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Zhao Y, Ghaedi A, Azami P, Nabipoorashrafi SA, Drissi HB, Dezfouli MA, Sarejloo S, Lucke-Wold B, Cerillo J, Khanzadeh M, Jafari N, Khanzadeh S. Inflammatory biomarkers in cardiac syndrome X: a systematic review and meta-analysis. BMC Cardiovasc Disord 2024; 24:276. [PMID: 38807048 PMCID: PMC11134643 DOI: 10.1186/s12872-024-03939-3] [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: 01/10/2023] [Accepted: 05/14/2024] [Indexed: 05/30/2024] Open
Abstract
INTRODUCTION In the current systematic review and meta-analysis, we aim to analyze the existing literature to evaluate the role of inflammatory biomarkers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein (CRP), tumor necrosis factor-a (TNF-a), and interleukin-6 (IL-6) among individuals with cardiac syndrome X (CSX) compared to healthy controls. METHODS We used PubMed, Web of Science, Scopus, Science Direct, and Embase to systematically search relevant publications published before April 2, 2023. We performed the meta-analysis using Stata 11.2 software (Stata Corp, College Station, TX). So, we used standardized mean difference (SMD) with a 95% confidence interval (CI) to compare the biomarker level between patients and healthy controls. The I2 and Cochran's Q tests were adopted to determine the heterogeneity of the included studies. RESULTS Overall, 29 articles with 3480 participants (1855 with CSX and 1625 healthy controls) were included in the analysis. There was a significantly higher level of NLR (SMD = 0.85, 95%CI = 0.55-1.15, I2 = 89.0 %), CRP (SMD = 0.69, 95%CI = 0.38 to 1.02, p < 0.0001), IL-6 (SMD = 5.70, 95%CI = 1.91 to 9.50, p = 0.003), TNF-a (SMD = 3.78, 95%CI = 0.63 to 6.92, p = 0.019), and PLR (SMD = 1.38, 95%CI = 0.50 to 2.28, p = 0.02) in the CSX group in comparison with healthy controls. CONCLUSION The results of this study showed that CSX leads to a significant increase in inflammatory biomarkers, including NLR, CRP, IL-6, TNF-a, and PLR.
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Affiliation(s)
- Yuexia Zhao
- Shandong Mental Health Center, Jinan, Shandong Province, China
| | - Arshin Ghaedi
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Pouria Azami
- Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Ali Nabipoorashrafi
- Endocrinology and Metabolism Research Center (EMRC), School of Medicine, Vali-Asr Hospital, Tehran, Iran
| | | | - Maryam Amin Dezfouli
- Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | | | - John Cerillo
- Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Tampa Bay Regional Campus, Gulf to Bay Blvd, Clearwater, FL, 3375, USA
| | - Monireh Khanzadeh
- Geriatric & Gerontology Department, Medical School, Tehran University of medical and health sciences, Tehran, Iran
| | - Negar Jafari
- Department of cardiovascular medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
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Ahmed R, Hamdy O, Awad RM. Diagnostic efficacy of systemic immune-inflammation biomarkers in benign prostatic hyperplasia using receiver operating characteristic and artificial neural network. Sci Rep 2023; 13:14801. [PMID: 37684320 PMCID: PMC10491602 DOI: 10.1038/s41598-023-41781-3] [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: 04/19/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
Benign prostatic hyperplasia (BPH) is a chronic, progressive disease characterized by mesenchymal cell-predominance and stromal and glandular cell-hyperproliferation. Although, the precise cause of BPH is unknown, it is believed to be associated with hormonal changes in aging men. Despite androgens and ageing are likely to play a role in the development of BPH, the pathophysiology of BPH remains uncertain. This paper aims to evaluate the diagnostic efficacy of platelet-to-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR) and systemic immune-inflammation index in in diagnosing BPH. A single-center-randomized-retrospective study was carried out at Alzahraa university hospital between January 2022 and November 2022 on 80 participants (40 non-BPH subjects and 40 patients with symptomatic enlarged prostate) who visited the outpatient clinic or admitted to the urology department. The BPH cases were evaluated by digital rectal examination (DRE), International Prostate Symptom Score (IPSS), prostate size, prostate specific antigen (PSA), TRUS biopsy in elevated PSA > 4 ng/ml, PLR, NLR and systemic immune inflammatory (SII). The diagnosing efficiency of the selected parameters was evaluated using Receiver Operating Characteristic (ROC) and Artificial Neural Network (ANN) showing excellent discrimination with 100% accuracy and AUC = 1 in the ROC curves. Moreover, the accuracy rate of the ANN exceeds 99%. Conclusion: PLR, NLR and SII can be significantly employed for diagnosing BPH.
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Affiliation(s)
- Rasha Ahmed
- Urology Department, Faculty of Medicine for Girls, Al Azhar University, Cairo, Egypt
| | - Omnia Hamdy
- Engineering Applications of Lasers Department, National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt.
| | - Refaat Mostafa Awad
- Urology Department, Faculty of Medicine for Girls, Al Azhar University, Cairo, Egypt
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Mansell T, Bekkering S, Longmore D, Magnussen CG, Vlahos A, Harcourt BE, McCallum Z, Kao KT, Sabin MA, Juonala M, Saffery R, Burgner DP, Saner C. Change in adiposity is associated with change in glycoprotein acetyls but not hsCRP in adolescents with severe obesity. Obes Res Clin Pract 2023; 17:343-348. [PMID: 37633821 DOI: 10.1016/j.orcp.2023.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 08/02/2023] [Accepted: 08/19/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND Obesity-associated chronic inflammation mediates the development of adverse cardiometabolic outcomes. There are sparse data on associations between severe obesity and inflammatory biomarkers in adolescence; most are cross-sectional and limited to acute phase reactants. Here, we investigate associations between adiposity measures and inflammatory biomarkers in children and adolescents with severe obesity both cross-sectionally and longitudinally. METHODS From the Childhood Overweight Biorepository of Australia (COBRA) study, a total of n = 262 participants, mean age 11.5 years (SD 3.5) with obesity had measures of adiposity (body mass index, BMI; % above the 95th BMI-centile, %>95th BMI-centile; waist circumference, WC; waist/height ratio, WtH; % total body fat, %BF; % truncal body fat, %TF) and inflammation biomarkers (glycoprotein acetyls, GlycA; high-sensitivity C-Reactive Protein, hsCRP; white blood cell count, WBC; and neutrophil/lymphocyte ratio, NLR) assessed at baseline. Ninety-eight individuals at mean age of 15.9 years (3.7) participated in a follow-up study 5.6 (2.1) years later. Sixty-two individuals had longitudinal data. Linear regression models, adjusted for age and sex for cross-sectional analyses were applied. To estimate longitudinal associations between change in adiposity measures with inflammation biomarkers, models were adjusted for baseline measures of adiposity and inflammation. RESULTS All adiposity measures were cross-sectionally associated with GlycA, hsCRP and WBC at both time points. Change in BMI, %>95th BMI-centile, WC, WtH and %TF were associated with concomitant change in GlycA and WBC, but not in hsCRP and NLR. CONCLUSION GlycA and WBC but not hsCRP and NLR may be useful in assessing adiposity-related severity of chronic inflammation over time.
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Affiliation(s)
- Toby Mansell
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Siroon Bekkering
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia; Dept of Internal Medicine and Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Danielle Longmore
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia; Department of Endocrinology, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Costan G Magnussen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland, and Centre for Population Health Research, University of Turku and Turku University Hospital Turku, Finland; Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Amanda Vlahos
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Brooke E Harcourt
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Zoe McCallum
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; Neurodevelopment and Disability, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Kung-Ting Kao
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; Department of Endocrinology, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Matthew A Sabin
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; Department of Endocrinology, The Royal Children's Hospital, Parkville, Victoria, Australia
| | - Markus Juonala
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia; Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland
| | - Richard Saffery
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - David P Burgner
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia; Department of Paediatrics, Monash University, Clayton, Victoria, Australia
| | - Christoph Saner
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Victoria, Australia; Division of Pediatric Endocrinology, Diabetology, and Metabolism, Department of Pediatrics, University Children's Hospital Bern, Inselspital Bern, Switzerland; Department of Biomedical Research, University of Bern, Bern, Switzerland.
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DEMİR YENİGURBUZ F, SÖBÜ E, BERK AKBEYAZ B. The comparison of inflammatory hematological parameters in obese and non-obese children. FAMILY PRACTICE AND PALLIATIVE CARE 2023. [DOI: 10.22391/fppc.1197997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Introduction: Obesity is an increasing health problem in the whole world, and it has an important inflammatory component related to the insulin resistance (IR), hypertension, atherosclerosis and some cancers. This study aims to evaluate the inflammatory hematological parameters in childhood obesity.Methods: Sixty-four obese and 50 normal weight cases were included in the study. The physical examination features and laboratory data of the patients were evaluated retrospectively from the patient’s files. Laboratory tests, hematological parameters, gender were compared between the groups. Correlations between Homeostasis model evaluation for insulin resistance (HOMA-IR) and other laboratory parameters in the obese group were examined.Results: The leukocyte, neutrophile, monocyte, lymphocyte, thrombocyte and MPV values of the obese group were found to be statistically higher than the control group (p: 0.006, p:0.015, p:0.014, p:0.001, p<0.001). There was no statistically significant difference between the two groups for Neutrophile/Lymphocyte ratio (NLR), Monocyte/Lymphocyte ratio (MLR) and Platelet/Lymphocyte ratio (PLR) (p:0.642, p:0.989, 0.982). Also, there was no statistically significant correlation between Homa IR and age, BMI, Neutrophil, Lymphocyte, Monocyte, Thrombocyte, Neutrophil/Lymphocyte, Monocyte/Lymphocyte and Thrombocyte/Lymphocyte values.Conclusion: The current study showed that there was no significant difference between obese and controls in terms of NLR, PLR, and MLR values. However, the leukocyte, neutrophile, monocyte, lymphocyte, thrombocyte and MPV values were statistically higher in obese group than controls. Nevertheless, these findings can point relation between obesity and inflammation.Keywords: obesity, children, inflammation, hematological parameters
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Affiliation(s)
- Fatma DEMİR YENİGURBUZ
- Department of Pediatric Hematology/Oncology & Bone Marrow Transplantation Unit, Faculty of Medicine, Acibadem University, Istanbul
| | - Elif SÖBÜ
- Department of Pediatric Endocrinology, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul
| | - Berkin BERK AKBEYAZ
- Department of Pediatric Hematology/Oncology, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul
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Li N, Liu C, Luo Q, Zhang F, Sheng D, Liu Z. Correlation of White Blood Cell, Neutrophils, and Hemoglobin with Metabolic Syndrome and Its Components. Diabetes Metab Syndr Obes 2023; 16:1347-1355. [PMID: 37197062 PMCID: PMC10183630 DOI: 10.2147/dmso.s408081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 04/29/2023] [Indexed: 05/19/2023] Open
Abstract
Background Metabolic syndrome (MetS) is a global health problem. White blood cell (WBC), neutrophils and neutrophil-to-lymphocyte ratio (NLR) are valid indicators involved in acute and chronic inflammation. The aims of our study were to analyze the correlation and severity of these indicators with MetS and its components, and explore the diagnostic value of their combined tests for MetS. Methods A total of 7726 subjects were recruited, and laboratory biomarkers were collected. The differences of indicators between MetS group and non-MetS group were analyzed. The linear trend between each indicator and the increasing number of metabolic disorders was analyzed using trend variance test. The correlation between each indicator and MetS with its components was analyzed by logistic regression. Results The levels of WBC, neutrophil, and hemoglobin grew significantly in the MetS group compared to non-MetS group, and gradually increased with the increased number of MetS disorders. Logistic regression analysis indicated significant correlations between WBC, neutrophils, and hemoglobin with MetS and its components. ROC curve analysis showed WBC, neutrophils, and hemoglobin served as good predictors for MetS, especially in adults aged under 40. Conclusion Our study indicated that WBC, neutrophils, and hemoglobin are efficient indicators for predicting MetS and evaluate its severity.
