclusions Patients with AF, especially those with CHA2DS2-VASc≥2, have higher markers of thrombogenicity in RA compared to LA. There was no difference in inflammatory properties between the atria.
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Affiliation(s)
- Olga Perelshtein Brezinov
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Ziv Sevilya
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Ella Yahud
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Michael Rahkovich
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Yonatan Kogan
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Gergana Marincheva
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Yana Kakzanov
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Eli Lev
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Avishag Laish-Farkash
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Yu Y, Cui WH, Cheng C, Lu Y, Zhang Q, Han RQ. Association between neutrophil-to-lymphocyte ratio and major postoperative complications after carotid endarterectomy: A retrospective cohort study. World J Clin Cases 2021; 9:10816-10827. [PMID: 35047593 PMCID: PMC8678856 DOI: 10.12998/wjcc.v9.i35.10816] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 06/27/2021] [Accepted: 09/16/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Carotid artery cross-clamping during carotid endarterectomy (CEA) may damage local cerebral perfusion and induce cerebral ischemia–reperfusion injury to activate local inflammatory responses. Neutrophil-to-lymphocyte ratio (NLR) is an indicator that reflects systemic inflammation. However, the correlation between NLR and complications after CEA remains unclear.
AIM To investigate the association between NLR and major complications after surgery in patients undergoing CEA.
METHODS This retrospective cohort study included patients who received CEA between January 2016 and July 2018 at Beijing Tiantan Hospital. Neutrophil and lymphocyte counts in whole blood within 24 h after CEA were collected. The primary outcome was the composite of major postoperative complications including neurological, pulmonary, cardiovascular and acute kidney injuries. The secondary outcomes included infections, fever, deep venous thrombosis, length of hospitalization and cost of hospitalization. Statistical analyses were performed using EmpowerStats software and R software.
RESULTS A total of 224 patients who received CEA were screened for review and 206 were included in the statistical analyses; of whom, 40 (19.42%) developed major postoperative complications. NLR within 24 h after CEA was significantly correlated with major postoperative complications (P = 0.026). After confounding factors were adjusted, the odds ratio was 1.15 (95%CI: 1.03–1.29, P = 0.014). The incidence of major postoperative complications in the high NLR group was 8.47 times that in the low NLR group (P = 0.002).
CONCLUSION NLR is associated with major postoperative complications in patients undergoing CEA.
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Affiliation(s)
- Yun Yu
- Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Wei-Hua Cui
- Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Chan Cheng
- Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Yu Lu
- Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Qing Zhang
- Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Ru-Quan Han
- Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
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12
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Kimura LF, Sant'Anna MB, Andrade SA, Ebram MC, Lima CFG, Celano RMG, Viégas RFM, Picolo G. COVID-19 induces proatherogenic alterations in moderate to severe non-comorbid patients: A single-center observational study. Blood Cells Mol Dis 2021; 92:102604. [PMID: 34517295 PMCID: PMC8426321 DOI: 10.1016/j.bcmd.2021.102604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 12/23/2022]
Abstract
Patients with COVID-19 can be asymptomatic or present mild to severe symptoms, leading to respiratory and cardiovascular complications and death. Type 2 diabetes mellitus (T2DM) and obesity are considered risk factors for COVID-19 poor prognosis. In parallel, COVID-19 severe patients exhibit dyslipidemia and alterations in neutrophil to lymphocyte ratio (NLR) associated with disease severity and mortality. To investigate whether such alterations are caused by the infection or results from preexisting comorbidities, this work analyzed dyslipidemia and the hemogram profile of COVID-19 patients according to the severity and compared with patients without T2DM or obesity comorbidities. Dyslipidemia, with a marked decrease in HDL levels, and increased NLR accompanied the disease severity, even in non-T2DM and non-obese patients, indicating that COVID-19 causes the observed alterations. Because decreased hemoglobin is involved in COVID-19 severity, and hemoglobin concentration is associated with metabolic diseases, the erythrogram of patients was also evaluated. We verified a drop in hemoglobin and erythrocyte number in severe patients, independently of T2DM and obesity, which may explain in part the need for artificial ventilation in severe cases. Thus, the control of such parameters (especially HDL levels, NLR, and hemoglobin concentration) could be a good strategy to prevent COVID-19 complications and death.
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Affiliation(s)
- Louise F Kimura
- Laboratory of Pain and Signaling, Butantan Institute, Avenida Vital Brazil 1500, São Paulo, SP 05503-900, Brazil.
| | - Morena B Sant'Anna
- Laboratory of Pain and Signaling, Butantan Institute, Avenida Vital Brazil 1500, São Paulo, SP 05503-900, Brazil.
| | - Sonia A Andrade
- Laboratory of Pain and Signaling, Butantan Institute, Avenida Vital Brazil 1500, São Paulo, SP 05503-900, Brazil.
| | - Matteo C Ebram
- Laboratory of Pain and Signaling, Butantan Institute, Avenida Vital Brazil 1500, São Paulo, SP 05503-900, Brazil.
| | - Cristiane F G Lima
- Laboratory of Pain and Signaling, Butantan Institute, Avenida Vital Brazil 1500, São Paulo, SP 05503-900, Brazil.
| | - Rosa M G Celano
- University of Taubaté (UNITAU), Rua Quatro de Março, 432, Taubaté, SP 12020-270, Brazil.
| | - Ruy F M Viégas
- University of Taubaté (UNITAU), Rua Quatro de Março, 432, Taubaté, SP 12020-270, Brazil.
| | - Gisele Picolo
- Laboratory of Pain and Signaling, Butantan Institute, Avenida Vital Brazil 1500, São Paulo, SP 05503-900, Brazil.
