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Patel AM, Khan S, Inam AMH, Alam R, Khan MM. Determination of Serum Zinc and Phosphorus Levels in Patients with Hypothyroidism. Biol Trace Elem Res 2024; 202:3018-3024. [PMID: 37819464 DOI: 10.1007/s12011-023-03905-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/03/2023] [Indexed: 10/13/2023]
Abstract
Various studies reported that serum zinc (Zn) and phosphorus (P) levels altered in patients with hypothyroidism and vice versa, but results were found inconsistent. It was aimed to find the association between serum Zn and P in patients with hypothyroidism. In this case-control study, a total of 100 subjects (50 newly diagnosed patients of hypothyroidism and 50 controls) were enrolled aged between 25 and 60 years. Biochemical parameters such as thyroid profile, serum Zn, and P were estimated in each subject. A p < 0.05 was considered statistically significant. The mean level of body mass index (BMI), thyroid-stimulating hormone (TSH), and serum P was found significantly elevated in cases compared to controls (p < 0.001). However, the mean level of total triiodothyronine (T3), thyroxine (T4), and serum Zn was found significantly reduced in cases compared to controls (p < 0.001). The serum Zn has shown a significant negative correlation with T3 and BMI among cases (r = - 0.313 p < 0.05, r = - 0.338 p < 0.05, respectively). However, serum P has shown a significant positive correlation with TSH and BMI among cases (r = 0.310 p < 0.05, r = 0.449 p < 0.01, respectively). Regression analysis indicated that serum Zn significantly predicted hypothyroidism (p < 0.00). Similarly, serum P significantly predicted hypothyroidism (p < 0.007). Results showed that serum Zn levels were significantly reduced and serum P levels were significantly elevated in cases compared to controls. The serum Zn and serum P both significantly associated with hypothyroidism.
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Affiliation(s)
- Amrendra Mani Patel
- Department of Biochemistry, Integral Institute of Medical Sciences & Research (IIMSR), Integral University, Lucknow, Uttar Pradesh, 226026, India
| | - Saba Khan
- Department of Biochemistry, Integral Institute of Medical Sciences & Research (IIMSR), Integral University, Lucknow, Uttar Pradesh, 226026, India
| | - Ahmad Merajul Hasan Inam
- Department of Physiotherapy, Integral Institute of Allied Health Sciences & Research (IIAHSR), Integral University, Lucknow, Uttar Pradesh, 226026, India
| | - Roshan Alam
- Department of Biochemistry, Integral Institute of Medical Sciences & Research (IIMSR), Integral University, Lucknow, Uttar Pradesh, 226026, India
| | - Mohammad Mustufa Khan
- Department of Basic Medical Sciences, Integral Institute of Allied Health Sciences & Research (IIAHSR), Integral University, Lucknow, Uttar Pradesh, 226026, India.
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Ahmed GM, Abed MN, Alassaf FA. Impact of calcium channel blockers and angiotensin receptor blockers on hematological parameters in type 2 diabetic patients. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024; 397:1817-1828. [PMID: 37750935 DOI: 10.1007/s00210-023-02731-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 09/20/2023] [Indexed: 09/27/2023]
Abstract
Antihypertensive medications have been associated with a reduction in hemoglobin (Hb) levels, leading to clinically significant anemia. We aimed to provide valuable insights into the impact of angiotensin receptor blockers (ARBs) and calcium channel blockers (CCBs) on hematological parameters by measuring the levels of erythropoietin (EPO), ferritin, and complete blood count (CBC) in individuals with type 2 diabetes mellitus (T2DM), particularly considering the duration of the antihypertensives use. In addition to comparing their effects on blood pressure, glycemic status, and renal function, a retrospective cohort study was conducted at the consultation unit of Alsalam Teaching Hospital, Mosul, Nineveh Province, between October 2022 and February 2023. A total of 160 participants were enrolled after being fully examined by the consultants to detect their eligibility for inclusion in the study and to rule out any abnormality. They consisted of 40 healthy controls, 30 T2DM patients (T2DM group), 30 T2DM patients with newly diagnosed hypertension (HT) (T2DM+HT group), 30 type 2 diabetic-hypertensives on ARBs (T2DM+HT+ARBs group), and 30 type 2 diabetic-hypertensives on CCBs (T2DM+HT+CCBs group). Five milliliters of blood was drawn from a vein and divided into two parts. Two milliliters was transferred into an anticoagulant tube for the measurement of HbA1c and complete blood picture. Serum was obtained from the remaining blood and used for assessment of ferritin, EPO, FSG, creatinine, urea, and uric acid. Significantly reduced FSG and HbA1c levels were observed in T2DM+HT+CCBs and T2DM+HT+ARBs groups vs T2DM+HT group (p < 0.05). The T2DM+HT+CCBs group had statistically higher urea levels than the T2DM group (p < 0.05). Both CCBs and ARBs use resulted in reduced creatinine clearance (CrCl). T2DM+HT+CCBs group exhibited slightly higher uric acid levels compared to controls (p < 0.05). Prolonged use of CCBs and ARBs led to disturbances in hematological parameters, with CCBs users showing the lowest levels of hemoglobin (Hb), RBCs, and hematocrit (Hct) among the groups. ARBs users displayed the lowest values of EPO and ferritin compared to other patient groups, along with reduced levels of Hb, RBCs, and Hct, albeit slightly higher than CCBs users. Our study highlights the importance of a balanced approach in prescribing ARBs and CCBs to patients with T2DM, given their potential to induce blood abnormalities, particularly with prolonged usage.
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Affiliation(s)
- Ghada M Ahmed
- Nineveh Health Directorate, Mosul, Nineveh Province, Iraq
| | - Mohammed N Abed
- Department of Pharmaceutical Chemistry, Mosul, Nineveh Province, Iraq.