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Affiliation(s)
- Nan Li
- Health Management Center, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Chenbing Liu
- Health Management Center, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Qian Luo
- Health Management Center, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Feng Zhang
- Health Management Center, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Di Sheng
- Health Management Center, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
| | - Zhong Liu
- Health Management Center, the First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
- Correspondence: Zhong Liu, The First Affiliated Hospital of Zhejiang University School of Medicine, No. 79 Qingchun Road, Shangcheng District, Hangzhou, Zhejiang, People’s Republic of China, Tel +8613957104885, Email
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Ray A, Bonorden MJL, Pandit R, Nkhata KJ, Bishayee A. Infections and immunity: associations with obesity and related metabolic disorders. J Pathol Transl Med 2023; 57:28-42. [PMID: 36647284 PMCID: PMC9846011 DOI: 10.4132/jptm.2022.11.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 11/14/2022] [Indexed: 01/18/2023] Open
Abstract
About one-fourth of the global population is either overweight or obese, both of which increase the risk of insulin resistance, cardiovascular diseases, and infections. In obesity, both immune cells and adipocytes produce an excess of pro-inflammatory cytokines that may play a significant role in disease progression. In the recent coronavirus disease 2019 (COVID-19) pandemic, important pathological characteristics such as involvement of the renin-angiotensin-aldosterone system, endothelial injury, and pro-inflammatory cytokine release have been shown to be connected with obesity and associated sequelae such as insulin resistance/type 2 diabetes and hypertension. This pathological connection may explain the severity of COVID-19 in patients with metabolic disorders. Many studies have also reported an association between type 2 diabetes and persistent viral infections. Similarly, diabetes favors the growth of various microorganisms including protozoal pathogens as well as opportunistic bacteria and fungi. Furthermore, diabetes is a risk factor for a number of prion-like diseases. There is also an interesting relationship between helminths and type 2 diabetes; helminthiasis may reduce the pro-inflammatory state, but is also associated with type 2 diabetes or even neoplastic processes. Several studies have also documented altered circulating levels of neutrophils, lymphocytes, and monocytes in obesity, which likely modifies vaccine effectiveness. Timely monitoring of inflammatory markers (e.g., C-reactive protein) and energy homeostasis markers (e.g., leptin) could be helpful in preventing many obesity-related diseases.
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Affiliation(s)
- Amitabha Ray
- College of Medical Science, Alderson Broaddus University, Philippi, WV, USA,Corresponding Author: Amitabha Ray, MD, PhD, College of Medical Science, Alderson Broaddus University, 101 College Hill Drive, Philippi, WV 26416, USA Tel: +1-304-457-6587, Fax: +1-304-457-6308, E-mail:
| | | | - Rajashree Pandit
- Division of Medical & Behavioral Health, Pueblo Community College, Pueblo, CO, USA
| | | | - Anupam Bishayee
- Lake Erie College of Osteopathic Medicine, Bradenton, FL, USA
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Omrani-Nava V, Moosazadeh M, Bahar A, Hedayatizadeh-Omran A, Ahmadi A, Alizadeh-Navaei R. Neutrophil-to-lymphocyte, platelet-to-lymphocyte and lymphocyte-to-monocyte ratios, any association with metabolic syndrome? CASPIAN JOURNAL OF INTERNAL MEDICINE 2023; 14:567-571. [PMID: 37520875 PMCID: PMC10379793 DOI: 10.22088/cjim.14.3.567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 08/01/2023]
Abstract
Background Metabolic syndrome is a critical health concern associated with an elevated risk of chronic health problems including cardiovascular disease and diabetes. There are shreds of evidence that novel inflammatory ratios including neutrophil-to-lymphocyte, platelet-to-lymphocyte and lymphocyte-to-monocyte ratios serve as prognostic biomarkers for metabolic syndrome (MetS). This hypothesis was investigated in a cohort of the Iranian population. Methods selection of MetS + subjects was based on the National Cholesterol Education Program Adult Treatment Panel III criteria 3 (NCEP ATP 3). The control group consisted of participants negative for any of the five MetS criteria. Demographic and laboratory data were extracted from the Tabari cohort study. Results A total of 1930 subjects including 965 Mets positive and 965 MetS criteria negative participants were evaluated. Diabetes (84.8%), hypertension (48.9%), hypertriglyceridemia (81.7%), low HDL cholesterol (70.3%), and high waist circumference (78.9%) were observed in patients. There were no differences between NLR (1.66±0.71 vs. 1.69±0.72 P=0.42), LMR (11.23±3.13 vs. 11.30±11.99, P= 0.86) and PLR (113.85±68.67 vs 114.11±35.85, P=0.91) between case and control groups, respectively. Logistic regression analysis revealed no association between ratios and MetS risk even after adjusting for potential confounders including age, gender, living place, and BMI. Conclusion In a relatively large population from Northern Iran, no association was observed between CBC-derived inflammatory ratios and the presence of MetS.
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Affiliation(s)
- Versa Omrani-Nava
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Adeleh Bahar
- Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Akbar Hedayatizadeh-Omran
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abdolrahim Ahmadi
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
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Recarte M, Corripio R, Palma S, Mata A, de-Cos AI. Improvement of Low-Grade Inflammation in Patients with Metabolically Healthy Severe Obesity After Primary Bariatric Surgery. Obes Surg 2023; 33:38-46. [PMID: 36348177 DOI: 10.1007/s11695-022-06345-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 10/16/2022] [Accepted: 10/25/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION The inflammatory state that accompanies adiposity and the metabolic syndrome (MetS) is called "low-grade" inflammation. White blood cell count (WBC) has been proposed as an emerging biomarker for predicting future cardiovascular events, MetS and mortality. Bariatric surgery (BS) improves comorbidities associated with obesity and the MetS and the surgically induced weight loss is known to improve inflammatory status. OBJECTIVES To analyze the improvement of low-grade inflammation associated to obesity in patients with metabolically healthy severe obesity (MHSO) and patients with metabolically unhealthy obesity (MUSO) (severe obesity with MetS) after primary bariatric surgery as well as the protective effect of BS against the development of MetS in patients with MHSO by reducing the WBC. MATERIALS AND METHODS Retrospective analysis of prospectively collected data of patients undergoing laparoscopic primary BS (gastric by-pass or sleeve gastrectomy) from January 2004-December 2015. Outcomes included changing of low-grade inflammation in terms of leukocytes, neutrophils, lymphocytes, and platelets. RESULTS Twenty-one patients with MHSO and 167 patients with MUSO underwent laparoscopic primary BS. The preoperative values of leukocyte and platelet were statistically higher in the group of patients with MHSO. In both groups, there was significant postoperative decrease of inflammatory markers. The greatest drop in WBC occurred in the second postoperative year. No patient of the group of patients with MHSO developed MetS within five postoperative years. CONCLUSIONS Surgically induced weight loss plays an important role for improvement in chronic inflammation associated to obesity because of reduction of visceral fat mass. MHSO associates a low-grade chronic inflammatory status comparable to MUSO. The improvement or decrease of low-grade inflammation in patients with metabolically healthy severe obesity after bariatric surgery could have a protective effect against the development of MetS and medical conditions associated with severe obesity.
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Affiliation(s)
- María Recarte
- Bariatric and Metabolic Surgery Unit, Department of General Surgery, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046, Madrid, Spain.
| | - Ramón Corripio
- Bariatric and Metabolic Surgery Unit, Department of General Surgery, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046, Madrid, Spain
| | - Samara Palma
- Department of Endocrinology and Metabolism, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046, Madrid, Spain
| | - Alberto Mata
- Department of General Surgery, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046, Madrid, Spain
| | - Ana I de-Cos
- Department of Endocrinology and Metabolism, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046, Madrid, Spain
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Sharifan P, Rashidmayvan M, Khorasanchi Z, Darroudi S, Heidari A, Hoseinpoor F, Vatanparast H, Safarian M, Eslami S, Afshari A, Asadi Z, Ghazizadeh H, Bagherniya M, Khedmatgozar H, Ferns G, Rezaie M, Mobarhan MG. Efficacy of low-fat milk and yogurt fortified with vitamin D3 on systemic inflammation in adults with abdominal obesity. JOURNAL OF HEALTH, POPULATION AND NUTRITION 2022; 41:8. [PMID: 35236423 PMCID: PMC8889656 DOI: 10.1186/s41043-022-00283-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 02/07/2022] [Indexed: 11/10/2022] Open
Abstract
Background The prevalence of vitamin D deficiency is increasing globally and is associated with an increased risk of metabolic syndrome, autoimmune disease, and cardiovascular disease. Vit D deficiency is also associated with increased systemic inflammation. The current study aimed to determine the efficacy of low-fat milk and yogurt fortified with 1500 IU nano-encapsulated vitamin D, on systemic inflammation in abdominal obese participants. Method This multi-center study was conducted using a 2.5-month parallel total-blind randomized clinical trial design. Two hundred and eighty nine subjects were allocated to four groups: low-fat milk fortified by 1500 IU nano-encapsulated vitamin D3 (200 mL/day). Simple milk (200 mL/day), low-fat yogurt fortified by 1500 IU nano-encapsulated vitamin D3 (150 g/day), and simple yogurt (150 g/day). Results The results showed that serum levels of neutrophils, lymphocytes, platelets and red blood cell distribution width (RDW) were significantly lower before and after the intervention in fortified dairy groups. The results showed that serum levels of neutrophils, lymphocytes, platelets, and RDW before and after intervention in the fortified dairy groups were significantly lower (p < 0.05). The values of = neutrophil to lymphocyte ratio (NLR), platelets to lymphocyte ratio, and RDW to platelets ratio (RPR) reduced significantly in the fortification group (p < 0.05). Conclusion Fortification with nano-encapsulated vitamin D3 of dairy products may decrease inflammation in individuals with abdominal obesity.
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Muacevic A, Adler JR, Al Mansour MH, Safhi AA. Evaluation of Serum 25(OH) Vitamin D as a Risk Factor in Adult Recurrent Tonsillitis. Cureus 2022; 14:e32083. [PMID: 36600833 PMCID: PMC9803801 DOI: 10.7759/cureus.32083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 12/03/2022] Open
Abstract
Background Studies have reported that the rate of upper respiratory tract infections in children and adults is inversely related to serum vitamin D levels and supplementation with vitamin D reduces the incidence of this infection. This study aimed to examine if vitamin D serum levels were a risk factor for recurrent tonsillitis among adult patients. Methods Retrospective comparative analysis was carried out on 100 patients diagnosed with recurrent tonsillitis with 100 age- and sex-matched individuals as controls between June 2016 and May 2022. Tonsillar size was assessed based on Brodsky grading system. Serum levels of 25-hydroxy (25(OH)) vitamin D, total calcium, iron, hemoglobin, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were analyzed. Results There was a statistically significant low vitamin D levels in tonsil size grades III+IV compared to grade I+II (p <0.001) among cases. There was a significantly lower serum value for 25(OH) vitamin D in the cases as compared to the control group (p <0.001). A high percentage (68%) of cases had vitamin D deficiency (<20 ng/mL) and this was statistically significant (p <0.001). There were statistically significant higher values of CRP and ESR among cases compared to the control group (p <0.001). At a cut off (≤21.2), serum vitamin D levels achieved 78% sensitivity, 65% specificity (p <0.001) to differentiate cases from controls. Following logistic regression analysis, the level of vitamin D was the only significant risk factor. Conclusion Findings from our study also suggest an association between recurrent tonsillitis among our adult cohorts and low serum 25(OH) vitamin D levels. Therefore, we opine that serum vitamin D levels should be considered in the management of adult patients with tonsillitis.
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Caimi G, Urso C, Brucculeri S, Amato C, Lo Presti R, Carlisi M. Leukocyte subtypes, gelatinases, and their tissue inhibitors in a group of subjects with asymptomatic carotid atherosclerosis. Clin Hemorheol Microcirc 2022; 82:37-51. [PMID: 35599473 PMCID: PMC9741743 DOI: 10.3233/ch-221380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
In a cohort of subjects with asymptomatic carotid atherosclerosis (ACA), we have evaluated the neutrophil and lymphocyte count and their ratio (NLR), the gelatinases (MMP-2 and MMP-9) and their tissue inhibitors (TIMP-1 and TIMP-2). At baseline, no difference was observed between ACA subjects and subject control group regarding neutrophil and lymphocyte count while was evident in ACA subjects a significant increase in MMP-2, MMP-9 and TIMP-2 associated to a significant decrease in TIMP-1. Dividing the ACA according to the number of cardiovascular risk factors (CRFs) we have observed an increase in lymphocyte count in the subgroup with 3-5 CRFs. Evaluating the leukocyte subtypes according to all the surrogate markers of insulin resistance has been noted, in the subgroups that exceed the medians of these markers, a significant increase in neutrophil and lymphocyte count without any variation of the NLR. Effecting the same evaluation for the MMP/TIMP pattern we observed, instead, that the same subgroups tend to show a decrease in MMP-2 and an increase in MMP-9. No difference instead for TIMP-1 and TIMP-2. The abnormality of the MMP/TIMP pattern, bearing in mind the cardiometabolic clustering present in this cohort of ACA subjects, would induce to use drugs able not only to cure the cardiometabolic risk factors but also to influence the MMP/TIMP profile.