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13
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Gupta S, Mohindra R, Singla M, Khera S, Sahni V, Kanta P, Soni RK, Kumar A, Gauba K, Goyal K, Singh MP, Ghosh A, Kajal K, Mahajan V, Bhalla A, Sorsa T, Räisänen I. The clinical association between Periodontitis and COVID-19. Clin Oral Investig 2021; 26:1361-1374. [PMID: 34448073 PMCID: PMC8390180 DOI: 10.1007/s00784-021-04111-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/27/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The study aimed to clinically assess the association between periodontitis and COVID-19-related outcomes. MATERIAL AND METHODS Data pertaining to patient demographics, medical history, blood parameters, periodontal clinical examination and aMMP-8 point-of-care diagnostics (both site-level and patient-level) was recorded for eighty-two COVID-19-positive patients. COVID-19-related outcomes such as COVID-19 pneumonia, death/survival, types of hospital admission and need of assisted ventilation were also assessed. RESULTS Males were predominantly afflicted with COVID-19, with advanced age exhibiting a greater association with the presence of periodontitis. Higher severity of periodontitis led to 7.45 odds of requiring assisted ventilation, 36.52 odds of hospital admission, 14.58 odds of being deceased and 4.42 odds of COVID-19-related pneumonia. The aMMP-8 mouthrinse kit was slightly more sensitive but less specific than aMMP-8 site-specific tests. CONCLUSIONS Based on the findings of the present study, periodontitis seems to be related to poorer COVID-19-related outcomes. However, within the constraints of this work, a direct causality may not be established. Periodontitis, by means of skewing the systemic condition for a number of comorbidities, may eventually influence COVID-19 outcomes in an indirect manner. CLINICAL RELEVANCE The study is the first to clinically, and by means of a validated point-of-care diagnostic methodology, assess the association between periodontal health and COVID-19-related outcomes. Assessment of the periodontal status of individuals can aid in the identification of risk groups during the pandemic along with reinforcing the need to maintain oral hygiene and seeking periodontal care.
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Affiliation(s)
- Shipra Gupta
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.
| | - Ritin Mohindra
- Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Mohita Singla
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Sagar Khera
- Department of Internal Medicine, PGIMER, Chandigarh, India
| | | | - Poonam Kanta
- Department of Virology, PGIMER, Chandigarh, India
| | | | - Amit Kumar
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Krishan Gauba
- Oral Health Sciences Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Kapil Goyal
- Department of Virology, PGIMER, Chandigarh, India
| | - Mini P Singh
- Department of Virology, PGIMER, Chandigarh, India
| | - Arnab Ghosh
- Department of Virology, PGIMER, Chandigarh, India
| | - Kamal Kajal
- Department of Anaesthesia & Intensive Care, PGIMER, Chandigarh, India
| | - Varun Mahajan
- Department of Anaesthesia & Intensive Care, PGIMER, Chandigarh, India
| | - Ashish Bhalla
- Department of Internal Medicine, PGIMER, Chandigarh, India
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Oral Diseases, Karolinska Institutet, Stockholm, Sweden
| | - Ismo Räisänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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14
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Li LL, Yang YQ, Qiu M, Wang L, Yuan HL, Zou RC. The clinical significance of neutrophil-lymphocyte ratio in patients treated with hemodialysis complicated with lung infection. Medicine (Baltimore) 2021; 100:e26591. [PMID: 34398014 PMCID: PMC8294898 DOI: 10.1097/md.0000000000026591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 05/23/2021] [Accepted: 06/18/2021] [Indexed: 01/04/2023] Open
Abstract
ABSTRACT The goal of this work was to investigate the potential significance of neutrophil-lymphocyte ratio (NLR) in patients treated with maintenance hemodialysis (MHD).Herein, we retrospectively reviewed the electronic medical records of 100 patients with end-stage renal failure who were treated with MHD. All patients enrolled in this study met the inclusion criteria and were followed. The differences in each indicator between the two groups were compared using the Wilcoxon rank-sum test. On the other hand, Spearman correlation and logistic regression analysis were used to explore the correlation and risk factors for pulmonary infection between NLR and other indicators. Finally, we determined the optimal cut-off values for NLR, hypersensitive c-reactive protein (hs-CRP), and procalcitonin (PCT) diagnosis of pulmonary infection using the receiver operating characteristic curve.We found that NLR was positively correlated with age, PCT, hs-CRP, and hospital stay, but negatively correlated with hemoglobin, red blood cell, and Albumin. The expression levels of PCT, hs-CRP, and NLR in the infected group decreased significantly than those before treatment. Multiple regression analysis revealed that NLR is an important independent risk factor for MHD patients with pulmonary infection. Additionally, receiver operating characteristic curve analysis showed that the sensitivity, specificity, and area under the curve were 87.76%, 100%, and 0.920 when using NLR combined with hs-CRP to predict pulmonary infection in MHD patients, whereas that of NLR combined with PCT were 87.76%, 96.08%, and 0.944, respectively.Findings from this study suggested that NLR is an independent risk factor for MHD patients with pulmonary infection, which can effectively predict pulmonary infection. Moreover, sensitivity and specificity were greatly enhanced when using NLR combined with PCT/hs-CRP to predict pulmonary infection in MHD patients.
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Affiliation(s)
- Ling-Lin Li
- Department of Nephrology, The Third People's Hospital of Yunnan Province, Kunming, Yunnan, P.R. China
- Department of Nephrology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, P.R China
| | - Yu-Qiong Yang
- Department of Nephrology, The Third People's Hospital of Yunnan Province, Kunming, Yunnan, P.R. China
| | - Min Qiu
- Department of Nephrology, The Third People's Hospital of Yunnan Province, Kunming, Yunnan, P.R. China
| | - Li Wang
- Department of Nephrology, The Third People's Hospital of Yunnan Province, Kunming, Yunnan, P.R. China
| | - Hong-Ling Yuan
- Department of Nephrology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, P.R China
| | - Ren-Chao Zou
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, P.R China
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15
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Gayretli Yayla K, Yayla C, Erdol MA, Karanfil M, Ertem AG, Akcay AB. Relationship Between C-Reactive Protein to Albumin Ratio and Infarct-Related Artery Patency in Patients With ST-Segment Elevation Myocardial Infarction. Angiology 2021; 73:260-264. [PMID: 34132120 DOI: 10.1177/00033197211024047] [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: 12/28/2022]
Abstract
The C-reactive protein to albumin ratio (CAR) is a predictive marker of systemic inflammatory state in atherosclerotic coronary disease when compared with the predictive value of these 2 markers separately. We investigated the relationship between CAR and infarct-related artery (IRA) patency in patients with ST-segment elevation myocardial infarction (STEMI). The study population (n = 1047) was divided into 2 groups according to IRA patency which was assessed by the Thrombolysis in Myocardial Infarction (TIMI) flow grade. Nonpatent flow was defined as TIMI grade 0 (no-reflow), 1, and 2 flows, and normal flow was defined as TIMI 3 flow. There was a significant positive correlation between CAR and SYNTAX score (r = 0.312, P < .001) and a negative correlation between CAR and TIMI grade flow (r = -0.210, P < .001). At a cutoff level of 0.693, the CAR predicted TIMI no-reflow with a sensitivity of 65.4% and a specificity of 65.5% (area under the curve: 0.670, 95% CI: 0.62-0.71, P < .001). Multivariate logistic regression analyses showed that CAR was an independent predictor of IRA patency (0.003 [0.001-0.029]; P < .001). A higher CAR is a significant and independent predictor of IRA patency in patients with STEMI.