- College of Pharmacy, University of Mosul, University Street, Mosul, 41002, Nineveh Province, Iraq.
| | - Fawaz A Alassaf
- College of Pharmacy, University of Mosul, University Street, Mosul, 41002, Nineveh Province, Iraq
- Department of Pharmacology and Toxicology, Mosul, Nineveh Province, Iraq
- College of Medicine, University of Warith Al-Anbiyaa, Karbala, Iraq
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Mukherjee P, Sanyal S, Chadha S, Mukherjee S. The Impact of Polycystic Ovary Syndrome (PCOS) on the Risk of Developing Ovarian Cancer and Thyroid Disorders: A Comprehensive Review. Endocr Metab Immune Disord Drug Targets 2024; 24:562-572. [PMID: 37986267 DOI: 10.2174/0118715303266512231103075551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/13/2023] [Accepted: 09/26/2023] [Indexed: 11/22/2023]
Abstract
Polycystic ovary syndrome (PCOS) is a common hormonal disorder that affects women. It is characterized by hyperandrogenism, polycystic ovarian morphology, and other related disorders. It is associated with various health conditions, such as infertility and increased risk of heart problems. Ovarian cancer is also a significant concern, as it is the fifth leading cause of death in women. While there is evidence suggesting a potential association between PCOS and ovarian cancer, the exact nature of this relationship remains unclear. Thyroid disorders, particularly hypothyroidism and Hashimoto's thyroiditis, have also been linked to PCOS. The presence of hypothyroidism can contribute to the development of polycystic ovarian morphology, affecting ovulation and hormone balance. Many works have shown a higher ubiquity of autoimmune thyroid disease in PCOS patients, indicating a potential association between the two conditions. The occurrence of PCOS, hirsutism, and acne underscores the frequency of endocrine disorders in women. This review paper examines the present relevant work on the association between PCOS and ovarian cancer as well as PCOS and thyroid disorders. A systematic literature search was conducted on the internet, such as PubMed, Scopus, and Google Scholar database, to identify peer-reviewed publications pertaining to PCOS, ovarian cancer, and thyroid disorders. While some studies have delineated a significant link between PCOS and ovarian cancer or thyroid disorders, others have yielded inconclusive results. Further research is necessary to establish a definitive causal relationship between these conditions. Understanding the relationship between PCOS, ovarian cancer, and thyroid disorders is crucial for early detection, accurate diagnosis, and effective management of these conditions. Identifying potential risk factors and developing appropriate screening strategies can improve women's health outcomes and reduce the burden associated with these disorders.
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Affiliation(s)
- Payal Mukherjee
- Amity Institute of Biotechnology, Amity University Uttar Pradesh Lucknow Campus, Lucknow, Uttar Pradesh, India
| | - Somali Sanyal
- Amity Institute of Biotechnology, Amity University Uttar Pradesh Lucknow Campus, Lucknow, Uttar Pradesh, India
| | - Sonia Chadha
- Amity Institute of Biotechnology, Amity University Uttar Pradesh Lucknow Campus, Lucknow, Uttar Pradesh, India
| | - Sayali Mukherjee
- Amity Institute of Biotechnology, Amity University Uttar Pradesh Lucknow Campus, Lucknow, Uttar Pradesh, India
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Osowiecka K, Skrypnik D, Myszkowska-Ryciak J. Assessment of the Impact of Nutritional Intervention with the Probiotic Lactiplantibacillus plantarum 299v on Nutritional Status and Quality of Life of Hashimoto's Thyroiditis Patients-A Randomized Double-Blind Study Protocol. J Pers Med 2023; 13:1659. [PMID: 38138886 PMCID: PMC10744439 DOI: 10.3390/jpm13121659] [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: 10/06/2023] [Revised: 11/01/2023] [Accepted: 11/08/2023] [Indexed: 12/24/2023] Open
Abstract
The current treatment for the autoimmune disease of hypothyroidism (AIDH) is based on pharmacotherapy with levothyroxine. A non-pharmacological supplementary element of therapy could be the implementation of an individualized balanced diet and probiotics. Lactiplantibacillus plantarum 299v (Lp299v), with its anti-inflammatory effects, may also support the therapy. However, the number of studies on personalized dietary interventions with probiotics in AIDH is limited, and no clear conclusions can be drawn from the results so far. Therefore, this trial will analyze the effect of Lp299v supplementation in conjunction with nutrition education on the quality of life and nutritional status of patients with Hashimoto's. Methods: This double-blind, 12-week intervention study will include 100 female patients with AIDH. They will be divided into two groups: (1) individual personalized nutrition education + Lp299v and (2) individual personalized nutrition education + placebo. Before and after the education intervention, selected elements in the diet, eating behavior, quality of life, nutritional status (anthropometric parameters, body composition), blood pressure, and anti-TPO (antibodies against thyroid peroxidase) titer will be assessed. Hypothesis: It is expected that this study will provide deeper knowledge on the validity of using proper nutritional principles and Lp299v in AIDH. Specifically, the impact on the subjective assessment of the quality of life, selected elements in the diet, and the state of nutrition and health will be assessed.
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Affiliation(s)
- Karolina Osowiecka
- Doctoral School, Warsaw University of Life Sciences (WULS), 02-787 Warsaw, Poland
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS), 02-776 Warsaw, Poland
| | - Damian Skrypnik
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences, 60-569 Poznan, Poland
| | - Joanna Myszkowska-Ryciak
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS), 02-776 Warsaw, Poland
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Cao C, Li C, Li X, Sun W, Wang Y. Association of systemic immune-inflammation index (SII) and aggregate index of systemic inflammation (AISI) with thyroid nodules in patients with type 2 diabetes mellitus: a retrospective study. BMC Endocr Disord 2023; 23:251. [PMID: 37986076 PMCID: PMC10659038 DOI: 10.1186/s12902-023-01509-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 11/08/2023] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVE This retrospective study aimed to investigate the association between TNs and the systemic immune-inflammation index (SII) and the aggregate index of systemic inflammation (AISI) in patients with T2DM. METHODS A total of 370 T2DM patients, who were admitted to Dongzhimen Hospital between January 2020 and March 2023, were included in this retrospective study. Binary logistic regression models with multivariable adjustment were employed to assess the relationship between SII, AISI quartiles, and TNs. Furthermore, receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic accuracy of SII and AISI in identifying T2DM patients with TNs. RESULTS Age, diabetes duration, diabetic nephropathy (DN), SII, and AISI demonstrated significant positive associations with TNs. Compared to the first quartile of SII, the second, third, and fourth quartiles showed increased risks of TNs with hazard ratios (HRs) of 1.578 (0.883-2.820), 2.279 (1.257-4.131), and 3.626 (1.931-6.810), respectively (P < 0.001). Similar results were observed for AISI and TNs. ROC curve analysis revealed that SII and AISI exhibited a high discriminatory capability for identifying TNs in the overall and male participant group, whereas the significance among females was not discernible. CONCLUSIONS This study provides evidence that SII and AISI are independent risk factors for TNs, suggesting that elevated SII and AISI levels may contribute to the development of TNs in patients with T2DM particularly among male individuals.