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Affiliation(s)
- Gregorio Caimi
- Department of Health Promotion and Child Care, Internal Medicine and Medical Specialties, Università degli Studi di Palermo, Palermo, Italy,Corresponding author: Gregorio Caimi, Via Leonardo Da Vinci, 52, 90145, Palermo, Italy. E-mails: ;
| | - C. Urso
- Fondazione Istituto “G. Giglio” Cefalù, Palermo, Italy
| | - S. Brucculeri
- Fondazione Istituto “G. Giglio” Cefalù, Palermo, Italy
| | - C. Amato
- Department of Health Promotion and Child Care, Internal Medicine and Medical Specialties, Università degli Studi di Palermo, Palermo, Italy
| | - R. Lo Presti
- Department of Psychology, Educational Science and Human Movement, Università degli Studi di Palermo, Palermo, Italy
| | - M. Carlisi
- Department of Health Promotion and Child Care, Internal Medicine and Medical Specialties, Università degli Studi di Palermo, Palermo, Italy
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12
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Yazaki LG, Faria JCP, de Souza FIS, Sarni ROS. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios of overweight children and adolescents. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2022; 68:1006-1010. [PMID: 36134828 PMCID: PMC9574978 DOI: 10.1590/1806-9282.20211253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/02/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study aimed to compare neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio of overweight children and adolescents with the eutrophic ratios and to verify whether these ratios are associated with age, inflammation, Z-score of body mass index, and waist-to-height ratio. METHODS This is a cross-sectional study involving 64 overweight and 106 eutrophic children and adolescents. Data on weight, height, and waist circumference (body mass index and waist-to-height ratio), blood count (neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio), and high-sensitivity C-reactive protein were collected. RESULTS The mean age of participants was 8.4±3.2 years. The ratios did not differ between the overweight and non-overweight groups. The platelet-to-lymphocyte ratio has shown a direct and independent association with body mass index (p=0.031) and waist-to-height ratio (p=0.018), a fact not observed for neutrophil-to-lymphocyte ratio. The ultrasensitive C-reactive protein level was higher in the obesity group (p=0.003). Both ratios had a direct and independent association with age. CONCLUSION The ratios did not differ between the overweight and non-overweight groups. There was a direct and independent association of platelet-to-lymphocyte ratio with overweight, not observed in neutrophil-to-lymphocyte ratio. The ratios have significantly increased according to the age of the participants.
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Affiliation(s)
| | - João Carlos Pina Faria
- Universidade Nove de Julho, Centro Universitário Faculdade de Medicina do ABC, Pediatrician and Pediatric Hematologist – São Paulo (SP), Brazil
- Corresponding author:
| | - Fabíola Isabel Suano de Souza
- Universidade Federal de São Paulo, Centro Universitário Faculdade de Medicina do ABC, Pediatrician and Pediatric Nutrologist – São Paulo (SP), Brazil
| | - Roseli Oselka Saccardo Sarni
- Universidade Federal de São Paulo, Centro Universitário Faculdade de Medicina do ABC, Pediatrician and Pediatric Nutrologist – São Paulo (SP), Brazil
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13
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Sanchez-Autet M, Arranz B, Sierra P, Safont G, Garcia-Blanco A, de la Fuente L, Garriga M, Marín L, García-Portilla MP. Association between neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and C-reactive protein levels and metabolic status in patients with a bipolar disorder. World J Biol Psychiatry 2022; 23:464-474. [PMID: 34856870 DOI: 10.1080/15622975.2021.2013089] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and C-Reactive Protein (CRP) are markers of inflammation that are elevated in bipolar disorder (BD) and are also related to a higher risk of metabolic syndrome (MetS). This study aimed at investigating for the first time the association between NLR, PLR, and CRP and the metabolic status in BD. METHODS We assessed the association between biomarkers and the metabolic status: number of metabolic risk factors, presence of MetS, insulin sensitivity (Quantitative Insulin Sensitivity Check Index, QUICKI) and insulin resistance (Homeostatic Model Assessment for Insulin Resistance, HOMA-IR index), in a sample of 219 outpatients with BD. RESULTS 25.9% of the sample met the criteria for MetS. High levels of CRP were found in 12% of the sample. Older age, low PLR, high NLR, and high CRP levels significantly predicted a higher number of MetS risk factors (p < 0.001). Older age and low PLR were associated with a greater likelihood of developing MetS (p = 0.007). CONCLUSIONS Although further studies are needed to replicate and validate these findings, inflammatory biomarkers as CRP, PLR and NLR could be useful tools to identify patients with a BD at risk for a metabolic adverse outcome.
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Affiliation(s)
| | - Belén Arranz
- Parc Sanitari Sant Joan de Deu, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Pilar Sierra
- Department of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain.,Department of Medicine, University of Valencia, Valencia, Spain
| | - Gemma Safont
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Hospital Universitari Mutua Terrassa, Barcelona, Spain
| | - Ana Garcia-Blanco
- Neonatal Research Unit, La Fe Health Research Institute, Valencia, Spain
| | - Lorena de la Fuente
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Psychiatry, University of Oviedo, Oviedo, Spain
| | - Marina Garriga
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Bipolar Disorder Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Lorena Marín
- Hospital Universitari Mutua Terrassa, Barcelona, Spain
| | - Maria Paz García-Portilla
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Psychiatry, University of Oviedo, Oviedo, Spain
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14
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Christakoudi S, Riboli E, Evangelou E, Tsilidis KK. Associations of body shape index (ABSI) and hip index with liver, metabolic, and inflammatory biomarkers in the UK Biobank cohort. Sci Rep 2022; 12:8812. [PMID: 35614088 PMCID: PMC9133113 DOI: 10.1038/s41598-022-12284-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 05/05/2022] [Indexed: 12/13/2022] Open
Abstract
Associations of liver, metabolic, and inflammatory biomarkers in blood with body shape are unclear, because waist circumference (WC) and hip circumference (HC) are dependent on overall body size, resulting in bias. We have used the allometric "a body shape index" (ABSI = WC(mm)[Formula: see text]Weight(kg)-2/3[Formula: see text]Height(m)5/6) and hip index (HIwomen = HC(cm)[Formula: see text]Weight(kg)-0.482[Formula: see text]Height(cm)0.310, HImen = HC(cm)[Formula: see text]Weight(kg)-2/5[Formula: see text]Height(cm)1/5), which are independent of body mass index (BMI) by design, in multivariable linear regression models for 121,879 UK Biobank men and 135,559 women. Glucose, glycated haemoglobin (HbA1c), triglycerides, low-density-lipoprotein cholesterol, apolipoprotein-B, alanine aminotransferase (ALT), gamma-glutamyltransferase, and lymphocytes were associated positively with BMI and ABSI but inversely with HI. High-density-lipoprotein cholesterol and apolipoprotein-A1 were associated inversely with BMI and ABSI but positively with HI. Lipid-related biomarkers and ALT were associated only with HI in obese men. C-reactive protein, neutrophils, monocytes, and alkaline phosphatase were associated positively, while bilirubin was associated inversely, with BMI and ABSI but not with HI. Associations were consistent within the clinical reference ranges but were lost or changed direction for low or high biomarker levels. Our study confirms associations with waist and hip size, independent of BMI, for metabolic biomarkers but only with waist size for inflammatory biomarkers, suggesting different contribution of the mechanistic pathways related to body shape.
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Affiliation(s)
- Sofia Christakoudi
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk place, London, W2 1PG, UK. .,Department of Inflammation Biology, School of Immunology and Microbial Sciences, King's College London, London, UK.
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk place, London, W2 1PG, UK
| | - Evangelos Evangelou
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk place, London, W2 1PG, UK.,Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk place, London, W2 1PG, UK.,Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
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15
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Kriplani A, Pandit S, Chawla A, de la Rosette JJMCH, Laguna P, Jayadeva Reddy S, Somani BK. Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) in predicting systemic inflammatory response syndrome (SIRS) and sepsis after percutaneous nephrolithotomy (PNL). Urolithiasis 2022; 50:341-348. [PMID: 35246692 PMCID: PMC9110452 DOI: 10.1007/s00240-022-01319-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 02/15/2022] [Indexed: 11/16/2022]
Abstract
The objective of this prospective observational study was to assess the clinical significance of neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR) and lymphocyte–monocyte ratio (LMR) as potential biomarkers to identify post-PNL SIRS or sepsis. Demographic data and laboratory data including hemoglobin (Hb), total leucocyte count (TLC), serum creatinine, urine microscopy and culture were collected. The NLR, LMR and PLR were calculated by the mathematical division of their absolute values derived from routine complete blood counts from peripheral blood samples. Stone factors were assessed by non-contrast computerized tomography of kidneys, ureter and bladder (NCCT KUB) and included stone burden (Volume = L × W × D × π × 0.167), location and Hounsfield value and laterality. Intraoperative factors assessed were puncture site, tract size, tract number, operative time, the need for blood transfusion and stone clearance. Of 517 patients evaluated, 56 (10.8%) developed SIRS and 8 (1.5%) developed sepsis. Patients developing SIRS had significantly higher TLC (10.4 ± 3.5 vs 8.6 ± 2.6, OR 1.19, 95% CI 1.09–1.3, p = 0.000002), higher NLR (3.6 ± 2.4 vs 2.5 ± 1.04, OR 1.3, 95% CI = 1.09–1.5, p = 0.0000001), higher PLR (129.3 ± 53.8 vs 115.4 ± 68.9, OR 1.005, 95% CI 1.001–1.008, p = 0.005) and lower LMR (2.5 ± 1.7 vs 3.2 ± 1.8, OR 1.18, 95% CI 1.04–1.34, p = 0.006). Staghorn stones (12.8 vs 3.24%, OR 4.361, 95% CI 1.605–11.846, p = 0.008) and long operative times (59.6 ± 14.01 vs 55.2 ± 16.02, OR 1.01, 95% CI 1.00–1.03, p = 0.05) had significant association with postoperative SIRS. In conclusion, NLR, PLR and LMR can be useful independent, easily accessible and cost-effective predictors for early identification of post-PNL SIRS/sepsis.
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Affiliation(s)
- Akshay Kriplani
- Department of Urology and Renal Transplant, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka India
| | - Shruti Pandit
- Department of Urology and Renal Transplant, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka India
| | - Arun Chawla
- Department of Urology and Renal Transplant, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka India
| | | | - Pilar Laguna
- Istanbul Medipol Mega University Hospital, Istanbul, Turkey
| | - Suraj Jayadeva Reddy
- Department of Urology and Renal Transplant, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka India
| | - Bhaskar K. Somani
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK
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16
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Işık AC, Kavas M, Boǧa S, Karagöz A, Kocabay G, Sen N. Are inflammatory and malnutrition markers associated with metabolic syndrome in patients with sarcoidosis? Rev Assoc Med Bras (1992) 2021; 67:1779-1784. [PMID: 34909949 DOI: 10.1590/1806-9282.20210689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 09/22/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The study aimed to investigate the use of Neutrophil/lymphocyte ratio, C-reactive protein/albumin ratio, controlling nutritional status, and prognostic nutritional index immune, inflammatory, and malnutrition markers Metabolic syndrome+ in sarcoidosis patients, as an early-stage marker. METHOD This is a single-center and cross-sectional study that determines the association of Metabolic syndrome in patients with sarcoidosis. Patients were evaluated based on the National Cholesterol Education Program's Adult Treatment Panel III criteria. Neutrophil/lymphocyte ratio, C-reactive protein/albumin ratio, controlling nutritional status, and prognostic nutritional index values were simultaneously determined through blood test. RESULTS A total of 253 patients diagnosed with sarcoidosis were included in this study. Metabolic syndrome- was detected in 37.2% of patients. The prevalence was significantly higher in females (p<0.001). Any degree of malnutrition assessed by controlling nutritional status had higher Metabolic syndrome (p=0.035). The Neutrophil/lymphocyte ratio cutoff value was 2.24, sensitivity was 70.53, specificity was 60.13, and Area Under the Curve value was 0.663 for predicting Metabolic syndrome in sarcoidosis patients. CONCLUSION Neutrophil/lymphocyte ratio and controlling nutritional status are associated with the Metabolic syndrome+ in sarcoidosis patients. Thus, close monitoring of Neutrophil/lymphocyte ratio and controlling nutritional status increase in terms of Metabolic syndrome and immune malnutrition may be important in sarcoidosis patients.