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Affiliation(s)
- Kadriye Gayretli Yayla
- Department of Cardiology, Dr. Abdurrahman Yurtaslan Ankara Onkoloji Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Cagri Yayla
- Department of Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Mehmet Akif Erdol
- Department of Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Mustafa Karanfil
- Department of Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Ahmet Goktug Ertem
- Department of Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Adnan Burak Akcay
- Department of Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
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16
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Ghamar Talepoor A, Khosropanah S, Doroudchi M. Frequency of Efficient Circulating Follicular Helper T Cells Correlates with Dyslipidemia and WBC Count in Atherosclerosis. IRANIAN BIOMEDICAL JOURNAL 2021; 25:117-31. [PMID: 33465845 PMCID: PMC7921518 DOI: 10.29252/ibj.25.2.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Background The significance of cTfh cells and their subsets in atherosclerosis is not well understood. We measured the frequency of cTfh subsets in patients with different degrees of stenosis using flow-cytometry. Methods Participants included high (≥50%; n = 12) and low (<50%; n = 12) stenosis groups, as well as healthy controls (n = 6). Results The frequency of CCR7loPD-1hiefficient-cTfh was significantly higher in patients with high stenosis compared to healthy controls (p = 0.003) and correlated with low-density lipoprotein (LDL; p = 0.043), cholesterol (p = 0.043), triglyceride (p = 0.019), neutrophil count (p = 0.032), platelet count (p = 0.024), neutrophil/lymphocyte ratio (NLR; p = 0.046), and platelet/lymphocyte ratio (PLR; p = 0.025) in high stenosis group. The frequency of CCR7hiPD-1lo quiescent-cTfh was higher in healthy controls compared to the high-stenosis group (p = 0.001) and positively correlated with high-density lipoprotein (p = 0.046). The frequency of efficient-cTfh cells was correlated with platelet count (p = 0.043), NLR (p = 0.036), and PLR (p P = 0.035) in low-stenosis group, while that of quiescent-cTfh cells was negatively correlated with LDL (p = 0.034), cholesterol (p = 0.047), platelet count (p = 0.032), and PLR (p = 0.041). Conclusion High percentages of cTfh and efficient-cTfh cells in patients with advanced atherosclerosis and their correlation with dyslipidemia and white blood cell counts suggest an ongoing cTfh subset deviation, towards efficient phenotype in the milieu of inflammation and altered lipid profile. Efficient cTfh cells have an effector phenotype and could in turn contribute to atherosclerosis progression.
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Affiliation(s)
- Atefe Ghamar Talepoor
- Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Cardiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahdad Khosropanah
- Department of Cardiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrnoosh Doroudchi
- Department of Immunology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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17
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The neutrophil-to-lymphocyte ratio is associated with bacteremia in older adults visiting the emergency department with urinary tract infections. Aging Clin Exp Res 2020; 32:1129-1135. [PMID: 31377997 DOI: 10.1007/s40520-019-01291-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 07/23/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE We evaluated the clinical features of older adults visiting the emergency department (ED) with urinary tract infections (UTIs), and the diagnostic utility of the neutrophil-to-lymphocyte ratio (NLR) in terms of identifying bacteremia. METHODS In total, 479 older adults admitted with UTIs via the ED between January 2010 and December 2015 were retrospectively reviewed. We recorded age, sex, comorbidities, body temperature, clinical findings, and initial laboratory results, including the NLR. RESULTS A UTI with bacteremia was identified in 186 (38.8%) older adults. Bacteremia was associated with a longer hospital stay (median 10 vs. 8 days, p < 0.001). NLRs and C-reactive protein, blood urea nitrogen and creatinine levels were significantly higher in the bacteremia group than in the non-bacteremia group (p < 0.001, p = 0.016, p = 0.008, and p = 0.011, respectively). The area under the curve for the NLR was 0.624 (95% CI = 0.579-0.668, p < 0.001), and the cutoff was 9.0 (sensitivity 74.2, specificity 49.2%). Independent risk factors for bacteremia were an NLR ≥ 9 and fever ≥ 39 °C (OR 2.43, OR 2.75: p < 0.001, p < 0.001, respectively). CONCLUSION Bacteremia was associated with a longer hospital stay in older adults with UTIs, in whom the initial NLR and high fever reliably predicted bacteremia. The NLR may help emergency physicians to predict bacteremia in older adults with UTIs visiting the ED.
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18
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Savran M, Aslankoc R, Ozmen O, Erzurumlu Y, Savas HB, Temel EN, Kosar PA, Boztepe S. Agomelatine could prevent brain and cerebellum injury against LPS-induced neuroinflammation in rats. Cytokine 2019; 127:154957. [PMID: 31869757 DOI: 10.1016/j.cyto.2019.154957] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 12/06/2019] [Accepted: 12/13/2019] [Indexed: 02/08/2023]
Abstract
Sepsis, systemic hyper-inflammatory immune response, causes the increase of morbidity and mortality rates due to multi-organ diseases such as neurotoxicity. Lipopolysaccharide (LPS) induces inflammation, oxidative stress and apoptosis to cause brain damage. We aimed to evaluate the antioxidant, anti-inflammatory and antiapoptotic effects of Agomelatine (AGM) on LPS induced brain damage via NF-kB signaling. Twenty-four animals were divided into three groups as control, LPS (5 mg/kg) and LPS + AGM (20 mg/kg). Six hours after the all administrations, rats were sacrificed, brain tissues were collected for biochemical, histopathological and immunohistochemical analysis. In LPS group; total oxidant status (TOS), OSI index, Caspase-8 (Cas-8), NF-kß levels increased and Total antioxidant status (TAS) levels decreased biochemically and Cas-8, haptoglobin and IL-10 expressions increased and sirtuin-1 (SIRT-1) levels decreased immunohistochemically. AGM treatment reversed these parameters except haptoglobin levels in hippocampus and SIRT-1 levels in cerebellum. Besides, AGM treatment blocked the phosphorylation of NF-kB biochemically and ameliorated increased the levels of hyperemia, edema and degenerative changes histopathologically. In conclusion, AGM enhanced SIRT-1 levels to negatively regulate the transcription and activation of p-NF-kB/p65 which caused to ameliorate inflammation, oxidative stress and apoptosis.