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Affiliation(s)
- Can Cao
- Department of Nephrology and Endocrinology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Chunyao Li
- Department of Nephrology and Endocrinology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Xiaoting Li
- Department of Nephrology and Endocrinology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Weiwei Sun
- Department of Nephrology and Endocrinology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Yaoxian Wang
- Department of Nephrology and Endocrinology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China.
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Kubiak K, Szmidt MK, Kaluza J, Zylka A, Sicinska E. Do Dietary Supplements Affect Inflammation, Oxidative Stress, and Antioxidant Status in Adults with Hypothyroidism or Hashimoto's Disease?-A Systematic Review of Controlled Trials. Antioxidants (Basel) 2023; 12:1798. [PMID: 37891878 PMCID: PMC10604871 DOI: 10.3390/antiox12101798] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 10/29/2023] Open
Abstract
This systematic review aims to summarise the results of controlled trials on dietary supplements (DS) usage and inflammation, oxidative stress, antioxidant status, and thyroid parameter improvement in hypothyroidism (HT)/Hashimoto's thyroiditis (AIT) patients. The study protocol was registered with PROSPERO (no. CRD42022365149). A comprehensive search of the PubMed, Scopus, and Web of Science databases resulted in the identification of nineteen randomised controlled trials and three non-randomised studies for the review; three studies examined the effect of supplementation with vitamin D, twelve studies-with selenium, and seven studies-with other DS. Based on very limited evidence, the lack of influence of vitamin D supplementation on inflammatory parameters was found, while no studies have examined oxidative stress and antioxidant status parameters, and only one provided results for a single thyroid parameter after an intervention. Some evidence was found proving that selenium supplementation may decrease inflammation and improve thyroid parameters, but reaching a conclusion about its influence on oxidative stress and antioxidant status is not possible because of the insufficient number of studies. Additionally, due to examining other DS (e.g., multicomponent, Nigella sativa, and genistein) only in single studies, conclusions cannot be drawn. Further long-term, high-quality randomised controlled trials are necessary to better understand the influence of DS on inflammation, oxidative stress, and antioxidant status, as well as their potential to improve thyroid gland function in HT/AIT patients.
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Affiliation(s)
- Katarzyna Kubiak
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), Nowoursynowska 166, 02-787 Warsaw, Poland
| | - Maria Karolina Szmidt
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), Nowoursynowska 166, 02-787 Warsaw, Poland
| | - Joanna Kaluza
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), Nowoursynowska 166, 02-787 Warsaw, Poland
| | - Agnieszka Zylka
- Department of Oncological Endocrinology and Nuclear Medicine, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Ewa Sicinska
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), Nowoursynowska 166, 02-787 Warsaw, Poland
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Naous E, Younes N, Achkar A, Osseis M, Atallah C. Transient facial nerve paralysis following low dose radioactive iodine in a patient with Graves' disease. Minerva Endocrinol (Torino) 2023; 48:364-366. [PMID: 36625795 DOI: 10.23736/s2724-6507.22.03876-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Elie Naous
- Saint Joseph University, Beirut, Lebanon -
- Division of Endocrinology, Department of Internal Medicine, Hotel Dieu de France Hospital, Beirut, Lebanon -
| | | | - Angela Achkar
- Saint Joseph University, Beirut, Lebanon
- Division of Endocrinology, Department of Internal Medicine, Hotel Dieu de France Hospital, Beirut, Lebanon
| | - Michael Osseis
- Saint Joseph University, Beirut, Lebanon
- Division of General Surgery, Department of Surgery, Hotel Dieu de France Hospital, Beirut, Lebanon
| | - Chawki Atallah
- Saint Joseph University, Beirut, Lebanon
- Division of Endocrinology, Department of Internal Medicine, Hotel Dieu de France Hospital, Beirut, Lebanon
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Liu L, Fu Q, Zhang D, Chen D, Wang F, Guo R, Xie X, Jiang Z, Yu J, Li Y. Analysis of Mean Corpuscular Volume and Red Cell Distribution Width in Patients with Aplastic Anemia. Hemoglobin 2023:1-5. [PMID: 37161838 DOI: 10.1080/03630269.2023.2206575] [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: 05/11/2023]
Abstract
To explore the characteristics of hemogram in patients with aplastic anemia (AA), especially mean corpuscular volume (MCV) and red cell distribution width (RDW). We examined the blood routine of 180 new-onset AA patients and used 166 patients with myelodysplastic syndrome (MDS) as controls. Among the 180 AA patients, 105 (58.3%) were diagnosed with severe AA (SAA), while 75 (41.7%) were diagnosed with non-severe AA (NSAA). Compared to MDS, patients with SAA generally had unfavorable hemogram, including significantly lower white blood cell (WBC), absolute neutrophil count (ANC), hemoglobin (Hb), platelet (PLT) and reticulocyte counts (RET). However, WBC, ANC and lymphocyte counts were higher in the NSAA group than in the MDS group; Hb and Ret were comparable between the two groups. 8.5% of SAA patients and 58.1% of NSAA patients presented with macrocytic anemia, whereas 25.7% of SAA and 64.0% of NSAA had a high RDW. In the MDS group, 54.7% of patients presented with macrocytic anemia, and 84.7% had increased RDW. WBC, ANC, PLT, and Ret in a high-RDW group (25.7% of SAA) were significantly higher than in a normal-RDW group (74.3% of SAA). Overall, most SAA patients exhibited normocytic-normochromic anemia, and their hemograms decreased more significantly; more than half of NSAA patients showed macrocytic-heterogeneous anemia, and their hemograms were similar to those of MDS. Patients with elevated RDW may have better residual bone marrow hematopoietic function than those with normal RDW but with more severe anemia.
