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Ke B, Li C, Shang H. Hematologic traits and primary biliary cholangitis: a Mendelian randomization study. J Hum Genet 2023:10.1038/s10038-023-01146-0. [PMID: 37012349 DOI: 10.1038/s10038-023-01146-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/13/2023] [Accepted: 03/26/2023] [Indexed: 04/05/2023]
Abstract
Hematologic abnormalities was observationally associated with the susceptibility of primary biliary cholangitis (PBC). However, the conclusion is still controversial and whether there exists a causal association remains elusive. Here we aimed to explore the causative role of hematological traits in the risk of PBC. We conducted two-sample and multivariable Mendelian randomization analyses based on summary statistics from previous large genome-wide association studies. Totally twelve red blood cell and six white blood cell traits were analyzed. Genetically determined higher hemoglobin level was significantly associated with a reduced risk of PBC (OR: 0.62, 95% CI: 0.47-0.81, P: 5.59E-04). Meanwhile, higher hematocrit level was nominally associated with reduced risk of PBC (OR: 0.73, 95% CI: 0.57-0.93, P: 0.01). These results could help better understand the role of hematological traits in the risk of PBC, and provide potential targets for the disease prevention and treatment.
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Affiliation(s)
- Bin Ke
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chunyu Li
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Huifang Shang
- Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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2
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Chang Y, Guo C, Guo G, Yuan Z, Zhou X, Wang J, Han Z, Chen Y, Jia G, Han Y. Erythrocyte count is associated with prognosis in Chinese patients with primary biliary cholangitis. Exp Ther Med 2020; 19:2075-2082. [PMID: 32104268 PMCID: PMC7027317 DOI: 10.3892/etm.2020.8446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 11/11/2019] [Indexed: 11/06/2022] Open
Abstract
Erythroid parameters have been indicated to be important prognostic factors for liver diseases. The present study aimed to evaluate the prognostic value of the erythrocyte count in Chinese patients with primary biliary cholangitis (PBC) and develop a prognostic model. The clinical data of 301 patients with PBC were retrospectively reviewed. Univariate and multivariate Cox regression analysis was performed to identify potential prognostic risk factors. Bivariate correlation analysis was used to determine the correlation coefficient of the erythrocyte count and biochemical indices. The prognostic values of different factors were compared by receiver operating characteristic (ROC) curve analysis. A novel prognostic model was constructed using multivariate logistic regression. Multivariate regression analysis suggested that the erythrocyte count was an independent risk factor/prognostic index (P=0.042). The erythrocyte count in peripheral blood decreased as the histological stage progressed (P<0.001). The erythrocyte count was correlated with albumin, liver stiffness and Fibrosis-4. Compared with that of platelets, the area under the ROC curve of the erythrocyte count was significantly greater. A similar area under the ROC curve was determined for the erythrocyte count, albumin and total bilirubin (P>0.05). A novel prognostic model was established as follows: P=1/{1 + e-[6.140-3.193 × Ln(erythrocyte count) -0.184 × albumin + 0.827 × Ln(total bilirubin)]}. The novel model had a comparable prognostic value to that of the GLOBE score and UK-PBC risk score, and had a better performance than the Mayo risk score at baseline (0.838 vs. 0.787). In conclusion, the erythrocyte count is an independent risk factor/prognostic index in Chinese patients with PBC. It was correlated with liver function and fibrosis in Chinese patients. The novel model incorporating the erythrocyte count and biochemical indices at baseline may serve as a prognostic tool in Chinese patients with PBC (Trial registration number, ChiCTR-ONRC-10002070; date of registration, 2010-05-10).