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Affiliation(s)
- M Savran
- Department of Pharmacology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey.
| | - R Aslankoc
- Department of Physiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - O Ozmen
- Department of Pathology, Faculty of Veterinary Medicine, Mehmet Akif Ersoy University, Burdur, Turkey
| | - Y Erzurumlu
- Department of Biochemistry, Faculty of Pharmacy, Suleyman Demirel University, Isparta, Turkey
| | - H B Savas
- Department of Medical Biochemistry, Faculty of Medicine, Alanya Alaaddin Keykubat University, Antalya, Turkey
| | - E N Temel
- Department of Infectious Diseases, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - P A Kosar
- Department of Medical Biology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - S Boztepe
- Department of Anesthesia and Reanimation, Antalya Training and Research Hospital, University of Health Sciences, Antalya, Turkey
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19
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Association of neutrophil-to-lymphocyte ratio with outcomes after elective abdominal aortic aneurysm repair. JOURNAL OF VASCULAR NURSING 2019; 37:213-220. [PMID: 31727313 DOI: 10.1016/j.jvn.2019.06.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/27/2019] [Accepted: 06/15/2019] [Indexed: 12/13/2022]
Abstract
Data are lacking regarding real-time prediction of postoperative complications after elective aneurysm repair. The neutrophil-to-lymphocyte ratio (NLR) has been evaluated as a predictor of outcomes after cardiac and infrapopliteal interventions and is associated with poor outcomes for critical limb ischemia. We examined NLR and outcomes after abdominal aortic aneurysm (AAA) repair. Inpatients undergoing elective AAA repair (2008 to 2015) were selected from the Cerner Health Facts database using International Classification of Disease (9th edition) procedure codes. Postoperative outcomes were identified using data from patient records within 1 week after surgery. NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count. The receiver operating characteristic curve was analyzed to define low and high postoperative NLR groups. Chi-square analysis and multivariable logistic regression models were used to identify characteristics (demographics, diagnoses, postoperative NLR) associated with postoperative complications. Elective AAA repair occurred in 5,655 patients. Of these, we could calculate postoperative NLR for 1,908 (34%), with 1,529 undergoing endovascular repair and 379 undergoing an open repair. Compared with patients with low postoperative NLR, patients with high postoperative NLR experienced longer hospital stays (5.7 vs 2.6 days, P < .0001); higher rates of in-hospital death (2.9% vs 1.4%, P = .002); higher rates of renal failure (11.6% vs 3.9%, P < .0001); cardiac problems or myocardial infarction (3.8% vs 1.2%, P = .0002); respiratory problems (13.3% vs 5.8%, P < .0001); and infection (8.9% vs 2.9%, P < .0001). The association between high postoperative NLR and adverse postoperative outcomes persisted on multivariable analysis. This included infection (odds ratio [OR], 2.59; 95% confidence interval [CI], 1.65-4.07), renal failure (OR, 2.19; 95% CI, 1.45-3.31), cardiac events (OR, 2.41; 95% CI, 1.21-4.77), and respiratory problems (OR, 1.73; 95% CI, 1.22-2.45).NLR was associated with adverse outcomes after elective endovascular and open AAA repair. An elevated NLR within 1 week after surgery was strongly associated with postoperative complications, and may identify at-risk patients who require closer follow-up. Given the perilous nature of vascular surgery and the risk-benefit ratio for prophylactic aneurysm repair, future study of postoperative outcome and preoperative NLR is needed to provide clinically important risk profiles before treatment decisions.
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Association between Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios and Coronary Artery Calcification Score among Asymptomatic Patients: Data from a Cross-Sectional Study. Mediators Inflamm 2019; 2019:6513847. [PMID: 31049026 PMCID: PMC6458900 DOI: 10.1155/2019/6513847] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 11/19/2018] [Accepted: 01/10/2019] [Indexed: 12/16/2022] Open
Abstract
Introduction Atherosclerosis is a low-grade inflammatory disease. Among markers of inflammation, importance has been given to the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR). The objective of this study was to examine the association between these hematological indices of inflammation and coronary atherosclerotic calcification in clinically asymptomatic patients. Methods This study had clinical and laboratorial data collected from consecutive asymptomatic patients that underwent computed tomography coronary artery calcium (CAC) scoring. Risk factors, NLR, and PLR were evaluated at different categories of CAC scoring. Statistical tests included chi-square, linear regression, and logistic regression. Patients (N = 247; age 60.4 ± 8.0 years and 60.7% men) were allocated into four categories according to the CAC score. Results Respective age, sex (male), NLR, and PLR distribution within groups were as follows: CAC = 0 (n = 98; 52.5 ± 13.6 years, 55%, 2.0 ± 1.0, and 121.5 ± 41.5), CAC 1-100 (N = 64; 61.3 ± 11.0 years, 60%, 2.2 ± 1.2, and 125.6 ± 45.6), CAC 101-400 (N = 37; 64.2 ± 11.6 years, 67%, 2.6 ± 1.3, and 125.4 ± 55.9), and CAC > 400 (N = 48; 69.3 ± 11.1 years, 66%, 3.3 ± 2.0, and 430.1 ± 1787.4). The association between risk factors and CAC score was assessed. Hypertension status and smoking status were similar within groups, while the presence of diabetes (P = 0.02) and older age (P ≤ 0.001) was more prevalent in the CAC > 400 group. LDL cholesterol was greater in the higher CAC score groups (P = 0.002). Multivariate logistic regression of the quartile analysis showed that age and NLR were independently associated with CAC > 100 (OR (CI), P value): 2.06 (1.55-2.73, P = 0.00001) and 1.82 (1.33-2.49, P = 0.0002), respectively. Conclusion Within asymptomatic patients, NLR provides additional risk stratification, as an independent association between NLR extent and CAD extent was identified. Moreover, PLR was not an inflammation marker for CAD severity.