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Affiliation(s)
- Arzu Cennet Işık
- University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, Internal Medicine Department - Istanbul, Turkey
| | - Murat Kavas
- University of Health Sciences, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pulmonology - Istanbul, Turkey
| | - Sibel Boǧa
- University of Health Sciences, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pulmonology - Istanbul, Turkey
| | - Ali Karagöz
- University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, Internal Medicine Department - Istanbul, Turkey
| | - Gönenç Kocabay
- University of Health Sciences, Kartal Koşuyolu Training and Research Hospital, Department of Cardiology - Istanbul, Turkey
| | - Nesrin Sen
- University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, Department of Rheumatology - Istanbul, Turkey
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17
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Hashemi Moghanjoughi P, Neshat S, Rezaei A, Heshmat-Ghahdarijani K. Is the Neutrophil-to-lymphocyte ratio an exceptional indicator for metabolic syndrome disease and outcomes? Endocr Pract 2021; 28:342-348. [PMID: 34838762 DOI: 10.1016/j.eprac.2021.11.083] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 11/09/2021] [Accepted: 11/17/2021] [Indexed: 12/11/2022]
Abstract
Metabolic syndrome is a syndrome compromised of elevated fasting blood glucose, increased blood pressure, central obesity, decreased high density lipoprotein, and increased triglyceride levels. Because of its growing incidence and prevalence, and the effect that it has on developing other non-communicable disease, the importance gets even more value. Prediction and control of this disease in early stages and in the cheapest way, is a crucial need these days. Due to role of chronic low-grade inflammation in metabolic syndrome, cytokines and inflammatory factors like interleukin-6 and Tumor necrosis factor-a have a critical effect on this phenomenon. Neutrophil to lymphocyte (NLR) ratio is an inflammatory marker that has an unchallenging availability, and has a reasonable price. NLR has a relation with obesity, type 2 diabetes, hypertension (HTN), blood cholesterol levels. This states that there should be a relation between NLR and metabolic syndrome. NLR as a low-grade inflammation marker indicates a positive relationship with central obesity. Also, studies indicate that diabetes' incidence, its severity, and its control contribute a relation with NLR. Hypertension, and hyperlipidemia, both can be noticed with higher NLRs. In this rapid review we are going to assess the association between metabolic syndrome and NLR.
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Affiliation(s)
| | - Sina Neshat
- M.D., School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abbas Rezaei
- M.D., School of Medicine, Boushehr University of Medical Sciences, Boushehr, Iran
| | - Kiyan Heshmat-Ghahdarijani
- M.D., Assistant Professor, Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
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18
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Onguc Aycan I, Taseli YC, Temel H, Dinc B, Coskunfirat N, Sanli S. Magnetic Resonance Imaging under Sedation in Pediatric Patients: A Single-Institution Experience. JOURNAL OF CHILD SCIENCE 2021. [DOI: 10.1055/s-0041-1731335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AbstractMagnetic resonance imaging (MRI) scans for children are a challenge for anesthesiologists since the child must be sedated enough to stand still. But anesthetic drugs used for sedation might have serious side effects and monitorization resources and accessibility to the patient during MRI scan is limited. We retrospectively examined 977 pediatric patients' files who had MRI scans in our hospital. We observed that children received one of the four combinations of anesthetic drugs: group 1 received midazolam, propofol, and ketamine; group 2 received midazolam and ketamine; group 3 received midazolam and thiopental; and group 4 received midazolam and propofol combination for sedation. The patients in group 1 had significantly higher vomiting rates than the patients in group 4 (p = 0.005). We observed bronchospasm in patients in group 1 (p = 0.006) and group 3 (p = 0.001), more than in patients in group 4. Nausea and vomiting ratios were lower in group 4. In patients with nausea and vomiting within a week after the procedure, statistically significant lower neutrophil–lymphocyte ratio values (p = 0.012) were observed. All four anesthetic combinations used in the trial provided safe anesthesia for the children, during the MRI scan. The anesthetic choice must be made according to the procedure time and patient's comorbidities. In this trial, we observed minimum side effects with midazolam and propofol combination.
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Affiliation(s)
- Ilker Onguc Aycan
- Department of Anesthesiology and Reanimation, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Yesim Cetintas Taseli
- Department of Anesthesiology and Reanimation, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Hakan Temel
- Department of Anesthesiology and Reanimation, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Bora Dinc
- Department of Anesthesiology and Reanimation, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Nesil Coskunfirat
- Department of Anesthesiology and Reanimation, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Suat Sanli
- Department of Anesthesiology and Reanimation, Akdeniz University Medical Faculty, Antalya, Turkey
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Jeong SY, Shim HY, Lee YJ, Park B. Association between Copper-Zinc Ratio in Hair and Neutrophil-Lymphocyte Ratio within the Context of a Normal White Blood Cell Count among Overweight or Obese Korean Individuals: A Pilot Study. Korean J Fam Med 2021; 42:240-244. [PMID: 32545948 PMCID: PMC8164926 DOI: 10.4082/kjfm.20.0018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 04/16/2020] [Accepted: 04/25/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Obesity is considered a state of enhanced oxidative stress as well as chronic and low-grade inflammation. The copper-zinc ratio in obese individuals has been reported to reflect systemic oxidative stress and inflammatory status. We investigated whether the neutrophil-lymphocyte ratio is related to the copper-zinc ratio in hair, within the context of a normal white blood cell count among overweight or obese Korean individuals. METHODS We included 56 participants aged older than 20 years who voluntarily sought weight reduction treatment and met the inclusion criterion of body mass index of 23 kg/m2 or greater. Intra-abdominal visceral adipose tissue was measured by computed tomography imaging, while the copper and zinc levels were measured by hair mineral analysis. Using multiple linear regression analysis, we examined the associations between the neutrophil-lymphocyte ratio and the copper-zinc ratio. RESULTS The mean age, body mass index, and visceral adipose tissue were 46.0±10.5 years, 29.0±4.1 kg/cm2 , and 142.9±68.8 cm2 , respectively. Pearson's correlation analysis revealed the association of the neutrophil-lymphocyte ratio with copper level (r=0.475, P<0.001) and copper-zinc ratio (r=0.494, P<0.001). After adjusting for confounding variables, we found the neutrophil-lymphocyte ratio was significantly associated with the level of copper and the copper-zinc ratio in hair (regression coefficient: 0.055±0.015; P<0.001 and regression coefficient: 0.761±0.185; P<0.001, respectively). CONCLUSION A higher copper-zinc ratio in hair is positively and independently associated with the neutrophil-lymphocyte ratio. Thus, a high hair copper-zinc ratio could be a useful parameter for oxidative burden of individuals predisposed to obesity-related comorbidity.
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Affiliation(s)
- Sun Young Jeong
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyo Young Shim
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Jae Lee
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Byoungjin Park
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea
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20
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Seeking New Parameters In Differentiating Child Tuberculosis From Community Acquired Pneumonia- Is It Possible?”. JOURNAL OF CONTEMPORARY MEDICINE 2021. [DOI: 10.16899/jcm.823844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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21
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Neutrophil-to-Lymphocyte Ratio as a Cardiovascular Risk Marker May Be Less Efficient in Women Than in Men. Biomolecules 2021; 11:biom11040528. [PMID: 33918155 PMCID: PMC8066649 DOI: 10.3390/biom11040528] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/22/2021] [Accepted: 03/30/2021] [Indexed: 12/21/2022] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death in women, although traditionally, it has been considered as a male dominated disease. Chronic inflammation plays a crucial role in the development of insulin resistance, diabetes type 2 and CVD. Since studies on women were scarce, in order to improve diagnosis and treatment of CVD, there is a need to improve understanding of the role of inflammation in the development of CVD in women. The neutrophil-to-lymphocyte ratio (NLR) is an inexpensive and widely available marker of inflammation, and has been studied in cardio-metabolic disorders. There is a paucity of data on sex specific differences in the lifetime course of NLR. Men and women differ to each other in sex hormones and characteristics of immune reaction and the expression of CVD. These factors can determine NLR values and their variations along the life course. In particular, menopause in women is a period associated with profound physiological and hormonal changes, and is coincidental with aging. An emergence of CV risk factors with aging, and age-related changes in the immune system, are factors that are associated with an increase in prevalence of CVD in both sexes. The aim of this review is to comprehend the available evidence on this issue, and to discuss sex specific differences in the lifetime course of NLR in the light of immune and inflammation mechanisms.
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22
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Inflammation-Related Markers and Thyroid Function Measures in Pediatric Patients: Is the Grade of Obesity Relevant? Diagnostics (Basel) 2021; 11:diagnostics11030485. [PMID: 33803348 PMCID: PMC7999014 DOI: 10.3390/diagnostics11030485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 02/19/2021] [Accepted: 03/05/2021] [Indexed: 01/28/2023] Open
Abstract
We aimed to investigate the effect of weight status on inflammation-related markers and thyroid function tests in overweight and obese pediatric patients. Children and adolescents diagnosed between January 2017 and January 2019 with overweight or obesity were included in the study. Neutrophil-to-lymphocyte ratio (NLR), platelet-to lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) were calculated for the groups defined according to Body Mass Index (BMI)-for-age z-score: overweight (≥1 BMI-for-age z-score), obese (≥2 BMI-for-age z-score) and severely obese (≥3 BMI-for-age z-score). Severely obese patients had significantly higher value of white blood cells (WBC) counts (median = 7.92) compared with overweight patients (7.37, p = 0.014). Absolute lymphocyte count was significantly associated with obesity degree in children (Spearman’s Rho coefficient ρ = 0.228. p = 0.035), whereas absolute polymorphonuclear neutrophils (PMNCs) count was significantly higher in severely obese adolescents than overweight adolescents (overweight: 4.04 vs. severely obese: 5.3 (p = 0.029)). In 8.19% of patients an elevated thyroid-stimulating hormone (TSH) level was found, and 3.36% of patients had a low level of free thyroxine with an elevated level of TSH. Total absolute WBC count may be a reliable inflammation-related marker in obese pediatric patients without metabolic syndrome, but needs to be validated in the context of all possible covariates. Subclinical and overt hypothyroidism may develop from an early age in overweight or obese patients.
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Alves da Silva R, Bersch-Ferreira ÂC, Gehringer MO, Ross-Fernandes MB, Kovacs do Amaral C, Lin Wang HT, Lima PH, de Lima PA, França JÍ, Weber B, Magnoni CD, Rogero MM. Effect of qualitative and quantitative nutritional plan on gene expression in obese patients in secondary prevention for cardiovascular disease. Clin Nutr ESPEN 2021; 41:351-359. [PMID: 33487289 DOI: 10.1016/j.clnesp.2020.11.002] [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: 04/21/2020] [Revised: 10/29/2020] [Accepted: 11/01/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND & AIMS Diet is a modifiable risk factor, which may influence the gene expression and the concentration of inflammatory biomarkers related to obesity and atherosclerosis. In this substudy from Brazilian Cardioprotective Nutritional (BALANCE) Program, we hypothesized that a nutritional intervention based on the usual Brazilian diet modulates the expression of genes involved with atherosclerosis and inflammatory biomarkers in male patients, in the secondary prevention for cardiovascular disease. METHODS Six male patients, aged 45 years or older, obese, were selected to follow a qualitative-quantitative food plan for 6 months. Glycemia, insulinemia, lipid profile, plasma concentration of inflammatory biomarkers (interleukin (IL) -1β), IL-6, IL-8, IL-10, IL-12, tumor necrosis factor alpha, C-reactive protein and adiponectin, and expression of 84 atherosclerosis-related genes in total peripheral blood cells, were measured. RESULTS After nutritional intervention, the participants reduced weight (p < 0.04), waist circumference (p < 0.04), Homeostasis Model Assessment index for insulin resistance (p = 0.046) and overall leukocyte count (p = 0.046) and neutrophils (p = 0.028). There was no significant modification in the plasma concentration of the inflammatory biomarkers, however, there was a significant increase in the expression of Apo A1 (p = 0.011), ELN (p = 0.017) and IL4 (p = 0.037) genes. CONCLUSIONS The BALANCE Program, the qualitative-quantitative food plan composed of Brazilian usual foods, did not reduce the concentration of inflammatory biomarkers, but increased in total peripheral blood cells the expression of genes involved in reducing the risk of cardiometabolic in obese patients, in secondary prevention for cardiovascular disease. The clinical trial is registered at https://clinicaltrials.gov/ and the unique identifier is NCT01620398.