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Affiliation(s)
- Lingling Liu
- Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Qiuhao Fu
- Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Danfeng Zhang
- Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Dandan Chen
- Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Fang Wang
- Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Rong Guo
- Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xinsheng Xie
- Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhongxing Jiang
- Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jifeng Yu
- Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yingmei Li
- Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Chen YL, Zhao ZW, Li SM, Guo YZ. Value of red blood cell distribution width in prediction of diastolic dysfunction in cirrhotic cardiomyopathy. World J Gastroenterol 2023; 29:2322-2335. [PMID: 37124890 PMCID: PMC10134422 DOI: 10.3748/wjg.v29.i15.2322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/27/2023] [Accepted: 03/16/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Clinical diagnosis of cirrhotic cardiomyopathy (CCM) often encounters challenges of lack of timeliness and disease severity, with the commonly positive indicator usually associated with advanced heart failure.
AIM To explore suitable biomarkers for early CCM prediction.
METHODS A total of 505 eligible patients were enrolled in this study and divided into four groups according to Child-Pugh classification: Group I, Class A without CCM (105 cases); Group II, Class A with CCM (175 cases); Group III, Class B with CCM (139 cases); and Group IV, Class C with CCM (86 cases). Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to determine whether red blood cell distribution width (RDW) was an independent risk factor for CCM risk. The relationships between RDW and Child-Pugh scores, Model for End-Stage Liver Disease (MELD) scores, and N-terminal pro-brain natriuretic peptide (NT-proBNP) were analyzed by Pearson correlation analysis.
RESULTS A constant RDW increase was evident from Group I to Group IV (12.54 ± 0.85, 13.29 ± 1.19, 14.30 ± 1.96, and 16.25 ± 2.13, respectively). Pearson correlation analysis showed that RDW was positively correlated with Child-Pugh scores (r = 0.642, P < 0.001), MELD scores (r = 0.592, P < 0.001), and NT-proBNP (r = 0.715, P < 0.001). Furthermore, between Group I and Group II, RDW was the only significant index (odds ratio: 2.175, 95% confidence interval [CI]: 1.549-3.054, P < 0.001), and it reached statistical significance when examined by ROC curve analysis (area under the curve: 0.686, 95%CI: 0.624-0.748, P < 0.001).
CONCLUSION RDW can serve as an effective and accessible clinical indicator for the prediction of diastolic dysfunction in CCM, in which a numerical value of more than 13.05% may indicate an increasing CCM risk.
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Affiliation(s)
- Yan-Ling Chen
- Department of Gastroenterology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian Province, China
| | - Zi-Wen Zhao
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian Province, China
| | - Shu-Mei Li
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian Province, China
| | - Yong-Zhe Guo
- Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian Province, China
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Liao W, Tao G, Chen G, He J, Yang C, Lei X, Qi S, Hou J, Xie Y, Feng C, Jiang X, Deng X, Ding C. A novel clinical prediction model of severity based on red cell distribution width, neutrophil-lymphocyte ratio and intra-abdominal pressure in acute pancreatitis in pregnancy. BMC Pregnancy Childbirth 2023; 23:189. [PMID: 36934238 PMCID: PMC10024436 DOI: 10.1186/s12884-023-05500-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 03/06/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Acute pancreatitis in pregnancy (APIP) with a high risk of death is extremely harmful to mother and fetus. There are few models specifically designed to assess the severity of APIP. Our study aimed to establish a clinical model for early prediction of severity of APIP. METHODS A retrospective study in a total of 188 patients with APIP was enrolled. The hematological indicators, IAP (intra-abdominal pressure) and clinical data were obtained for statistical analysis and prediction model construction. RESULTS According to univariate and multivariate logistic regression analysis, we found that red cell distribution width (RDW), neutrophil-lymphocyte ratio (NLR) and Intra-abdominal pressure (IAP) are prediction indexes of the severity in APIP (p-value < 0.05). Our novel clinical prediction model was created by based on the above three risk factors and showed superior predictive power in primary cohort (AUC = 0.895) and validation cohort (AUC = 0.863). A nomogram for severe acute pancreatitis in pregnancy (SAPIP) was created based on the three indicators. The nomogram was well-calibrated. CONCLUSION RDW, NLR and IAP were the independent risk factors of APIP. Our clinical prediction model of severity in APIP based on RDW, NLR and IAP with predictive evaluation is accurate and effective.
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Affiliation(s)
- Wenyan Liao
- The First Affiliated Hospital, Department of Gynaecology and Obstetrics, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Guangwei Tao
- The First Affiliated Hospital, Department of Hepatopancreatobiliary Surgery, Hengyang Medical School, University of South China, No. 69, Chuanshan Road, Hengyang, Hunan, 421001, China
| | - Guodong Chen
- The First Affiliated Hospital, Department of Hepatopancreatobiliary Surgery, Hengyang Medical School, University of South China, No. 69, Chuanshan Road, Hengyang, Hunan, 421001, China
| | - Jun He
- The Nanhua Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Chunfen Yang
- The First Affiliated Hospital, Department of Gynaecology and Obstetrics, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Xiaohua Lei
- The First Affiliated Hospital, Department of Hepatopancreatobiliary Surgery, Hengyang Medical School, University of South China, No. 69, Chuanshan Road, Hengyang, Hunan, 421001, China
| | - Shuo Qi
- The First Affiliated Hospital, Department of Hepatopancreatobiliary Surgery, Hengyang Medical School, University of South China, No. 69, Chuanshan Road, Hengyang, Hunan, 421001, China
| | - Jiafeng Hou
- The First Affiliated Hospital, Department of Hepatopancreatobiliary Surgery, Hengyang Medical School, University of South China, No. 69, Chuanshan Road, Hengyang, Hunan, 421001, China
| | - Yi Xie
- The First Affiliated Hospital, Department of Hepatopancreatobiliary Surgery, Hengyang Medical School, University of South China, No. 69, Chuanshan Road, Hengyang, Hunan, 421001, China
| | - Can Feng
- The First Affiliated Hospital, Department of Hepatopancreatobiliary Surgery, Hengyang Medical School, University of South China, No. 69, Chuanshan Road, Hengyang, Hunan, 421001, China
| | - Xinmiao Jiang
- The First Affiliated Hospital, Department of Hepatopancreatobiliary Surgery, Hengyang Medical School, University of South China, No. 69, Chuanshan Road, Hengyang, Hunan, 421001, China
| | - Xin Deng
- The First Affiliated Hospital, Department of Hepatopancreatobiliary Surgery, Hengyang Medical School, University of South China, No. 69, Chuanshan Road, Hengyang, Hunan, 421001, China
| | - Chengming Ding
- The First Affiliated Hospital, Department of Hepatopancreatobiliary Surgery, Hengyang Medical School, University of South China, No. 69, Chuanshan Road, Hengyang, Hunan, 421001, China.