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21
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Yuan Q, Wang J, Peng Z, Zhou Q, Xiao X, Xie Y, Wang W, Huang L, Tang W, Sun D, Zhang L, Wang F, Zhao MH, Tao L, He K, Xu H. Neutrophil-to-lymphocyte ratio and incident end-stage renal disease in Chinese patients with chronic kidney disease: results from the Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE). J Transl Med 2019; 17:86. [PMID: 30876475 PMCID: PMC6420746 DOI: 10.1186/s12967-019-1808-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 02/21/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) leads to end-stage renal failure and cardiovascular events. An attribute to these progressions is abnormalities in inflammation, which can be evaluated using the neutrophil-to-lymphocyte ratio (NLR). We aimed to investigate the association of NLR with the progression of end stage of renal disease (ESRD), cardiovascular disease (CVD) and all-cause mortality in Chinese patients with stages 1-4 CKD. METHODS Patients with stages 1-4 CKD (18-74 years of age) were recruited at 39 centers in 28 cities across 22 provinces in China since 2011. A total of 938 patients with complete NLR and other relevant clinical variables were included in the current analysis. Cox regression analysis was used to estimate the association between NLR and the outcomes including ESRD, CVD events or all-cause mortality. RESULTS Baseline NLR was related to age, hypertension, serum triglycerides, total serum cholesterol, CVD history, urine albumin to creatinine ratio (ACR), chronic kidney disease-mineral and bone disorder (CKD-MBD), hyperlipidemia rate, diabetes, and estimated glomerular filtration rate (eGFR). The study duration was 4.55 years (IQR 3.52-5.28). Cox regression analysis revealed an association of NLR and the risk of ESRD only in patients with stage 4 CKD. We did not observe any significant associations between abnormal NLR and the risk of either CVD or all-cause mortality in CKD patients in general and CKD patients grouped according to the disease stages in particular. CONCLUSION Our results suggest that NLR is associated with the risk of ESRD in Chinese patients with stage 4 CKD. NLR can be used in risk assessment for ESRD among patients with advanced CKD; this application is appealing considering NLR being a routine test. Trial registration ClinicalTrials.gov Identifier NCT03041987. Registered January 1, 2012. (retrospectively registered) ( https://www.clinicaltrials.gov/ct2/show/NCT03041987?term=Chinese+Cohort+Study+of+Chronic+Kidney+Disease+%28C-STRIDE%29&rank=1 ).
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Affiliation(s)
- Qiongjing Yuan
- Department of Nephrology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Jinwei Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, 100034, China
| | - Zhangzhe Peng
- Department of Nephrology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Qiaoling Zhou
- Department of Nephrology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Xiangcheng Xiao
- Department of Nephrology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Yanyun Xie
- Department of Nephrology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Wei Wang
- Department of Nephrology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Ling Huang
- Department of Nephrology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Wenbin Tang
- Department of Nephrology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Danni Sun
- Department of Nephrology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Luxia Zhang
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, 100034, China.,Center for Data Science in Health and Medicine, Peking University, Beijing, China
| | - Fang Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, 100034, China
| | - Ming-Hui Zhao
- Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, 100034, China.,Peking-Tsinghua Center for Life Sciences, Beijing, China
| | - Lijian Tao
- Department of Nephrology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China
| | - Kevin He
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Hui Xu
- Department of Nephrology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China.
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Abstract
Major advances in coronary interventional techniques and pharmacotherapy as well as the use of drug-eluting stents (DESs) have considerably reduced the risk of in-stent restenosis (ISR). However, ISR remains a major clinical challenge. Inflammation and platelet activation are important processes that underlie the pathophysiology of ISR. Parameters related to blood cells, entailing both cell count and morphology, are useful markers of the inflammatory response and platelet activation in clinical practice. Recent studies have highlighted several new combined or derived parameters related to blood cells that independently predict ISR after DES implantation. The neutrophil/lymphocyte ratio, an inflammatory marker, is regarded as a predictor of the risk of ISR and the stability of atherosclerotic plaques. The mean platelet volume, a widely used platelet activation parameter, has been shown to be a predictor of the risk of ISR and the efficacy of antiplatelet therapy. Other markers considered include the platelet/lymphocyte ratio, red blood cell distribution width, and platelet distribution width. This review provides an overview of these parameters that may help stratify the risk of coronary angiographic and clinical outcomes related to ISR.
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Affiliation(s)
- Zhichao Wang
- 1 Department of Cardiology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Chi Liu
- 2 Department of Rehabilitation, Jing An District Central Hospital, Shanghai, China
| | - Hong Fang
- 1 Department of Cardiology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
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Pierre-Louis WS, Bath J, Mikkilineni S, Scott MC, Harlander-Locke M, Rasor Z, Smeds M. Neutrophil to Lymphocyte Ratio as a Predictor of Outcomes after Amputation. Ann Vasc Surg 2018; 54:84-91. [PMID: 30339899 DOI: 10.1016/j.avsg.2018.10.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 10/02/2018] [Accepted: 10/09/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND The neutrophil-to-lymphocyte ratio (NLR) has become a prognostic marker for proinflammatory states. It is associated with outcomes in many clinical processes including critical limb ischemia. We sought to identify predictors of amputation failure and mortality, in addition to the role of NLR in patients undergoing above-knee amputations (AKAs) or below-knee amputations (BKAs). METHODS All patients undergoing BKA or AKA between 2004 and 2014 at 3 institutions were identified and analyzed (n = 513). Patients were excluded if they did not have a complete blood count with differential within 7 days prior to their operations. Comparison groups were formed between patients requiring unplanned revision and those who did not, and additionally between survivors and nonsurvivors at 30 days postamputation. Patient demographics, intraoperative data, and postoperative courses were compared. A multinomial logistic regression model was created to further compare the groups. RESULTS Four hundred and ten patients were included for analysis, of which 142 (35%) required unplanned revision. Nearly 5% of patients (19/410) died within 30 days of the initial amputation. On univariate analysis, those requiring revision were more likely to be current smokers compared to former smokers (P = 0.004 and P = 0.021, respectively), have a lower ankle-brachial index (ABI) (P = 0.019), and have undergone a BKA (P < 0.001). Patients with congestive heart failure (CHF) were less likely to require a revision after an amputation (P = 0.007). Postoperative NLR was higher in patients requiring revision (9.9 vs. 7.0, P < 0.001) and both preoperative and postoperative NLRs were higher in those with 30-day mortality (21.0 vs. 7.0, P < 0.001; 19.4 vs. 7.5, P < 0.001). A multinomial logistic regression model identified CHF (P = 0.004), ABI (P = 0.041), and elevated body mass index (BMI, P = 0.045) as predictors of revision, while coronary artery disease (CAD, P = 0.031), CHF (P = 0.029), and postoperative NLR (P < 0.001) were predictive of 30-day mortality. CONCLUSIONS Postoperative elevated NLR, CAD, and CHF are predictors of 30-day mortality in patients undergoing major limb amputation, while CHF, elevated ABI, and high BMI are predictors of revision. This study suggests that NLR may have a role as a biomarker for poor outcomes in patients with underlying peripheral vascular disease and warrants further investigation.