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Affiliation(s)
- Renata Alves da Silva
- Department of Clinical Nutrition, Instituto Dante Pazzanese de Cardiologia, 04012-090, São Paulo, SP, Brazil.
| | | | - Marcella Omena Gehringer
- Nutritional Genomics and Inflammation Laboratory, Department of Nutrition, School of Public Health, University of São Paulo, 01246-904, São Paulo, Brazil.
| | - Maria Beatriz Ross-Fernandes
- Nutritional Genomics and Inflammation Laboratory, Department of Nutrition, School of Public Health, University of São Paulo, 01246-904, São Paulo, Brazil.
| | - Cristiane Kovacs do Amaral
- Department of Clinical Nutrition, Instituto Dante Pazzanese de Cardiologia, 04012-090, São Paulo, SP, Brazil.
| | - Hui-Tzu Lin Wang
- Department of Clinical Nutrition, Instituto Dante Pazzanese de Cardiologia, 04012-090, São Paulo, SP, Brazil.
| | - Paula Helena Lima
- Department of Clinical Nutrition, Instituto Dante Pazzanese de Cardiologia, 04012-090, São Paulo, SP, Brazil.
| | - Patrícia Azevedo de Lima
- Nutritional Genomics and Inflammation Laboratory, Department of Nutrition, School of Public Health, University of São Paulo, 01246-904, São Paulo, Brazil.
| | - João Ítalo França
- Department of Clinical Nutrition, Instituto Dante Pazzanese de Cardiologia, 04012-090, São Paulo, SP, Brazil.
| | - Bernardete Weber
- Research Institute - Hospital do Coração, 04005-000, São Paulo, SP, Brazil.
| | - Carlos Daniel Magnoni
- Department of Clinical Nutrition, Instituto Dante Pazzanese de Cardiologia, 04012-090, São Paulo, SP, Brazil.
| | - Marcelo Macedo Rogero
- Nutritional Genomics and Inflammation Laboratory, Department of Nutrition, School of Public Health, University of São Paulo, 01246-904, São Paulo, Brazil.
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Shin G, Jang K, Kim M, Lee JH, Yoo HJ. Inflammatory Markers and Plasma Fatty Acids in Predicting WBC Level Alterations in Association With Glucose-Related Markers: A Cross-Sectional Study. Front Immunol 2020; 11:629. [PMID: 32346379 PMCID: PMC7172801 DOI: 10.3389/fimmu.2020.00629] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 03/19/2020] [Indexed: 12/26/2022] Open
Abstract
Aging leads to immune function changes which contribute to occurrence of chronic conditions. White blood cell (WBC) level is a marker widely known to reflect the immune function, thus, prediction of WBC level changes by using certain biomarkers is needed to prevent chronic conditions and to decrease the burdens of aging. In this respect, the present study aimed to explore the relationships between inflammatory markers and plasma fatty acid (FA) composition according to WBC levels for verifying potential predictors of WBC levels. Study subjects were divided into three groups according to their WBC count: moderate-low WBC (MLW), normal WBC, and moderate-high WBC (MHW). Inflammatory markers were measured, and plasma FA profiles were constructed via gas chromatography-mass spectrometry (GC-MS). In the MHW group, insulin, homeostatic model assessment of insulin resistance (HOMA-IR), γ-glutamyltransferase (GGT), high-sensitivity C-reactive protein (hs-CRP), and interferon (IFN)-γ showed significant increases compared to those in the other groups. In addition, the granulocyte-to-lymphocyte ratio (GLR) significantly increased according to the WBC levels, whereas the platelet-to-lymphocyte ratio (PLR) showed the opposite result. Total ω-3 polyunsaturated fatty acids (PUFAs) showed significant differences among the groups. Regarding ω-6 PUFAs, dihomo-γ-linolenic acid and docosatetraenoic acid levels were significantly increased in the MHW group compared to the other groups. Finally, multivariate linear regression analysis revealed that GGT, hs-CRP, IFN-γ, ω-3 PUFAs, and dihomo-γ-linolenic acid were independent factors for altering WBC levels. In conclusion, elevated WBC levels accompanied by an increased GLR and a decreased PLR were associated with the risk of type 2 diabetes based on increased insulin and HOMA-IR levels and decreased adiponectin levels. Additionally, GGT, hs-CRP, IFN-γ, ω-3 PUFAs, and dihomo-γ-linolenic acid levels emerged as independent biomarkers for predicting WBC level alterations. Therefore, this study showed that these inflammatory markers and plasma FAs not only affect WBC level alterations but also may play roles in the risk of type 2 diabetes as one of the chronic conditions by certain mechanisms, which should be further studied. Finally, checking these biomarkers along with WBC levels can be helpful to prevent the chronic conditions.
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Affiliation(s)
- Gurum Shin
- Department of Food and Nutrition, College of Human Ecology, National Leading Research Laboratory of Clinical Nutrigenetics/Nutrigenomic, Yonsei University, Seoul, South Korea
| | - Kyunghye Jang
- Department of Food and Nutrition, College of Human Ecology, National Leading Research Laboratory of Clinical Nutrigenetics/Nutrigenomic, Yonsei University, Seoul, South Korea
| | - Minjoo Kim
- Department of Food and Nutrition, College of Life Science and Nano Technology, Hannam University, Daejeon, South Korea
| | - Jong Ho Lee
- Department of Food and Nutrition, College of Human Ecology, National Leading Research Laboratory of Clinical Nutrigenetics/Nutrigenomic, Yonsei University, Seoul, South Korea.,Research Center for Silver Science, Institute of Symbiotic Life-TECH, Yonsei University, Seoul, South Korea
| | - Hye Jin Yoo
- Department of Food and Nutrition, College of Human Ecology, National Leading Research Laboratory of Clinical Nutrigenetics/Nutrigenomic, Yonsei University, Seoul, South Korea.,Research Center for Silver Science, Institute of Symbiotic Life-TECH, Yonsei University, Seoul, South Korea
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Chen T, Chen H, Xiao H, Tang H, Xiang Z, Wang X, Wang X, Zou H. Comparison of the Value of Neutrophil to High-Density Lipoprotein Cholesterol Ratio and Lymphocyte to High-Density Lipoprotein Cholesterol Ratio for Predicting Metabolic Syndrome Among a Population in the Southern Coast of China. Diabetes Metab Syndr Obes 2020; 13:597-605. [PMID: 32184639 PMCID: PMC7053653 DOI: 10.2147/dmso.s238990] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 02/15/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND This study aimed to determine the optimal cutoff values and evaluate the associations of neutrophil to high-density lipoprotein cholesterol ratio (NHR) and lymphocyte to high-density lipoprotein cholesterol ratio (LHR) with metabolic syndrome (MetS), stratified by sex. METHODS A large-scale cross-sectional survey was conducted among 1401 adults from January to April 2018 in six communities in Wanzhai Town, Zhuhai City, on the southern coast of China. Receiver operating characteristics (ROC) analyses and logistic regression analysis were conducted to assess the optimal cutoff and value of NHR and LHR for predicting MetS. RESULTS Hematological parameters showed the correlation with the occurrence of MetS (red blood cells, hemoglobin, and white blood cells and subtypes). Binomial logistic regression analysis found that LHR (OR: 3.671; 95% CI: 2.385-5.651; p<0.001) and NHR (OR: 1.728; 95% CI: 1.353-2.207; p<0.001) can predict MetS in females, independent of confounding factors. Although LHR (OR: 1.571; 95% CI: 1.001-2.468; p=0.05) and NHR (OR: 1.163; 95% CI: 0.909-1.48; p<0.01) were independent risk factors for MetS in males after adjustment for age, current smoking, current alcohol use, physical activity, educational attainment, waist circumference, systolic pressure, diastolic pressure and hypersensitive C-reactive protein (hs-CRP), when further adjusted for fasting plasma glucose level, LHR and NHR, both lost their independence. ROC curves showed that LHR had the highest AUC for predicting MetS in females and NHR had the highest AUC in males. The cutoff points of LHR and NHR were 1.36 and 2.31 in females, and 1.96 and 3.38 in males. CONCLUSION LHR and NHR may become valuable makers and have strong predictive power for predicting MetS, especially in females.
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Affiliation(s)
- Tong Chen
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Haishan Chen
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Hua Xiao
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Hongjuan Tang
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Zhicong Xiang
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Xin Wang
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Xuan Wang
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Hequn Zou
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
- Correspondence: Hequn Zou Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China Email
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Abstract
Salusins have emerged as a new biomarker that reflects an increased inflammatory state, which is associated with cardiovascular risk. We investigated the predictive value and usefulness of salusins as an inflammatory biomarker in obese children. This prospective cohort study included 75 obese children and 101 healthy children (as a control group). Salusin-α, Salusin-β, and various cardiovascular parameters were assessed in both groups. Correlation analyses of Salusin-α and Salusin-β with body mass index standard deviation scores and inflammatory and cardiovascular markers were performed. The mean patient age was 11.9±2.4 years for the obese group and 12.5±2.1 years for the control group. The obese children had a significantly higher heart rate, systolic blood pressure, diastolic blood pressure, epicardial adipose tissue thickness, and left ventricular mass than did the children in the control group. There was no significant correlation between Salusin-α and Salusin-β and body mass index; however, there was a negative correlation between Salusin- α and diastolic blood pressure (r = 0.277, p = 0.004). Overall, there was no significant difference in the Salusin-α and Salusin-β levels between obese and healthy children. However, a negative correlation was found between Salusin-α and diastolic blood pressure. Although this result suggests that Salusin-α might be an early marker of cardiovascular involvement in obese children, further studies are needed to demonstrate the predictive value of salusins.
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27
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Liu CC, Ko HJ, Liu WS, Hung CL, Hu KC, Yu LY, Shih SC. Neutrophil-to-lymphocyte ratio as a predictive marker of metabolic syndrome. Medicine (Baltimore) 2019; 98:e17537. [PMID: 31651856 PMCID: PMC6824790 DOI: 10.1097/md.0000000000017537] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Neutrophil-to-lymphocyte ratio (NLR) serves as a strong prognostic indicator for patients suffering from various diseases. Neutrophil activation promotes the recruitment of a number of different cell types that are involved in acute and chronic inflammation and are associated with cancer treatment outcome. Measurement of NLR, an established inflammation marker, is cost-effective, and it is likely that NLR can be used to predict the development of metabolic syndrome (MS) at an early stage. MS scores range from 1 to 5, and an elevated MS score indicates a greater risk for MS. Monitoring NLR can prevent the risk of MS.A total of 34,013 subjects were enrolled in this study. The subjects (score 0-5) within the 6 groups were classified according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria, and all anthropometrics, laboratory biomarkers, and hematological measurements were recorded. For the 6 groups, statistical analysis and receiver operating characteristic (ROC) curves were used to identify the development of MS.Analysis of the ROC curve indicated that NLR served as a good predictor for MS. An MS score of 1 to 2 yielded an acceptable discrimination rate, and these rates were even higher for MS scores of 3 to 5 (P < .001), where the prevalence of MS was 30.8%.NLR can be used as a prognostic marker for several diseases, including those associated with MS.