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Affiliation(s)
- Yinghao Chang
- Department of Digestive Diseases, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China.,Department of Gastroenterology and Hepatology, General Hospital of Western Theater Command, Chengdu, Sichuan 610083, P.R. China
| | - Changcun Guo
- Department of Digestive Diseases, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Guanya Guo
- Department of Digestive Diseases, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Zhou Yuan
- Department of Digestive Diseases, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Xinmin Zhou
- Department of Digestive Diseases, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Jingbo Wang
- Department of Digestive Diseases, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Zheyi Han
- Department of Digestive Diseases, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Yu Chen
- Department of Digestive Diseases, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Gui Jia
- Department of Digestive Diseases, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Ying Han
- Department of Digestive Diseases, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
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Dvornik Š, Zaninović Jurjević T, Jurjević N, Lekić A, Zaputović L. Prognostic factors for in-hospital mortality of patients hospitalized for acutely decompensated heart failure. Acta Clin Belg 2018; 73:199-206. [PMID: 29207933 DOI: 10.1080/17843286.2017.1410599] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objectives Despite improved treatment during last 20 years, prognosis for patients hospitalized for acutely decompensated heart failure (ADHF) is poor and mortality rates reported for these patients are high. Laboratory results can assist clinicians in evaluation and triaging of patients on hospital admission, and are important for the medical decision-making and prognosis assessments. Recently, new guidelines for the diagnosis and treatment of acute and chronic HF patients were published introducing a new group of patients with mid-range left ventricular ejection fraction (LVEF). Methods In order to explore the prognostic value for the in-hospital mortality of ADHF patients we analyzed laboratory test results for 165 emergency hospitalized patients regarding the survival and LVEF. Results In-hospital mortality was 16%. Patients who died were older than survivals (p = 0.003). There were no differences in LVEF between survivals and non-survivals. Patients who survived had significantly lower N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin T (hs-cTnT), uric acid, urea, creatinine, and red blood cell distribution width (RDW) than patients who died (p < 0.001). All these tests had a good discrimination power between survivals and non-survivals (p < 0.001), but their incremental addition to NT-proBNP didn't improve its overall prognostic value. There was only a very weak correlation between NT-proBNP concentrations and LVEF. Groups with different LVEF status showed significant difference in number of erythrocytes, RDW and hemoglobin concentrations. Conclusions NT-proBNP had the best discriminatory power between survivals and non-survivals. Some routine laboratory test results, like RDW, uric acid, urea, and creatinine, have potentially significant value.
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Affiliation(s)
- Štefica Dvornik
- Department for Laboratory and Radiological Diagnostics, Faculty of Health Studies, University of Rijeka, Clinical Hospital Centre Rijeka, Rijeka, Croatia
- Department for Laboratory Diagnostics, Clinical Hospital Centre Rijeka, Rijeka, Croatia
| | - Teodora Zaninović Jurjević
- Department for Cardiovascular Diseases, Internal Medicine Clinic, Clinical Hospital Centre Rijeka, Rijeka, Croatia
| | | | | | - Luka Zaputović
- Department for Cardiovascular Diseases, Internal Medicine Clinic, Clinical Hospital Centre Rijeka, Rijeka, Croatia
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Peng Y, Li Y, He Y, Wei Q, Xie Q, Zhang L, Xia Y, Zhou X, Zhang L, Feng X, Chen K, Chen S, Chen W, Long Q, Chai J. The role of neutrophil to lymphocyte ratio for the assessment of liver fibrosis and cirrhosis: a systematic review. Expert Rev Gastroenterol Hepatol 2018; 12:503-513. [PMID: 29629626 DOI: 10.1080/17474124.2018.1463158] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Neutrophil to lymphocyte ratio (NLR) is widely used to assess inflammatory diseases. We performed a systematic review to explore the prognostic role of NLR for the assessment of liver fibrosis and cirrhosis. Areas covered: We searched the PubMed and EMBASE databases for the eligible papers which explored the association between NLR and liver fibrosis/cirrhosis or investigated the prognostic value of NLR in cirrhotic patients. Expert commentary: In accordance with assessment of liver fibrosis stage, we classified papers into four subgroups by etiology. For the patients with nonalcoholic fatty liver disease (NAFLD) there was a significant association between NLR and fibrosis stage and nonalcoholic fatty liver disease activity score (NAS), while NLR had a negative correlation with fibrosis stage for the patients with chronic hepatitis B (CHB). As for the patients with and chronic hepatitis C (CHC), NLR might not be significantly associated with fibrosis stage. Moreover, NLR seemed to be significantly useful for predicting outcomes in cirrhotic patients. Hence, NLR might be associated with liver fibrosis stage, especially in patients with NAFLD. Furthermore, NLR might be a useful biomarker for evaluating the prognosis in cirrhotic patients.