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Affiliation(s)
| | - Jonathan Bath
- Division of Vascular Surgery, University of Missouri Hospitals & Clinics, Columbia, MO
| | | | - Michael C Scott
- University of Arkansas for Medical Sciences, Little Rock, AR
| | | | - Zachary Rasor
- Division of Podiatric Surgery, University of Cincinnati Medical Center, Cincinnati, OH
| | - Matthew Smeds
- Division of Vascular Surgery, St. Louis University, St. Louis, MO
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Kuo YT, Wang YY, Lin SY, Chang WD. Age and sex differences in the relationship between neutrophil-to-lymphocyte ratio and chronic kidney disease among an adult population in Taiwan. Clin Chim Acta 2018; 486:98-103. [PMID: 30025754 DOI: 10.1016/j.cca.2018.07.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 06/28/2018] [Accepted: 07/14/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND This study investigated the association between systemic inflammation and chronic kidney disease (CKD), and whether this association changes with aging in adults, by using neutrophil-to-lymphocyte ratio (NLR) as an inflammation marker. MATERIALS AND METHODS A total of 2954 adults (1815 men and 1139 women) who attended a health examination at a medical center in central Taiwan were included for the final cross-sectional analysis. RESULTS Compared with participants aged <60 years, participants aged ≥60 years had a markedly higher prevalence rate of CKD in both men (7.6% vs. 37.8%, p < .001) and women (3.8% vs. 28.0%, p < .001). In men aged <60 years, multivariable logistic regression analysis revealed that, after adjusting for conventional CKD risk factors, higher NLR (per 1 unit increment) was independently associated with higher risk of CKD [adjusted OR = 1.48 (95% C.I.: 1.10 to 1.99, p = .009)]. There was no such association in both men and women aged ≧60 years, and woman aged <60 years. CONCLUSIONS Our study showed a differential effect that aging has on the relationship between NLR and CKD in men but not in women. Being inexpensive and readily available, NLR may potentially be used for CKD risk assessment in men younger than 60 years of age.
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Affiliation(s)
- Yi-Ting Kuo
- Department of Internal Medicine, Taichung Veterans General Hospital, Wanqiao Branch, Chiayi, Taiwan; Division of Endocrinology and Metabolism, Department of Internal Medicine, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan
| | - Ya-Yu Wang
- School of Medicine, National Yang Ming University, Taipei, Taiwan; Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan; Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Shih-Yi Lin
- School of Medicine, National Yang Ming University, Taipei, Taiwan; Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan.
| | - Wen-Dau Chang
- Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
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Li C, Shen Y, Xu R, Dai Y, Chang S, Lu H, Dong Z, Deng J, Qian J, Ge J. Evaluation of Preprocedural Laboratory Parameters as Predictors of Drug-Eluting Stent Restenosis in Coronary Chronic Total Occlusion Lesions. Angiology 2018; 70:272-278. [PMID: 29338303 DOI: 10.1177/0003319717752245] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
This retrospective, single-center study assessed the prognostic value of several emerging inflammatory markers as predictors of in-stent restenosis (ISR) after drug-eluting stent implantation for coronary chronic total occlusion (CTO) lesions. Consecutive patients (n = 416) who underwent successful percutaneous coronary intervention (PCI) for documented CTO lesions and with follow-up angiography were enrolled. Preprocedural high-sensitivity C-reactive protein (hsCRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and red cell distribution width (RDW) were analyzed. At mean follow-up of 14.4 ± 3.3 months, ISR occurred in 72 patients. Compared with the non-ISR group, preprocedural hsCRP level, PLR, NLR, and RDW were significantly higher in the ISR group. The ISR group also had significantly greater proportions of patients with diabetes and smoking history, lower estimated glomerular filtration rate, higher low-density lipoprotein cholesterol (LDL-C) level and neutrophil count, longer stent length, and higher rate of severe dissection. In multivariate analysis, NLR (odds ratio [OR]: 3.110; 95% confidence interval [CI], 2.102-4.063; P < .001) and PLR (OR: 1.029; 95% CI, 1.016-1.143; P < .001) were independent predictors of ISR, along with LDL-C level and stent length. In conclusion, higher preprocedural NLR and PLR levels were independent risk factors for the development of ISR in patients who underwent PCI for CTO lesions.
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Affiliation(s)
- Chenguang Li
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Yi Shen
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Rende Xu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Yuxiang Dai
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Shufu Chang
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Hao Lu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Zhaohui Dong
- Department of Cardiology, Fengcheng Hospital, Shanghai, China
| | - Jianxin Deng
- Department of Cardiology, Fengcheng Hospital, Shanghai, China
| | - Juying Qian
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Junbo Ge
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
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Chang Z, Huangfu C, Grainger AT, Zhang J, Guo Q, Shi W. Accelerated atherogenesis in completely ligated common carotid artery of apolipoprotein E-deficient mice. Oncotarget 2017; 8:110289-110299. [PMID: 29299147 PMCID: PMC5746382 DOI: 10.18632/oncotarget.22685] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 11/05/2017] [Indexed: 12/22/2022] Open
Abstract
Complete ligation of the common carotid artery near its bifurcation induces neointimal formation due to smooth muscle cell proliferation in normolipidemic wild-type mice, but it was unknown what would happen to hyperlipidemic apolipoprotein E-deficient (Apoe-/-) mice. Examination of these mice revealed rapid development of atherosclerotic lesions in completely ligated carotid arteries within 4 weeks. Mice were fed a Western diet, starting 1 week before ligation, or a chow diet. Foam cell lesions formed as early as 1 week after ligation in mice fed the Western diet and 2 weeks in mice fed the chow diet. Fibrous lesions comprised of foam cells and smooth muscle cells and more advance lesions containing neovessels occurred at 2 and 4 weeks after ligation, respectively, in the Western diet group. Lesions were larger and more advanced in the Western diet group than the chow group. Neutrophil infiltration was observed in growing intimal lesions in both diet groups, while CD8+ T cells were found in lesions of chow-fed mice. This study demonstrates that Apoe-/- mice develop the entire spectrum of atherosclerosis in ligated carotid arteries in an accelerated manner and this model could be a valuable tool for investigating the development and therapy of atherosclerosis.