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Affiliation(s)
- Chuan-Chuan Liu
- The Institute of Health Policy and Management, College of Public Health, National Taiwan University
- Health Evaluation Center, Mackay Memorial Hospital
| | - Hung-Ju Ko
- Health Evaluation Center, Mackay Memorial Hospital
| | - Wan-Shan Liu
- Health Evaluation Center, Mackay Memorial Hospital
| | - Chung-Lieh Hung
- Mackay Medical College
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital
| | - Kuang-Chun Hu
- Health Evaluation Center, Mackay Memorial Hospital
- Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Lo-Yip Yu
- Health Evaluation Center, Mackay Memorial Hospital
- Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital
| | - Shou-Chuan Shih
- Health Evaluation Center, Mackay Memorial Hospital
- Mackay Medical College
- Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital
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28
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Lillycrop KA, Garratt ES, Titcombe P, Melton PE, Murray RJS, Barton SJ, Clarke-Harris R, Costello PM, Holbrook JD, Hopkins JC, Childs CE, Paras-Chavez C, Calder PC, Mori TA, Beilin L, Burdge GC, Gluckman PD, Inskip HM, Harvey NC, Hanson MA, Huang RC, Cooper C, Godfrey KM. Differential SLC6A4 methylation: a predictive epigenetic marker of adiposity from birth to adulthood. Int J Obes (Lond) 2019; 43:974-988. [PMID: 30622309 PMCID: PMC6522375 DOI: 10.1038/s41366-018-0254-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 08/21/2018] [Accepted: 08/26/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND The early life environment may influence susceptibility to obesity and metabolic disease in later life through epigenetic processes. SLC6A4 is an important mediator of serotonin bioavailability, and has a key role in energy balance. We tested the hypothesis that methylation of the SLC6A4 gene predicts adiposity across the life course. METHODS DNA methylation at 5 CpGs within the SLC6A4 gene identified from a previous methyl binding domain array was measured by pyrosequencing. We measured DNA methylation in umbilical cord (UC) from children in the Southampton Women's Survey cohort (n = 680), in peripheral blood from adolescents in the Western Australian Pregnancy Cohort Study (n = 812), and in adipose tissue from lean and obese adults from the UK BIOCLAIMS cohort (n = 81). Real-time PCR was performed to assess whether there were corresponding alterations in gene expression in the adipose tissue. RESULTS Lower UC methylation of CpG5 was associated with higher total fat mass at 4 years (p = 0.031), total fat mass at 6-7 years (p = 0.0001) and % fat mass at 6-7 years (p = 0.004). Lower UC methylation of CpG5 was also associated with higher triceps skinfold thickness at birth (p = 0.013), 6 months (p = 0.038), 12 months (p = 0.062), 2 years (p = 0.0003), 3 years (p = 0.00004) and 6-7 years (p = 0.013). Higher maternal pregnancy weight gain (p = 0.046) and lower parity (p = 0.029) were both associated with lower SLC6A4 CpG5 methylation. In adolescents, lower methylation of CpG5 in peripheral blood was associated with greater concurrent measures of adiposity including BMI (p ≤ 0.001), waist circumference (p = 0.011), subcutaneous fat (p ≤ 0.001) and subscapular, abdominal and suprailiac skinfold thicknesses (p = 0.002, p = 0.008, p = 0.004, respectively). In adipose tissue, methylation of both SLC6A4 CpG5 (p = 0.019) and expression of SLC6A4 (p = 0.008) was lower in obese compared with lean adults. CONCLUSIONS These data suggest that altered methylation of CpG loci within SLC6A4 may provide a robust marker of adiposity across the life course.
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Affiliation(s)
- Karen A Lillycrop
- Centre for Biological Sciences, Faculty of Natural and Environmental Sciences, University of Southampton, Southampton, UK.
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - Emma S Garratt
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Academic Unit of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Philip Titcombe
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Phillip E Melton
- Centre for Genetics of Health and Disease, University of Western Australia, Perth, Australia
- Faculty of Health Science, Curtin University, Perth, WA, Australia
| | - Robert J S Murray
- Academic Unit of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Sheila J Barton
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Rebecca Clarke-Harris
- Academic Unit of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Paula M Costello
- Academic Unit of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Joanna D Holbrook
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Academic Unit of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - James C Hopkins
- Academic Unit of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Caroline E Childs
- Academic Unit of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Carolina Paras-Chavez
- Academic Unit of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Philip C Calder
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Academic Unit of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Trevor A Mori
- School of Medicine, University of Western Australia, Perth, WA, Australia
| | - Lawrie Beilin
- School of Medicine, University of Western Australia, Perth, WA, Australia
| | - Graham C Burdge
- Academic Unit of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Peter D Gluckman
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Hazel M Inskip
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Nicholas C Harvey
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Mark A Hanson
- Academic Unit of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Rae-Chi Huang
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Cyrus Cooper
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Keith M Godfrey
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
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Aoyama T, Takano M, Miyamoto M, Yoshikawa T, Kato K, Sakamoto T, Takasaki K, Matsuura H, Soyama H, Hirata J, Suzuki A, Sasa H, Tsuda H, Furuya K. Pretreatment Neutrophil-to-Lymphocyte Ratio Was a Predictor of Lymph Node Metastasis in Endometrial Cancer Patients. Oncology 2019; 96:259-267. [PMID: 30893700 DOI: 10.1159/000497184] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 01/22/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The pretreatment neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) have been reported to be useful as markers for prognostic factors and metastasis in several cancers. The aim of this study was to identify the predictor of lymph node (LN) metastasis by pretreatment NLR and PLR in patients with endometrial cancer. METHODS Medical charts of the patients with endometrial cancers that received primary surgery at our hospital between 2007 and 2013 were retrospectively analyzed. The cutoff value was calculated from the receiver operating characteristics (ROC) curve. Clinicopathological parameters including inflammatory markers were evaluated for LN metastasis using multiple logistic regression analysis. RESULTS Among 197 patients enrolled in the study, LN metastasis was observed in 25 patients (13%). ROC curves demonstrated that the best cutoff value of NLR for predicting LN metastasis was 2.18 and that of PLR was 206. In univariate analysis, several pathological factors, NLR, and PLR were identified as predictors of LN metastasis. In multiple logistic regression analysis, lymphovascular invasion and NLR were found to be significantly correlated with LN metastasis (p = 0.002, 0.039). CONCLUSION A higher pretreatment NLR was identified as a predictor of LN metastasis in endometrial cancers. Although further study is needed to confirm the results, NLR could be a candidate clinical marker for detection of LN metastasis.
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Affiliation(s)
- Tadashi Aoyama
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Masashi Takano
- Department of Clinical Oncology, National Defense Medical College Hospital, Tokorozawa, Japan,
| | - Morikazu Miyamoto
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Tomoyuki Yoshikawa
- Department of Clinical Oncology, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Kento Kato
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Takahiro Sakamoto
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Kazuki Takasaki
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Hiroko Matsuura
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Hiroaki Soyama
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Junko Hirata
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Ayako Suzuki
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Hidenori Sasa
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, Tokorozawa, Japan
| | - Hitoshi Tsuda
- Department of Basic Pathology, National Defense Medical College, Tokorozawa, Japan
| | - Kenichi Furuya
- Department of Obstetrics and Gynecology, National Defense Medical College Hospital, Tokorozawa, Japan
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KARAKAYA S, ALTAY M, KAPLAN EFE F, KARADAĞ İ, ÜNSAL O, BULUR O, ESER M, TANER ERTUĞRUL D. The neutrophil-lymphocyte ratio and its relationship with insulin resistance in obesity. Turk J Med Sci 2019; 49:245-248. [PMID: 30761879 PMCID: PMC7350826 DOI: 10.3906/sag-1804-68] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Background/aim In this study, our aim was to investigate the neutrophil/lymphocyte (N/L) ratio, variations in leukocytes and leukocyte subtypes, and the relationship between N/L ratio and insulin resistance (IR) in obesity. Materials and methods Ninety-six patients and 40 healthy controls were included in this study. Patients’ blood glucose levels, insulin levels, and hemogram parameters upon 8 h of fasting were determined. Body mass index (BMI) and Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) values were calculated. Results Neutrophil numbers were found to be higher among obese patients with IR than among non-IR obese patients. The N/L ratio was, moreover, found to be higher among obese patients with IR when compared to non-IR obese patients. A positive correlation was found between insulin resistance and both neutrophil and WBC counts. Positive correlations were also found between insulin levels and the N/L ratio, WBC counts, and neutrophil counts. Conclusion In our study, leukocyte numbers and subtypes were determined to be higher among obese individuals than among healthy individuals. The N/L ratio was increased significantly only among obese patients with IR. Further studies are needed in order to better demonstrate the relationship between the N/L ratio and IR/inflammation.
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Affiliation(s)
- Serdar KARAKAYA
- Department of Medical Oncology, University of Health Sciences,Dr. A. Yurtaslan Health Administration and Research Center, AnkaraTurkey
- * To whom correspondence should be addressed. E-mail:
| | - Mustafa ALTAY
- Department of Endocrinology and Metabolism, University of Health Sciences,Keçiören Health Administration and Research Center, AnkaraTurkey
| | - Fatma KAPLAN EFE
- Department of Internal Medicine, University of Health Sciences,Keçiören Health Administration and Research Center, AnkaraTurkey
| | - İbrahim KARADAĞ
- Department of Internal Medicine, University of Health Sciences,Keçiören Health Administration and Research Center, AnkaraTurkey
| | - Oktay ÜNSAL
- Department of Internal Medicine, University of Health Sciences,Keçiören Health Administration and Research Center, AnkaraTurkey
| | - Oktay BULUR
- Department of Internal Medicine, University of Health Sciences,Keçiören Health Administration and Research Center, AnkaraTurkey
| | - Murat ESER
- Department of Internal Medicine, University of Health Sciences,Keçiören Health Administration and Research Center, AnkaraTurkey
| | - Derun TANER ERTUĞRUL
- Department of Endocrinology and Metabolism, University of Health Sciences,Keçiören Health Administration and Research Center, AnkaraTurkey
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31
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Mărginean CO, Meliţ LE, Ghiga DV, Mărginean MO. Early Inflammatory Status Related to Pediatric Obesity. Front Pediatr 2019; 7:241. [PMID: 31275906 PMCID: PMC6591428 DOI: 10.3389/fped.2019.00241] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 05/28/2019] [Indexed: 01/04/2023] Open
Abstract
Background: Obese individuals are often in a chronic inflammatory condition due to the malfunction of immune-related activities in the adipose tissue, involving a transient infiltration of neutrophils within the abdominal fat and their binding to adipocytes. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are considered cost-effective markers for the detection of subclinical inflammation. Our study intends to assess the early stages of inflammation associated with overweight and obesity in children. Materials and Methods: We performed a prospective study with 164 children, aged between 5 and 18 years, admitted to a Pediatric Tertiary Hospital in Romania between January 2018 and January 2019. The patients were divided according to body mass index (BMI) into two groups: Group 1: 77 overweight and obese children (BMI percentile ≥85), and Group 2: 87 children with a normal BMI, in order to evaluate the correlation between BMI and laboratory parameters (CBC, ESR, transaminase, total protein, albumin, and blood glucose levels), inflammatory biomarkers, NLR and PLR, and changes in abdominal ultrasound findings. Results: We found that the leukocyte, lymphocyte, erythrocyte, platelet, CRP, and transaminase levels were significantly higher in the overweight/obese group (p = 0.0379, p = 0.0002, p = 0.0003, p = 0.0006, p < 0.0001, p = 0.0332, and p < 0.0001, respectively). No significant statistical differences between the two groups in terms of neutrophil, hemoglobin, albumin, total protein, and glycemia levels were noted (p > 0.05). Moreover, NLR and PLR did not differ significantly between the two groups (p = 0.4674 and p = 0.9973, respectively). Conclusions: Obesity is associated with systemic low-grade inflammation which is reaching alarming rates worldwide among both children and adults. Our study proved that leukocyte, lymphocyte, erythrocyte, and platelet levels are significantly higher in overweight/obese children, emphasizing the inflammatory status related to this condition. Therefore, obesity-related studies involving pediatric patients are of major interest in order to develop appropriate methods to prevent the development of further complications in adulthood.