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Erdur ZB, Özdoğan HA, Yener HM, Karaman E, Cansız H, Aliyeva Ç, Batur Ş, İnan HC. Evaluation of Inflammatory Blood Markers in Sinonasal Inverted Papilloma. EAR, NOSE & THROAT JOURNAL 2023; 102:96-100. [PMID: 33459561 DOI: 10.1177/0145561320988366] [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: 02/02/2023] Open
Abstract
OBJECTIVE Sinonasal inverted papillomas are benign neoplasms of the nasal cavity and paranasal sinuses. They have characteristic features such as a high risk of recurrence and possible malignant transformation. This study was conducted to investigate the relationship between sinonasal inverted papilloma and inflammatory blood markers. PATIENTS AND METHODS Sixty-five patients who were diagnosed histologically as having sinonasal inverted papilloma and 65 age- and sex-matched healthy controls were included in the study. Inflammatory blood markers such as neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), red cell distribution width (RDW), mean platelet volume (MPV), and platelet distribution width (PDW) of the patient and control groups were compared. RESULTS There were no statistically significant differences between the patients and controls for white blood cell, platelet, hemoglobin, neutrophil, and lymphocyte counts (P > .05). No statistically significant difference was found between the patients and controls for NLR, PLR, RDW, MPV, and PDW (P > .05). In the logistic regression analysis model, which was created to investigate the effects of inflammatory blood markers in determining the patient group, the increase in the NLR and decrease in the PLR were found to be statistically significant factors (P = .008, P = .039). CONCLUSION This is the first study in the literature to investigate the relationship between sinonasal inverted papilloma and inflammatory blood markers, and the results suggest that NLR and PLR may be used to distinguish patients with sinonasal inverted papilloma from controls.
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Affiliation(s)
- Zülküf Burak Erdur
- Department of Otolaryngology Head and Neck Surgery, Kirklareli Training and Research Hospital, Kirklareli, Turkey
| | - Hasan Ahmet Özdoğan
- Department of Otolaryngology Head and Neck Surgery, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Haydar Murat Yener
- Department of Otolaryngology Head and Neck Surgery, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Emin Karaman
- Department of Otolaryngology Head and Neck Surgery, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Harun Cansız
- Department of Otolaryngology Head and Neck Surgery, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Çınare Aliyeva
- Department of Otolaryngology Head and Neck Surgery, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Şebnem Batur
- Department of Pathology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Hakkı Caner İnan
- Department of Otolaryngology Head and Neck Surgery, Uludag University Medical Faculty, Bursa, Turkey
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Mohamedahmed KA, Mubarak MO, Talha AA. Assessment of Red Cell Distribution Width among Sudanese Patients with Hypothyroidism.. [DOI: 10.21203/rs.3.rs-2518318/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Abstract
Background: Thyroid dysfunction has a strong linkage with anemia. RDW was traditionally regarded as a part of routine evaluation of anemia Elevated RDW level was significantly associated with subclinical hypothyroidism and hypothyroidism.
Objectives: The aim of this is study to assess the Red Cell Distribution Width (RDW-CV and RDW-SD) in patients with hypothyroidism.
Methodology: This is a case-control laboratory-based study conducted among 50 patients with hypothyroidism as cases (38.50 ± 10.46 years; 36% males and 64% females) and 50 normal healthy individuals as controls (35.52 ± 11.64 years; 46% males and 54% females) in National Cancer Institute – University of Gezira (NCI-UG), Gezira State, Sudan from January to October 2020. Three ml of venous blood sample was collected in an EDTA container. Red cell parameters (RBC count, MCV, RDW-CV, and RDW-SD) were measured using Sysmex XP 300 Cell Counter. SPSS computer program (v 22.0) was used for data analysis.
Results: The average RDW (SD and CV) of cases were higher than controls (P value = 0.000, 0.000 respectively). There was a significant difference in RDW-CV between mild and severe hypothyroidism (P value = 0.040). RDW-SD and RDW-CV had significant positive correlation within TSH (r = 0.361, P value = 0.000; r = 0.407, P value = 0.000 respectively) and significant negative correlation within T3 (r = - 0.419, P value = 0.000; r = - 0.507, P value = 0.000 respectively) and T4 (r = - 0.406, P value = 0.000; r = - 0.506, P value = 0.000 respectively).
Conclusion: The study concluded that RDW was significantly higher in patients with hypothyroidism and had a significant positive correlation with TSH and a significant negative correlation within T3 and T4. So, RDW may be used as a significant clinical marker of hypothyroidism.
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Söbü E, Yildiz Z. Does cystatin C have an immunomodulatory role in Hashimoto's thyroiditis? J Pediatr Endocrinol Metab 2023; 36:58-63. [PMID: 36327158 DOI: 10.1515/jpem-2022-0386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Studies which report cystatin C's (Cys-C) role in immunological disorders are increasing. However, data in the pediatric age group is limited. In this study, we aimed to evaluate the association between serum Cys-C levels and thyroid autoantibodies in children and adolescents diagnosed with euthyroid Hashimoto's thyroiditis. METHODS The patient group was included 50 participants aged between 3 and 18 years, and the control group included 50 healthy children matched for age, gender, and body mass index. Patients with hypothyroidism or taking any medication were not included in the study. Fasting glucose, liver enzymes, urea, creatinine, lipid profile, Cys-C, free thyroxine (fT4), free triiodothyronine (fT3), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), and thyroglobulin antibodies (TGAb) levels were recorded in all subjects. RESULTS The mean age of control group was 13.5 ± 2.5 years, and the mean age of Hashimoto thyroiditis (HT) group was 14.2 ± 2.7 years, no statistically significant differences existed (p=0.205). Cys-C values were significantly higher in the HT group than in the control group (p=0.041). When all cases were evaluated, Cys-C levels were statistically positively correlated with fT3, TPOAb, and TGAb values (p<0.001, p=0.029, p=0.013 respectively). CONCLUSIONS Based on the results of our study, Cys-C levels in children and adolescents with euthyroid Hashimoto thyroiditis were statistically higher than their healthy peers. In conclusion, it can be said that Cys-C may be a factor in the etiopathogenesis of autoimmune thyroiditis, and even small changes in TSH values affect Cys-C levels.