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Affiliation(s)
- Zhihui Chang
- Department of Radiology & Medical Imaging, University of Virginia, Charlottesville, Virginia, USA
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chaoji Huangfu
- Department of Radiology & Medical Imaging, University of Virginia, Charlottesville, Virginia, USA
- Beijing Key Laboratory of Blood Safety and Supply Technologies, Beijing Institute of Transfusion Medicine, Beijing, China
| | - Andrew T. Grainger
- Biochemistry & Molecular Genetics, University of Virginia, Charlottesville, Virginia, USA
| | - Jingang Zhang
- Beijing Key Laboratory of Blood Safety and Supply Technologies, Beijing Institute of Transfusion Medicine, Beijing, China
| | - Qiyong Guo
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Weibin Shi
- Department of Radiology & Medical Imaging, University of Virginia, Charlottesville, Virginia, USA
- Biochemistry & Molecular Genetics, University of Virginia, Charlottesville, Virginia, USA
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Neutrophil to Lymphocyte Count Ratio Has a Close Association With Severe Acute Colonic Diverticulitis in Patients Undergoing Surgical Treatment. Int Surg 2017. [DOI: 10.9738/intsurg-d-17-00120.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective:
To investigate the diagnostic potential of neutrophil-to-lymphocyte count ratio (NLCR) for acute diverticulitis.
Summary of Background Data:
We evaluated NLCR in patients with acute colonic diverticulitis who were treated with conservative and surgical treatments.
Methods:
A total of 205 patients who underwent surgical treatment or conservative management of acute diverticulitis between 2012 and 2016 were reviewed. Patients' age; sex; hospital days; co-morbidity; complication; period of use of antibiotics; treatment method; body temperature; and initial laboratory results such as neutrophil count, lymphocyte count, NLCR, and serum levels of C-reactive protein (CRP) were assessed.
Results:
The median ages of the conservative and surgical treatment groups were 46 and 68 years, respectively. Median CRP and glucose levels were high in acute colonic diverticulitis patients who underwent surgical treatment (P < 0.001, P < 0.001). Albumin level was low in the surgical treatment group (P < 0.001). NLCR was significantly different in both groups (conservative management vs surgical treatment, 4.1 mg/L versus 8.5 mg/L; P < 0.001). Median white blood cells was 11.36 × 109/L in the conservative management group and 14.0 × 109/L in the surgical treatment group, with no significance (P = 0.071). Multivariate analysis revealed that NLCR >10.21 [odds ratio (OR) = 5.613, P = 0.022]; CRP >17.23 mg/L (OR = 4.241, P = 0.006); and albumin ≤3.5 (OR = 4.192, P = 0.036) were significant for acute colonic diverticulitis patients.
Conclusion:
NLCR, CRP, and albumin levels were significantly associated with acute colonic diverticulitis in the surgical treatment group, and NLCR was the most powerful predictive marker of severe acute colonic diverticulitis.
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Neutrophil-to-lymphocyte count ratio is associated with perforated appendicitis in elderly patients of emergency department. Aging Clin Exp Res 2017; 29:529-536. [PMID: 27216860 DOI: 10.1007/s40520-016-0584-8] [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] [Received: 12/17/2015] [Accepted: 04/29/2016] [Indexed: 12/17/2022]
Abstract
PURPOSE The diagnostic value of the neutrophil-to-lymphocyte count ratio (NLR) and the Appendicitis Inflammatory Response (AIR) score for identifying acute appendicitis (AA) perforation in elderly patients in the emergency department (ED) were evaluated. METHODS A total of 103 patients who were admitted for appendectomy for AA via the ED between January 2012 and December 2014 were reviewed retrospectively. Patients aged 65 and over were included. Patient age, sex, comorbidities, body temperature, clinical findings and initial laboratory results including white blood cell (WBC) count, NLR, serum levels of CRP and total bilirubin (TB) in the ED were assessed, and the AIR score was calculated. RESULTS Perforation due to AA was identified in 58 (56.3 %) elderly patients. Median WBC count, neutrophil count, CRP and TB were significantly higher in the perforated group compared to the non-perforated group (p = 0.005, p = 0.001, p = 0.004 and p = 0.012) in the ED. The NLR was significantly different in the two groups (perforated vs non-perforated group, 9.5 vs 5.1, p < 0.001). The area under the curve value of NLR was 0.755 (95 % CI 0.660-0.834), and the cutoff value was 5.6 (sensitivity 78.0 % and specificity 65.9 %). In multivariate logistic analysis, NLR > 5.6 [odds ratio (OR) 6.794, p = 0.001] was significant independent factor for AA perforation in elderly patients. The AIR score risk probability did not differ between the two groups of elderly patients (p = 0.094). Twenty-five (42.4 %) patients in the perforated group and five (11.4 %) patients in the non-perforated group were classified as high probability by the modified AIR score including the NLR value (p = 0.001). CONCLUSION We suggest that the initial NLR in the elderly patient is the most powerful predictive factor for the diagnosis of AA perforation in the ED.
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Fagerberg B, Borné Y, Barregard L, Sallsten G, Forsgard N, Hedblad B, Persson M, Engström G. Cadmium exposure is associated with soluble urokinase plasminogen activator receptor, a circulating marker of inflammation and future cardiovascular disease. ENVIRONMENTAL RESEARCH 2017; 152:185-191. [PMID: 27792942 DOI: 10.1016/j.envres.2016.10.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 09/26/2016] [Accepted: 10/19/2016] [Indexed: 05/19/2023]
Abstract
BACKGROUND Diet and smoking are the main sources of cadmium exposure in the general population. Cadmium increases the risk of cardiovascular diseases, and experimental studies show that it induces inflammation. Blood cadmium levels are associated with macrophages in human atherosclerotic plaques. Soluble urokinase-type plasminogen activator receptor (suPAR) is an emerging biomarker for cardiovascular events related to inflammation and atherosclerotic plaques. The aim was to examine whether blood cadmium levels are associated with circulating suPAR and other markers of inflammation. METHODS A population sample of 4648 Swedish middle-aged women and men was examined cross-sectionally in 1991-1994. Plasma suPAR was assessed by ELISA, leukocytes were measured by standard methods, and blood cadmium was analysed by inductively coupled plasma mass spectrometry. Prevalent cardiovascular disease, ultrasound-assessed carotid plaque occurrence, and several possible confounding factors were recorded. RESULTS After full adjustment for risk factors and confounding variables, a 3-fold increase in blood cadmium was associated with an 10.9% increase in suPAR concentration (p<0.001). In never-smokers, a 3-fold increase in blood cadmium was associated with a 3.7% increase in suPAR concentration (p<0.01) after full adjustment. Blood cadmium was not associated with C-reactive protein, white blood cell count and Lp-PLA2 but with neutrophil/lymphocyte ratio in one of two statistical models. CONCLUSIONS Exposure to cadmium was associated with increased plasma suPAR in the general population, independently of smoking and cardiovascular disease. These results imply that cadmium is a possible cause for raised levels of this inflammatory marker.