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Affiliation(s)
- Cristina Oana Mărginean
- Department of Pediatrics, University of Medicine, Pharmacy, Sciences, and Technology, Târgu Mureş, Romania
| | - Lorena Elena Meliţ
- Department of Pediatrics, University of Medicine, Pharmacy, Sciences, and Technology, Târgu Mureş, Romania
| | - Dana Valentina Ghiga
- Department of Medical Informatics and Biostatistics, University of Medicine, Pharmacy, Sciences and Technology, Târgu Mureş, Romania
| | - Maria Oana Mărginean
- Department of Pediatric Cardiology, University of Medicine, Pharmacy, Sciences and Technology, Târgu Mureş, Romania
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Abdel-Moneim A, Mahmoud B, Sultan EA, Mahmoud R. Relationship of leukocytes, platelet indices and adipocytokines in metabolic syndrome patients. Diabetes Metab Syndr 2019; 13:874-880. [PMID: 30641824 DOI: 10.1016/j.dsx.2018.12.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 12/19/2018] [Indexed: 12/14/2022]
Abstract
AIMS The current study aimed to explore the correlation between leukocytes and platelets indices with adipocytokines (leptin and adiponectin) and MetS components. METHODS A total of 100 healthy subjects and 200 patients diagnosed with different MetS components were enrolled in the study. Eligible patients were allocated into four groups (50 patients). Group1 include patients with 2 criteria of MetS components, group 2 with 3 criteria, group 3 with 4 criteria and group 4 had patients with 5 criteria. RESULTS Regarding white blood cell indices, data showed that total leukocyte and neutrophil count as well as neutrophil/lymphocyte (N/L) ratio were significantly increased in all groups of MetS patients when compared to the healthy group. Additionally, platelets count, platelet distribution width (PDW), and main platelet volume (MPV) levels and platelets/lymphocyte (P/L) ratio were significantly higher in all patients with MetS as compared to the healthy subjects. Serum leptin concentration and leptin-to-adiponectin ratio (LAR) were elevated significantly, while adiponectin level was significantly diminished in all MetS groups when compared to the control. CONCLUSION leukocytes and platelets indices were associated with hyperleptinemia and hypoadiponectinemia as well as MetS components. The study also suggested the necessary role of leukocytes, platelet indices, and LAR as markers in early diagnoses of individuals with MetS components.
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Affiliation(s)
- Adel Abdel-Moneim
- Physiology Division, Zoology Department, Faculty of Science, Beni-Suef University, Egypt.
| | - Basant Mahmoud
- Biochemistry Division, Chemistry Department, Faculty of Science, Beni-Suef University, Egypt
| | - Eman A Sultan
- Endocrinology and Metabolism Department, National Nutrition Institute, Cairo, Egypt
| | - Rania Mahmoud
- Biochemistry Division, Chemistry Department, Faculty of Science, Beni-Suef University, Egypt
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Syauqy A, Hsu CY, Rau HH, Chao JCJ. Association of dietary patterns, anthropometric measurements, and metabolic parameters with C-reactive protein and neutrophil-to-lymphocyte ratio in middle-aged and older adults with metabolic syndrome in Taiwan: a cross-sectional study. Nutr J 2018; 17:106. [PMID: 30454030 PMCID: PMC6240947 DOI: 10.1186/s12937-018-0417-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 10/29/2018] [Indexed: 12/27/2022] Open
Abstract
Background Metabolic syndrome is commonly associated with inflammation. The underlying factors of inflammation in metabolic syndrome are not fully understood. The objective of the study was to determine the association of dietary patterns, anthropometric measurements, and metabolic parameters with inflammatory markers in middle-aged and older adults with metabolic syndrome in Taiwan. Methods A total of 26,016 subjects aged ≥35 y with metabolic syndrome were recruited from Mei Jau institution between 2004 and 2013 for a cross sectional study. Metabolic syndrome was defined by the International Diabetes Federation. Multivariate logistic regression was performed to evaluate the association of dietary patterns, anthropometric measurements, and metabolic parameters with C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR) in men and women with metabolic syndrome. Crude and adjusted models were analyzed by gender. Results The western dietary pattern, obesity, high body fat, high waist or hip circumference, and high waist-to-hip ratio were significantly associated with increased odds ratios of high CRP and NLR in both genders. High systolic or diastolic blood pressure (BP), low high-density lipoprotein-cholesterol (HDL-C), high low-density lipoprotein-cholesterol (LDL-C), high total cholesterol (TC), high serum triglycerides (TG), and high fasting blood glucose (FBG) were significantly correlated with increased odds ratios of high CRP in both genders. Low HDL-C, high LDL-C, high serum TG, and high FBG were significantly associated with increased odds ratios of high NLR in both genders. However, high systolic (OR = 1.124, 95% CI 1.047–1.206, P < 0.01) or diastolic BP (OR = 1.176, 95% CI 1.087–1.273, P < 0.001) and high TC (OR = 1.138, 95% CI 1.062–1.220, P < 0.001) were significantly correlated with increased odds ratios of high NLR only in men. Conclusions The western dietary pattern, obese-related anthropometric parameters, and most components of metabolic syndrome are positively associated with CRP levels and NLR in men and women with metabolic syndrome.
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Affiliation(s)
- Ahmad Syauqy
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 110, Taiwan.,Department of Nutrition Science, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
| | - Chien-Yeh Hsu
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.,Master Program in Global Health and Development, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | | | - Jane C-J Chao
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 110, Taiwan. .,Master Program in Global Health and Development, College of Public Health, Taipei Medical University, Taipei, Taiwan. .,Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
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Torres K, Pietrzyk Ł, Plewa Z, Załuska-Patel K, Majewski M, Radzikowska E, Torres A. TGF-β and inflammatory blood markers in prediction of intraperitoneal adhesions. Adv Med Sci 2018; 63:220-223. [PMID: 29223125 DOI: 10.1016/j.advms.2017.11.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 08/11/2017] [Accepted: 11/21/2017] [Indexed: 12/17/2022]
Abstract
PURPOSE Intraperitoneal adhesions (IA) develop as a consequence of the healing process in peritoneum injured during surgeries. IA might be formed after all types of surgical interventions regardless the surgical approach with a higher incidence in obese individuals. Here we determine the diagnostic power of TGF-β and blood inflammatory parameters in the prediction of IA in obese patients undergoing second surgical intervention. MATERIALS AND METHODS Eighty patients were divided into groups according to body mass index (BMI) values and presence of intraperitoneal adhesions (IA). Evaluation of peritoneal adhesion index (PAI), serum TGF-β and blood inflammatory parameters was performed. RESULTS Level of TGF-β, C-reactive protein (CRP), leukocytes, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio were significantly higher in obese patients while TGF-β, CRP, and leukocytes were higher in patients with IA. There was a significant correlation between PAI values and TGF-β concentration (p<0.001; r=0.869) in IA group. CONCLUSIONS The preoperative TGF-β concentration, BMI, CRP and NLR could be strong predictors of intraperitoneal adhesions in patients with the history of surgeries.
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Fang Q, Tong YW, Wang G, Zhang N, Chen WG, Li YF, Shen KW, Wu BW, Chen XS. Neutrophil-to-lymphocyte ratio, obesity, and breast cancer risk in Chinese population. Medicine (Baltimore) 2018; 97:e11692. [PMID: 30045325 PMCID: PMC6078664 DOI: 10.1097/md.0000000000011692] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Breast cancer (BC), obesity, and metabolic syndrome (MetS) shared a common mechanism of dysregulated metabolism and inflammatory response in disease initiation. Neutrophil-to-lymphocyte ratio (NLR) is associated with adverse survival of BC patients. The aim of this study is to identify risk effect between NLR and BC in Chinese population with or without obesity and MetS. BC and age-matched breast benign disease (BBD) patients were retrospectively analyzed from Comprehensive Breast Health Center, Shanghai Ruijin Hospital. MetS was defined using AHA/NHLBI criteria. Individuals were classified into very low (0-1.30), low (1.31-1.67), intermediate (1.68-2.20), and high (>2.20) NLR subsets by each NLR quartile. In all, 1540 BC and 1540 BBD patients were included. Univariate and multivariate analysis found that NLR (OR: 1.27, 95% CI: 1.16-1.39, P < .001) and obesity (OR: 1.19, 95% CI: 1.00-1.42, P = .046) but not MetS (P = .060) were significantly associated with increased BC risk. Intermediate or high NLR substantially increased BC risk compared to very low NLR group (OR: 1.57, 95% CI: 1.29-1.92, P < .001; OR: 1.84, 95% CI: 1.50-2.25, P < .001; respectively) in whole population. Subgroup analysis found that the impact of higher NLR on BC risk was more obvious in patients without obesity (intermediate NLR, OR: 1.72, 95% CI: 1.37-2.16, P < .001; high NLR, OR: 1.92, 95% CI: 1.53-2.41, P < .001) or without MetS (intermediate NLR, OR: 1.70, 95% CI: 1.35-2.14, P < .001; high NLR, OR: 1.98, 95% CI: 1.57-2.51, P < .001). Higher preoperative NLR was found in BC patients compared with BBD patients. Intermediate to high NLR level substantially increased BC risk, which was more relevant for those without obesity or MetS.
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Affiliation(s)
- Qiong Fang
- School of Nursing, Shanghai Jiao Tong University
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - Yi-Wei Tong
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - Gen Wang
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - Nan Zhang
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei-Guo Chen
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - Ya-Fen Li
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - Kun-Wei Shen
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
| | - Bei-Wen Wu
- Department of Nursing, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao-Song Chen
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
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Kim JK, Lee AY, Kang JH, Yu BY, Kim SJ. Association of Fasting Glucose Level with Neutrophil-Lymphocyte Ratio Compared to Leukocyte Count and Serum C-Reactive Protein. Korean J Fam Med 2018; 39:42-50. [PMID: 29383211 PMCID: PMC5788845 DOI: 10.4082/kjfm.2018.39.1.42] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 06/22/2017] [Accepted: 07/11/2017] [Indexed: 12/17/2022] Open
Abstract
Background The neutrophil-lymphocyte ratio (NLR) is often used as an inflammatory marker in chronic diseases such as cancer or cardiovascular diseases. However, there are few studies about the association between the NLR and diabetes mellitus (DM) or impaired fasting glucose (IFG) patients in Korea. This study investigated the association between the fasting plasma glucose (FPG) level and NLR in Koreans. Methods This cross-sectional retrospective study included 3,219 healthy subjects who visited Konyang University Hospital in South Korea for regular health examinations. Participants with a history of insulin administration, anti-diabetic drugs, anti-inflammatory drugs, or underlying diseases related to inflammation were excluded. Results All statistical evaluation was performed by dividing participants into males and females. Based on FPG levels, the subjects were classified into three groups, with normal fasting glucose (n=1,969), IFG (n=1,138), and DM (n=122). The NLR had no significant mean differences among these groups for both sexes. Multiple linear regression analysis between FPG level and NLR showed an independent and significantly negative association (β±standard error, −0.67±0.24; P=0.006) in normal subjects after adjustment. Log(serum C-reactive protein [S-CRP]) showed an independently and significantly positive association with FPG in male IFG/DM patients. Total leukocyte (white blood cell [WBC]) showed an independently and significantly positive association with FPG in female IFG/DM patients. Conclusion In normal subjects, NLR shows an independently and significantly negative association with FPG. In IFG/DM patients, NLR was not significantly related to FPG. WBC count in female patients and S-CRP level in male patients were significantly positively associated with FPG only in IFG/DM.
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Affiliation(s)
- Jin-Kyu Kim
- Department of Family Medicine, Konyang University Hospital, Daejeon, Korea
| | - Ah-Young Lee
- Department of Family Medicine, Konyang University Hospital, Daejeon, Korea
| | - Jee-Hyun Kang
- Department of Family Medicine, Konyang University Hospital, Daejeon, Korea
| | - Byung-Yeon Yu
- Department of Family Medicine, Konyang University Hospital, Daejeon, Korea
| | - Seong-Ju Kim
- Department of Family Medicine, Konyang University Hospital, Daejeon, Korea
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Uslu AU, Sekin Y, Tarhan G, Canakcı N, Gunduz M, Karagulle M. Evaluation of Monocyte to High-Density Lipoprotein Cholesterol Ratio in the Presence and Severity of Metabolic Syndrome. Clin Appl Thromb Hemost 2017; 24:828-833. [PMID: 29212375 PMCID: PMC6714883 DOI: 10.1177/1076029617741362] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Monocyte to high-density lipoprotein cholesterol ratio (MHR) is a systemic inflammatory marker, and recently, it has been used quite commonly for the assessment of inflammation in cardiovascular disorders. The aim of the present study is to investigate the relevance of MHR as a marker to assess metabolic syndrome (MetS) and MetS severity in clinical practice. A total of 147 patients with MetS who were diagnosed according to National Cholesterol Education Program Adult Treatment Panel III criteria and 134 healthy controls, matched for age and gender, were included in our retrospective study. MHR values were 13.15 ± 6.07 for patients with MetS and 9.74 ± 5.24 for the control group. MHR values of the patients were found to be statistically significantly higher than the control group ( P < .0001). MHR showed a significantly positive correlation with the severity of MetS ( r = .429; P < .0001). When patients with MetS were assessed with MHR in the study population, receiver-operating characteristic curve analysis yielded a cutoff value of 9.36 with a sensitivity of 72%, a specificity of 61%, and a P value <.0001. In logistic regression analyses of MetS with several variables, MHR remained as an independent predictor of MetS (95% CI: 0.721-0.945, P = .005). MHR might be an available and useful inflammatory marker to evaluate patients with MetS and disease severity.