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Affiliation(s)
- Elif Söbü
- Department of Pediatric Endocrinology, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
| | - Zeynep Yildiz
- Department of Medical Biochemistry, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey
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Wang H, Li H, Wang Y, Zhao C, Tian QW, Wang Q, He GW, Lun LM, Xuan C. Hematological parameters and early-onset coronary artery disease: a retrospective case-control study based on 3366 participants. Ther Adv Chronic Dis 2023; 14:20406223221142670. [PMID: 36699111 PMCID: PMC9869207 DOI: 10.1177/20406223221142670] [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: 05/23/2022] [Accepted: 11/15/2022] [Indexed: 01/19/2023] Open
Abstract
Background Thrombosis and inflammation are crucial elements in the pathogenesis of cardiovascular disease. Hematological parameters elucidate information involving the inflammatory and blood coagulation processes. Objectives The current study explored the association of hematological parameters with EOCAD to identify specific risk factors. Design A single-center retrospective case-control study was conducted with 1693 coronary artery disease patients and 1693 controls. Methods Hematological parameters were examined through an automated analyzer. Results The basophil percentage was significantly reduced in EOCAD (0.43 ± 0.26, p < 0.001) and MI (0.33 ± 0.24, p < 0.001) groups compared with controls (0.54 ± 0.28). The eosinophil percentage was also significantly lower in EOCAD (2.21 ± 1.71, p < 0.001) and MI (1.71 ± 2.44, p < 0.001) groups compared with controls (2.41 ± 1.75). The lymphocyte percentage in patients of EOCAD and MI and controls was 31.65 ± 7.93, 25.48 ± 9.43, and 34.82 ± 7.28, respectively. A significant difference was observed among the groups (p < 0.001). Except for the mean corpuscular hemoglobin (MCH), other red blood cell (RBC) parameters significantly differed between EOCAD patients and controls. The red blood cell distribution width (RDW), hematocrit (HCT), RBC count, mean corpuscular hemoglobin concentration (MCHC), mean corpuscular volume (MCV), and hemoglobin level were associated with EOCAD prevalence after adjusting for baseline differences. Platelet volume distribution width (PDW) also correlated with EOCAD prevalence (ORadjust = 1.087, 95% CI: 1.044-1.131). Conclusions Hematological parameters are closely associated with EOCAD. Moreover, leukocyte parameters correlated with the presence and severity of the disease. In addition, erythrocyte parameters were associated with the disease presence but not with the disease severity. Among the platelet parameters, only PDW was related to the disease presence.
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Affiliation(s)
- Huan Wang
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Hui Li
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yan Wang
- Health Management Institute, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Cong Zhao
- Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Qing-Wu Tian
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Qing Wang
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Guo-Wei He
- Department of Cardiovascular Surgery, TEDA International Cardiovascular Hospital, Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.,Department of Surgery, Oregon Health and Science University, Portland, OR, USA
| | - Li-Min Lun
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Chao Xuan
- Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, No. 1677, Wutai Mountain Road, Qingdao 266500, China
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Chen C, Zhong S, Wu Z, Tang H, Wang Z, Jiang D. Investigation of the relationship between red blood cell distribution width and mortality in patients with hemophagocytic lymphohistiocytosis: a retrospective study. SAO PAULO MED J 2023; 141:e2022190. [PMID: 36629554 PMCID: PMC10065090 DOI: 10.1590/1516-3180.2022.0190.r1.17102022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 10/17/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Red blood cell distribution width (RDW) is related to sepsis-related mortality. Hemophagocytic lymphohistiocytosis (HLH) is a syndrome caused by severe infection, tumors, or autoimmunity without a specific diagnosis. OBJECTIVE To explore the correlation between RDW and mortality in patients with HLH. DESIGN AND SETTING A retrospective study conducted in a hospital in China. METHODS A total of 101 inpatients with HLH from January 1, 2017 to December 31, 2021 were divided into non-survivor (n = 52) and survivor (n = 49) groups. A non-parametric test was used to analyze demographic, clinical, and laboratory data between groups. Independent variables with P < 0.05 were analyzed using binary logistic regression to screen out mortality-related variables. Selected variables were subjected to multivariate logistic regression analysis, and those with strong correlations were screened. Receiver operating characteristic (ROC) curves of strongly correlated variables and area under curve (AUC) values were obtained. RESULTS The APACHE II score, RDW, and platelet (PLT) and fibrinogen (FIB) levels (P < 0.05) different significantly. RDW, PLT, FIB were correlated with mortality. The AUC values of RDW, PLT, and FIB were 0.857, 0.797, and 0.726, respectively. RDW was associated with mortality in patients with HLH (P < 0.01, cut-off value: 16.9). The sensitivity and specificity of predicting mortality were 97.96% and 96.1%, respectively. CONCLUSION Logistic regression analysis showed a correlation between RDW and patients' mortality. Therefore, RDW can be used to predict mortality in patients with HLH.