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Affiliation(s)
- Björn Fagerberg
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory for Cardiovascular and Metabolic Research, University of Gothenburg, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden.
| | - Yan Borné
- Department of Clinical Sciences in Malmö, Cardiovascular Epidemiology, CRC, Jan Waldenströms gata 35, Lund University, Skåne University Hospital, Malmö, SE-205 02 Malmö, Sweden
| | - Lars Barregard
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, SE-413 45 Gothenburg, Sweden
| | - Gerd Sallsten
- Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, SE-413 45 Gothenburg, Sweden
| | - Niklas Forsgard
- Department of Clinical Chemistry, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden
| | - Bo Hedblad
- Department of Clinical Sciences in Malmö, Cardiovascular Epidemiology, CRC, Jan Waldenströms gata 35, Lund University, Skåne University Hospital, Malmö, SE-205 02 Malmö, Sweden
| | - Margaretha Persson
- Department of Clinical Sciences in Malmö, Cardiovascular Epidemiology, CRC, Jan Waldenströms gata 35, Lund University, Skåne University Hospital, Malmö, SE-205 02 Malmö, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences in Malmö, Cardiovascular Epidemiology, CRC, Jan Waldenströms gata 35, Lund University, Skåne University Hospital, Malmö, SE-205 02 Malmö, Sweden
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Beliaev AM, Angelo N, Booth M, Bergin C. Evaluation of neutrophil-to-lymphocyte ratio as a potential biomarker for acute cholecystitis. J Surg Res 2016; 209:93-101. [PMID: 28032577 DOI: 10.1016/j.jss.2016.09.034] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 09/01/2016] [Accepted: 09/21/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND The diagnosis of acute cholecystitis (AC) is frequently associated with an increase in white cell count (WCC) and C-reactive protein (CRP). However, one or both of these inflammatory biomarkers can be normal in AC. The aim of this study was to evaluate and compare the discriminative powers of the neutrophil-to-lymphocyte ratio (NLR) with WCC and CRP in diagnosing AC. METHODS This was a retrospective cohort study. For more than a period of 5 y, 1959 patients were identified from the cholecystectomy Registry. Laparoscopic cholecystectomy patients with histologic evidence of AC were included if they also had preoperative WCC and CRP measurements. Eligibility criteria were met by 177 patients. These patients were compared with 45 control subjects who had normal gallbladder histology. RESULTS One unit of increase in the NLR was associated with a 2.5 times increase in the odds of AC (odds ratio = 2.48; 95% confidence interval [CI], 1.5-4.1; P < 0.0005). NLR cutoff values of 4.1 (95% CI, 3.42-4.79), 3.25 (95% CI, 1.95-4.54), and 4.17 (95% CI, 3.76-4.58) were diagnostic for the overall AC, mild, and moderate-severe AC, respectively. The NLR areas under the receiver operating characteristic curve in AC, mild, and moderate-severe AC were 94% (95% CI, 91%-97%), 87% (95% CI, 81%-93%), and 98% (95% CI, 96%-100%), respectively. The discriminative power of an NLR was superior to that of the WCC and similar to CRP for diagnosing AC and different grades of severity. CONCLUSIONS NLR can be considered as a potential inflammatory biomarker for AC.
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Affiliation(s)
- Andrei M Beliaev
- Green Lane Cardiothoracic Surgical Unit, Auckland City Hospital, Grafton, Auckland, New Zealand.
| | - Neville Angelo
- Surgical Pathology Unit, North Shore Hospital, Takapuna, Auckland, New Zealand
| | - Michael Booth
- Department of General Surgery, North Shore Hospital, Takapuna, Auckland, New Zealand
| | - Colleen Bergin
- Anatomy with Imaging, FMHS University of Auckland, Grafton, Auckland, New Zealand
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Li C, Zhang F, Shen Y, Xu R, Chen Z, Dai Y, Lu H, Chang S, Qian J, Wang X, Ge J. Impact of Neutrophil to Lymphocyte Ratio (NLR) Index and Its Periprocedural Change (NLR Δ) for Percutaneous Coronary Intervention in Patients With Chronic Total Occlusion. Angiology 2016; 68:640-646. [PMID: 27207843 DOI: 10.1177/0003319716649112] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
We assessed the association between neutrophil to lymphocyte ratio (NLR) and chronic coronary total occlusion (CTO), as well as clinical prognosis of percutaneous coronary intervention (PCI). Patients referred for elective coronary angiography for stable angina pectoris were enrolled, including a CTO (n = 160) and a non-CTO group (n = 160). Neutrophil to lymphocyte ratio on admission and post-PCI was measured, and NLRΔ was defined as the change between the 2 values. Subgroup analysis was performed based on the value of NLRΔ (≥0.5 vs <0.5). Clinical characteristics, angiographic data, and follow-up data were recorded. Compared with the non-CTO group, the total white blood cell count, neutrophil counts, and NLR were significantly higher in the CTO group. In the NLRΔ ≥ 0.5 subgroup, the incidence of severe dissection, slow coronary flow, in-stent restenosis (ISR), and major adverse cardiac events (MACEs) was obviously higher. In multivariate analysis, NLRΔ was independently and positively associated with higher risks of ISR and MACE. The NLR could be a potential predictor of CTO, and NLRΔ is independently associated with the adverse clinical outcomes in patients who underwent PCI.
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Affiliation(s)
- Chenguang Li
- 1 Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University, Shanghai, China
| | - Feng Zhang
- 1 Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University, Shanghai, China
| | - Yi Shen
- 2 Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Rende Xu
- 1 Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University, Shanghai, China
| | - Zhangwei Chen
- 1 Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University, Shanghai, China
| | - Yuxiang Dai
- 1 Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University, Shanghai, China
| | - Hao Lu
- 1 Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University, Shanghai, China
| | - Shufu Chang
- 1 Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University, Shanghai, China
| | - Juying Qian
- 1 Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University, Shanghai, China
| | - Xiangfei Wang
- 1 Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University, Shanghai, China
| | - Junbo Ge
- 1 Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University, Shanghai, China
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