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Affiliation(s)
- Ying Peng
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Yan Li
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Yonghong He
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Qinglin Wei
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Qiaoling Xie
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Liangjun Zhang
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Yiju Xia
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Xueqian Zhou
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Lu Zhang
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Xinchan Feng
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Kun Chen
- b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Sheng Chen
- c Department of Pediatrics, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Wensheng Chen
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Qinglin Long
- b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Jin Chai
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
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Goyal H, Hu ZD. Prognostic value of red blood cell distribution width in hepatocellular carcinoma. ANNALS OF TRANSLATIONAL MEDICINE 2017; 5:271. [PMID: 28758097 DOI: 10.21037/atm.2017.06.30] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Red blood cell distribution width (RDW) is a simple, inexpensive, routinely measured and automatically reported blood test parameter, which reflects the degree of anisocytosis of red blood cells in peripheral blood. RDW was found to be associated with and retain clinical significance for assessing disease severity and outcomes in a number of hematological and solid malignancies. Motley of interacting clinical and biochemical factors have an impact on the red cell population biology. Malignancies per se can act as a causative factor, or anisocytosis may develop as a result of chronic inflammation. RDW has also been shown to be affected by nutritional status, which is typically deranged in malignancies. RDW is shown to be a clinically useful marker of disease severity and level of fibrosis in liver cirrhosis of various causes such as hepatitis B, hepatitis C and non-alcoholic fatty liver disease. Whether liver cirrhosis patients with higher RDW are at increased risk of hepatocellular cancer is yet to be determined, but several lines of evidence confirm that RDW has clinical significance in hepatocellular carcinoma (HCC). In this review, we specifically discuss the current literature about the association between RDW and HCC. The available evidences were summarized and the potential underlying mechanisms were analyzed.
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Affiliation(s)
- Hemant Goyal
- Mercer University School of Medicine, Macon, Georgia, USA
| | - Zhi-De Hu
- Department of Laboratory Medicine, General Hospital of Jinan Military Region of PLA, Jinan 250031, China
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Wei TT, Wang LL, Yin JR, Liu YT, Qin BD, Li JY, Yin X, Zhou L, Zhong RQ. Relationship between red blood cell distribution width, bilirubin, and clinical characteristics of patients with gastric cancer. Int J Lab Hematol 2017; 39:497-501. [PMID: 28497572 DOI: 10.1111/ijlh.12675] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 02/27/2017] [Indexed: 12/23/2022]
Affiliation(s)
- T.-T. Wei
- Department of Laboratory Medcine; Changzheng Hospital; The Second Military Medical University; Shanghai China
| | - L.-L. Wang
- Department of Laboratory Medcine; Changzheng Hospital; The Second Military Medical University; Shanghai China
| | - J.-R. Yin
- Department of Laboratory Medcine; Changzheng Hospital; The Second Military Medical University; Shanghai China
| | - Y.-T. Liu
- Department of Laboratory Medcine; Changzheng Hospital; The Second Military Medical University; Shanghai China
| | - B.-D. Qin
- Department of Laboratory Medcine; Changzheng Hospital; The Second Military Medical University; Shanghai China
| | - J.-Y. Li
- Department of Laboratory Medcine; Changzheng Hospital; The Second Military Medical University; Shanghai China
| | - X. Yin
- Department of Laboratory Medcine; Changzheng Hospital; The Second Military Medical University; Shanghai China
| | - L. Zhou
- Department of Laboratory Medcine; Changzheng Hospital; The Second Military Medical University; Shanghai China
| | - R.-Q. Zhong
- Department of Laboratory Medcine; Changzheng Hospital; The Second Military Medical University; Shanghai China
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