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Affiliation(s)
- Chunyan Chen
- MD, MSc. Physician, Department of Intensive Care Unit, Daping
Hospital, Army Medical University, Chongqing, China
| | - Shili Zhong
- MD, MSc. Physician, Department of Intensive Care Unit, Daping
Hospital, Army Medical University, Chongqing, China
| | - Zhengbin Wu
- MD, MSc. Physician, Department of Intensive Care Unit, Daping
Hospital, Army Medical University, Chongqing, China
| | - Hao Tang
- MD, PhD. Assistant Professor, Department of Intensive Care Unit,
Daping Hospital, Army Medical University, Chongqing, China
| | - Zhen Wang
- MD, PhD. Assistant Professor, Department of Intensive Care Unit,
Daping Hospital, Army Medical University, Chongqing, China
| | - Dongpo Jiang
- MD, MSc. Physician, Department of Intensive Care Unit, Daping
Hospital, Army Medical University, Chongqing, China
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Çağlar Çil Ö, Metin ÖK, Çayır A. Evaluation of Mitochondrial Copy Number in Thyroid Disorders. Arch Med Res 2022; 53:711-717. [DOI: 10.1016/j.arcmed.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/16/2022] [Accepted: 10/12/2022] [Indexed: 11/02/2022]
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Cai Y, Ren L, Liu X, Li C, Gang X, Wang G. Thyroid storm complicated by corpus callosum infarction in a young patient: A case report and literature review. Medicine (Baltimore) 2022; 101:e30318. [PMID: 36042649 PMCID: PMC9410692 DOI: 10.1097/md.0000000000030318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
RATIONALE Thyroid storm (TS) is a rare life-threatening hypermetabolic thyrotoxicosis with an incidence of 0.57-0.76/100,000. The coexistence of TS and acute cerebral infarction is rare. Previous studies have shown that hyperthyroidism complicated by cerebral infarction mainly occurs in the intracranial basal ganglia; however, there are no reports of corpus callosum infarction. We report a case of TS complicated by cerebral infarction of the corpus callosum at our hospital. PATIENT CONCERNS A 31-year-old male patient with a history of hyperthyroidism was admitted to the hospital because of fatigue, palpitations, fever, and profuse sweating accompanied by a mild decrease in the muscle strength of the left limb. Diagnosis of a TS was confirmed by the laboratory test results. The patient's clinical symptoms gradually improved after treatment. However, his left limb muscle strength progressively decreased, and the bilateral pathological signs were positive at the same time. Magnetic resonance imaging (MRI) of the head revealed acute cerebral infarction of the corpus callosum and pons. DIAGNOSIS The diagnosis was thyroid strom with acute cerebral infarction of the corpus callosum and pons and severe stenosis or occlusion of the basilar artery. INTERVENTIONS The patient was given 300 mg hydrocortisone intravenously per day, propylthiouracil tablets of 200 mg 3 times a day by nasal feeding, and 20 mg propranolol three times a day by nasal feeding. Aspirin and clopidogrel were administered to prevent platelet aggregation, and atorvastatin calcium was administered to lower lipid levels to stabilize plaques. OUTCOMES The patient's left limb muscle strength recovered to grade 4+, and he could walk beside the bed with support. Simultaneously, thyroid function was better than before. LESSONS Careful physical examination should be performed in patients with thyroid storm, and head imaging examination should be improved for the early detection of cerebral infarction.
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Affiliation(s)
- Yunjia Cai
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun 130021, China
| | - Linan Ren
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun 130021, China
| | - Xinming Liu
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun 130021, China
| | - Chen Li
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun 130021, China
| | - Xiaokun Gang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun 130021, China
| | - Guixia Wang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun 130021, China
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18
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Elbayiyev S, Şimşek GK, Ceran B, Akın MŞ, Kanmaz Kutman HG, Canpolat FE. Could red cell distribution width be used for predicting cardiac injury in neonates with COVID-19? J Med Virol 2022; 94:5739-5745. [PMID: 35938314 PMCID: PMC9538182 DOI: 10.1002/jmv.28050] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) can affect people of all age groups and it can occasionally cause life-threatening clinical illnesses in immunologically immature populations, especially in newborns. High red cell distribution width (RDW) values were used as an early prognostic biomarker of some neonatal diseases. We aimed to determine the prognostic value of RDW in severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infected neonates. METHODS Newborns with positive SARS-CoV-2 polymerase chain reaction (PCR) test from a nasopharyngeal swab sample, who had refractory fever (>38°C and lasting more than 24 h during hospitalization), were screened for multisystem inflammatory syndrome in newborns (MIS-N), systemic inflammatory indexes calculated and cardiologic evaluations. Due to troponin levels (high: >45 ng/L and low: ≤45 ng/L) patients were grouped. RESULTS Out of the 68 SARS-CoV-2 PCR-positive newborns, 26 patients had refractory fever. Comparison of laboratory findings between the high and low-troponin groups showed that RDW and neutrophil/lymphocyte ratio values were significantly higher in patients with high troponin levels (p = 0.022 and p = 0.030, respectively). The cut-off values with optimal sensitivity and specificity were determined as 1.00 for neutrophil/lymphocyte ratio (p = 0.205) and 16.6 for RDW (p = 0.014). None of the patients died. CONCLUSIONS Neonatal COVID-19 generally has a benign prognosis, but can progress to severe disease and cases of MIS-N are rare. RDW could be prognostic in the diagnosis and management of neonates with SARS-CoV-2 infection with high troponin levels.
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Affiliation(s)
- Sarkhan Elbayiyev
- Department of NeonatologyAnkara City Hospital University of Health SciencesAnkaraBilkentTurkey
| | - Gülsüm K. Şimşek
- Department of NeonatologyAnkara City Hospital University of Health SciencesAnkaraBilkentTurkey
| | - Burak Ceran
- Department of NeonatologyAnkara City Hospital University of Health SciencesAnkaraBilkentTurkey
| | - Mustafa Ş. Akın
- Department of NeonatologyAnkara City Hospital University of Health SciencesAnkaraBilkentTurkey
| | - H. Gözde Kanmaz Kutman
- Department of NeonatologyAnkara City Hospital University of Health SciencesAnkaraBilkentTurkey
| | - Fuat E. Canpolat
- Department of NeonatologyAnkara City Hospital University of Health SciencesAnkaraBilkentTurkey
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Arkew M, Gemechu K, Haile K, Asmerom H. Red Blood Cell Distribution Width as Novel Biomarker in Cardiovascular Diseases: A Literature Review. J Blood Med 2022; 13:413-424. [PMID: 35942475 PMCID: PMC9356613 DOI: 10.2147/jbm.s367660] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/26/2022] [Indexed: 11/23/2022] Open
Abstract
Red blood cell distribution width (RDW) is a measure of the change in size of red blood cells and it is used in combination with other hematological parameters for the differential diagnosis of anemias. Recent evidence suggested that the change in RDW level may be a predictive biomarker of morbidity and mortality in cardiovascular diseases (CVDs). Cardiovascular diseases are the most common cause of death globally as compared to cancer and communicable diseases. Early diagnosis and prompt intervention of these diseases are very important to minimize their complications. Nowadays, the diagnosis of most cardiovascular diseases majorly depends on clinical judgment, electrocardiography and biochemical parameters. Red blood cell distribution width as a new predictive biomarker may play a pivotal role in assessing the severity and progression of CVDs. However, the underlying mechanisms for the association between RDW and CVDs are not clear. A deeper understanding of their association could help the physicians in more careful identification, early prevention, intervention, and treatment to prevent adverse cardiovascular events. This review aims to elaborate on the recent knowledge on the association between RDW and cardiovascular diseases and some possible pathophysiological mechanisms.