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Affiliation(s)
- Ali Ugur Uslu
- 1 Department of Internal Medicine, Yunus Emre State Hospital, Eskisehir, Turkey
| | - Yahya Sekin
- 1 Department of Internal Medicine, Yunus Emre State Hospital, Eskisehir, Turkey
| | - Gulten Tarhan
- 1 Department of Internal Medicine, Yunus Emre State Hospital, Eskisehir, Turkey
| | - Nuray Canakcı
- 1 Department of Internal Medicine, Yunus Emre State Hospital, Eskisehir, Turkey
| | - Mehmet Gunduz
- 2 Department of Cardiology, Yunus Emre State Hospital, Eskisehir, Turkey
| | - Mustafa Karagulle
- 3 Department of Hematology, Yunus Emre State Hospital, Eskisehir, Turkey
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Tang K, Liu H, Jiang K, Ye T, Yan L, Liu P, Xia D, Chen Z, Xu H, Ye Z. Predictive value of preoperative inflammatory response biomarkers for metabolic syndrome and post-PCNL systemic inflammatory response syndrome in patients with nephrolithiasis. Oncotarget 2017; 8:85612-85627. [PMID: 29156745 PMCID: PMC5689635 DOI: 10.18632/oncotarget.20344] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 07/12/2017] [Indexed: 11/25/2022] Open
Abstract
Neutrophil to lymphocyte ratio (NLR), derived neutrophil to lymphocyte ratio (dNLR), platelet to lymphocyte ratio (PLR) and lymphocyte to monocyte ratio (LMR) were promising biomarkers used to predict diagnosis and prognosis in various inflammatory responses diseases and cancers. However, there have been no reports regarding these biomarkers in kidney stone patients. This study aimed to evaluate the predictive value of inflammatory biomarkers for metabolic syndrome (MetS) and post-PCNL SIRS in nephrolithiasis patients. We retrospectively enrolled 513 patients with nephrolithiasis and 204 healthy controls. NLR, dNLR, LMR and PLR in nephrolithiasis patients were significantly higher than control group. Patients with renal stone have higher NLR, dNLR, LMR and PLR than those without. ROC curve analysis indicated NLR, dNLR, LMR and PLR for predicting patients with nephrolithiasis and MetS, displayed AUC of 0.730, 0.717, 0.627 and 0.606. Additionally, ROC curves, using post-PCNL SIRS as the end-point for NLR, dNLR, LMR and PLR with AUC of 0.831, 0.813, 0.723 and 0.685. Multivariate analysis revealed that NLR, dNLR represented independent factors for predicting post-PCNL SIRS. While LMR independently associated with MetS. These resluts demonstrate preoperative NLR, dNLR and LMR appears to be effective predictors of post-PCNL SIRS and LMR of MetS in nephrolithiasis patients.
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Affiliation(s)
- Kun Tang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,Institute of Urology of Hubei Province, Wuhan 430030, China
| | - Haoran Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,Institute of Urology of Hubei Province, Wuhan 430030, China
| | - Kehua Jiang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,Institute of Urology of Hubei Province, Wuhan 430030, China
| | - Tao Ye
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,Institute of Urology of Hubei Province, Wuhan 430030, China
| | - Libin Yan
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,Institute of Urology of Hubei Province, Wuhan 430030, China
| | - Peijun Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,Institute of Urology of Hubei Province, Wuhan 430030, China
| | - Ding Xia
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,Institute of Urology of Hubei Province, Wuhan 430030, China
| | - Zhiqiang Chen
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,Institute of Urology of Hubei Province, Wuhan 430030, China
| | - Hua Xu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,Institute of Urology of Hubei Province, Wuhan 430030, China
| | - Zhangqun Ye
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,Institute of Urology of Hubei Province, Wuhan 430030, China
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Dynamic thiol/disulphide homeostasis as a novel indicator of oxidative stress in obese children and its relationship with inflammatory-cardiovascular markers. Anatol J Cardiol 2017; 18:361-369. [PMID: 28761018 PMCID: PMC5731286 DOI: 10.14744/anatoljcardiol.2017.7740] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Objective: Childhood obesity is an important cause of cardiovascular risk with chronic inflammation. Oxidative stress may contribute to the pathogenesis of obesity-related cardiovascular pathologies. We aimed to evaluate thiol/disulphide homeostasis as a novel and sensitive marker of oxidative stress and to evaluate its relationship with some inflammatory and cardiovascular markers in obese children. Methods: In this case-controlled study, 65 children with exogenous obesity and 64 healthy children, as a control group, were included. In both groups, thiol/disulphide homeostasis parameters and inflammatory (white blood cells, platelets, mean corpuscular volume, neutrophil/lymphocyte ratio, and high-sensitivity C-reactive protein) and cardiovascular (epicardial adipose tissue thickness and left ventricular mass index) markers were studied. Correlation analyses of thiol/disulphide homeostasis parameters with body mass index standard deviation scores (BMI SDS) and inflammatory and cardiovascular markers were performed. Receiver-operating characteristic analysis was performed to determine the sensitivity, specificity, and optimal cut-off values of thiol/disulphide homeostasis parameters. Results: Native thiol, total thiol, and native thiol/total thiol ratios (antioxidant parameters) were lower (p<0.05) and disulphide/native thiol and disulphide/total thiol ratios (oxidant parameters) were higher in the obese group than in the control group (p<0.01). A positive correlation of oxidant parameters with BMI SDS and inflammatory markers was found. However, a negative correlation of antioxidant parameters with BMI SDS and inflammatory markers was found. The specificities of disulphide/native thiol and disulphide/total thiol ratios were higher in the obese group. Conclusion: The impairment in thiol/disulphide homeostasis, which is indicative of oxidative stress, is associated with inflammation in obesity. In addition, cardiovascular involvement may also contribute to this impairment.
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Release of mitochondrial DNA correlates with peak inflammatory cytokines in patients with acute myocardial infarction. Anatol J Cardiol 2016; 17:224-228. [PMID: 27721319 PMCID: PMC5864983 DOI: 10.14744/anatoljcardiol.2016.7209] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Objective: The present study is an exploration of the dynamic changes of plasma mitochondrial deoxyribonucleic acid (mtDNA) and inflammatory level in patients with acute myocardial infarction (MI). Methods: Thirty-eight patients with acute MI and 33 control participants were included in the study. Blood samples were collected on admission, 12 hours post-percutaneous coronary intervention (PCI), 24 hours post-PCI, and 48 hours post-PCI. White blood cell (WBC) count and C-reactive protein (CRP) level were determined. Plasma was isolated from whole blood. Plasma mtDNA was measured using real-time polymerase chain reaction, and tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) were measured using enzyme-linked immunosorbent assay kits. Bivariate correlation analysis was used to find correlation between plasma mtDNA and inflammatory level on admission. Results: Plasma mtDNA was significantly higher in patients with acute MI than controls on admission (p<0.01). Plasma mtDNA decreased significantly after PCI treatment (p=0.01). WBC count, TNF-α, IL-6 and CRP showed similar pattern: elevation after onset of acute MI and contraction after PCI treatment (p<0.05). Positive correlations between plasma mtDNA and WBC count (r=0.435; p<0.001), TNF-α (r=0.538; p<0.001), IL-6 (r=0.518; p<0.001), and CRP (r=0.524; p<0.001) were identified. Conclusion: Plasma mtDNA elevated after onset of acute MI and positive correlation was observed between plasma mtDNA and inflammatory level, suggesting that mtDNA may play a key role in inflammatory responses in patients with acute MI.
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Abstract
Objective: Metabolic syndrome (MS) is defined by a cluster of interdependent physiological, biochemical, and clinical risk factors and linked to a state of chronic inflammation. YKL-40 is known as an inflammatory glycoprotein, which is secreted by various cell lines during inflammation. Thus, we aimed to assess the association of serum YKL-40 levels with the presence and severity of MS. Methods: In this prospective cross-sectional study, a total of 177 consecutive patients [n=114 MS present and n=63 MS absent] were enrolled. MS was defined according to National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. Serum YKL-40 and hs-CRP levels were measured for all participants. Results: Serum YKL-40, hs-CRP and white blood cell count (WBC) were significantly higher in the MS present group (p<0.05). There was a graded relationship between increasing number of MS components and serum YKL-40 level (p<0.05). In addition, serum YKL-40 level was positively correlated with hs-CRP level (r=0.467, p<0.001) and WBC count (r=0.251, p=0.001). In multivariable regression analysis, serum YKL-40 [1.022 (1.011–1.033), p<0.001] and hs-CRP [1.346 (1.111–1.632), p=0.002] were remained as independent predictors for the presence of MS. In the ROC curve analysis, using a cut-off level of 147.0, YKL-40 well predicted the presence of MS with a sensitivity of 73.7% and specificity of 69.8% (AUC: 0.785; 95% CI: 0.718–0.853, p<0.001). Conclusion: In this study, we demonstrated that serum YKL-40 level was significantly associated with the presence of MS. According to these findings, we concluded that serum YKL-40 may be a novel and useful indicator for MS. (Anatol J Cardiol 2016; 16: 953-8)
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Elbey B, Baykal B, Yazgan ÜC, Zengin Y. The prognostic value of the neutrophil/lymphocyte ratio in patients with snake bites for clinical outcomes and complications. Saudi J Biol Sci 2015; 24:362-366. [PMID: 28149174 PMCID: PMC5272947 DOI: 10.1016/j.sjbs.2015.10.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 10/02/2015] [Accepted: 10/07/2015] [Indexed: 11/17/2022] Open
Abstract
Introduction Snake bites have cardiotoxicity, neurotoxic, myotoxic, nephrotoxic, and hemotoxic features. The neutrophil/lymphocyte ratio (NLR) provides valuable information for the determination of the diagnosis and prognosis of various diseases. In this study, we aimed to investigate the relationship between NLR with the development of complications and duration of hospital stay in snakebite cases. Method In this study, 107 patients with snakebite complaints that applied to a tertiary care university hospital between 2011 and 2014 were retrospectively reviewed. The control group compromised of 107 age-and gender-matched healthy subjects. These patients were examined using their previous laboratory results, bite areas pictures, geographic location, and analysis of complications that developed during the hospitalization. Results Patients in our snake bites group (n = 107), included males (64%) and females (36%). When NLR1–NLR2, NLR1–NLR3, and NLR2–NLR3 were compared, a statistically significant difference was found (p < 0.001). No mortality was observed in our patients. In cases of snakebites, 4.67% of the patients underwent finger amputation. Compartment syndrome occurred in 3.73% of patients. In one case that developed compartment syndrome, a finger amputation was made. When 8 patients with a complication were compared with patients having snakebite but no complication, the initial NLR was found to be higher and statistically significant (p = 0.042). The average length of stay of patients in the hospital was 9 days. In the analysis of the correlation between the duration of hospitalization and NLR, the patients with a high level of NLR were found to have a longer hospital stay compared to lower NLR levels (p = 0.012). Conclusion NLR was significantly increased in patients that developed complications and needed a longer stay in the hospital.
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Affiliation(s)
- Bilal Elbey
- Dicle University, Faculty of Medicine, Department of Immunology, Diyarbakır, Turkey
| | - Burhan Baykal
- Dicle University, Faculty of Medicine, Department of Medical Biology & Genetics, Diyarbakır, Turkey
| | - Ümit Can Yazgan
- Zirve University, Faculty of Medicine, Department of Physiology, Gaziantep, Turkey
| | - Yılmaz Zengin
- Dicle University, Faculty of Medicine, Department of Emergency Medicine, Diyarbakır, Turkey
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