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Affiliation(s)
- Mesay Arkew
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Correspondence: Mesay Arkew, School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, P.O. Box: 235, Harar, Ethiopia, Email
| | - Kabtamu Gemechu
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kassahun Haile
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Haftu Asmerom
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Xie Z, Li C, An Y, Zhao D, Wang X. Thyroid hormone resistance syndrome due to a novel heterozygous mutation and concomitant Hashimoto's Thyroiditis: A pedigree report. J Int Med Res 2022; 50:3000605221109398. [PMID: 35850606 PMCID: PMC9310067 DOI: 10.1177/03000605221109398] [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] [Indexed: 12/01/2022] Open
Abstract
Thyroid hormone resistance syndrome (THRS) is a rare disease characterized by
reduced sensitivity to thyroid hormones. Mutations in the thyroid hormone
receptor beta (THRB) gene are considered as contributing to the
pathogenesis. This report describes a Chinese pedigree with THRS and Hashimoto’s
thyroiditis (HT) due to novel point mutation in the 11th exon of the
THRB gene (c. 1378 G > A). The proband complained of
goitre with increased thyroid hormone and normal thyroid stimulating hormone
levels. Gene sequencing was performed to confirm the diagnosis. HT was also
diagnosed based on positive thyroid autoantibodies and diffuse, grid-like
changes in the thyroid on ultrasound examination. Additionally, a comprehensive
examination of the proband’s pedigree was conducted. The patient’s father
exhibited the same gene mutation site and was diagnosed with THRS and HT. No
mutation site was detected in three patients with HT only and three healthy
volunteers. Thus, gene sequencing should be considered the gold standard for
diagnosing THRS. Furthermore, treatment should be individualized to control the
patient’s symptoms rather than normalizing thyroid hormone levels. Further
studies that determine the relationship between THRS and TH are warranted.
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Affiliation(s)
- Zongyan Xie
- Department of Clinical Pharmacology, Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing, China
| | - ChenFei Li
- Department of Endocrinology, Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing, China
| | - Yaxin An
- Department of Endocrinology, Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing, China
| | - Dong Zhao
- Department of Endocrinology, Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing, China
| | - Xuhong Wang
- Department of Clinical Pharmacology, Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing, China
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21
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Hong J, Hu X, Liu W, Qian X, Jiang F, Xu Z, Shen F, Zhu H. Impact of red cell distribution width and red cell distribution width/albumin ratio on all-cause mortality in patients with type 2 diabetes and foot ulcers: a retrospective cohort study. Cardiovasc Diabetol 2022; 21:91. [PMID: 35658957 PMCID: PMC9166463 DOI: 10.1186/s12933-022-01534-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/27/2022] [Indexed: 12/12/2022] Open
Abstract
Background Red blood cell distribution width (RDW) has emerged as a prognostic factor for mortality in various diseases. Up to now, few studies have focused on the prognostic value of RDW in patients with diabetic foot ulcers (DFUs). This retrospective cohort study aimed to investigate the impact of RDW and RDW/albumin (ALB) ratio on all-cause mortality in patients with DFUs. Methods This study included 860 patients with DFUs in a tertiary academic hospital. The associations of RDW and RDW/ALB with all-cause mortality were assessed by multivariable cox regression analyses. The pairwise comparisons of receiver operating characteristic (ROC) curves were performed to compare the predictive performance of RDW and RDW/ALB ratio. Harrell’s concordance index, integrated discrimination improvement, and net reclassification improvement were used to estimate the improvements in risk discrimination. Results Patients with high RDW and RDW/ALB had lower overall survival rates (all P < 0.001). The multivariable Cox regression revealed that high RDW [adjusted hazard ratio (HR) 2.426, 95% confidence interval (CI): 1.557–3.778, P < 0.001] and high RDW/ALB (adjusted HR 2.360, 95% CI: 1.414–3.942, P = 0.001) were independent associated with high all-cause mortality. In subgroup analyses, the comparative analysis of ROC curves revealed that the discriminating ability of the RDW/ALB ratio was significantly superior to RDW in patients with no severe DFUs or no severe peripheral artery disease, or in young and middle-aged patients (all P < 0.05). Adding RDW and RDW/ALB ratio to base models improved discrimination and risk reclassification for all-cause mortality. Conclusions RDW and RDW/ALB ratio are robust and independent prognostic markers in patients with DFUs. The RDW/ALB ratio appears to be of more predictive value for mortality in younger and less severely ill patients with DFUs. Both RDW and RDW/ALB ratio can provide incremental predictive value for all-cause mortality over traditional risk factors. RDW and RDW/ALB ratio can be used to identify high-risk patients with DFUs. Supplementary Information The online version contains supplementary material available at 10.1186/s12933-022-01534-4.
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Affiliation(s)
- Jing Hong
- Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Xiang Hu
- Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Wenyue Liu
- Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Xuehua Qian
- Department of Information, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Feifei Jiang
- Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Zeru Xu
- Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Feixia Shen
- Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China
| | - Hong Zhu
- Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
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22
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Pan M, Zhou P, Liu Z, Guo J, Du L, Jin X. Peripheral complete blood cell count indices and serum lipid levels in polypoidal choroidal vasculopathy. Clin Exp Optom 2022:1-6. [PMID: 35645225 DOI: 10.1080/08164622.2022.2079399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Meng Pan
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Henan Province Eye Hospital, Henan International Joint Research Laboratory for Ocular Immunology and Retinal Injury Repair, Zhengzhou, China
| | - Pengyi Zhou
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Henan Province Eye Hospital, Henan International Joint Research Laboratory for Ocular Immunology and Retinal Injury Repair, Zhengzhou, China
| | - Zhenhui Liu
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Henan Province Eye Hospital, Henan International Joint Research Laboratory for Ocular Immunology and Retinal Injury Repair, Zhengzhou, China
| | - Ju Guo
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Henan Province Eye Hospital, Henan International Joint Research Laboratory for Ocular Immunology and Retinal Injury Repair, Zhengzhou, China
| | - Liping Du
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Henan Province Eye Hospital, Henan International Joint Research Laboratory for Ocular Immunology and Retinal Injury Repair, Zhengzhou, China
| | - Xuemin Jin
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Henan Province Eye Hospital, Henan International Joint Research Laboratory for Ocular Immunology and Retinal Injury Repair, Zhengzhou, China
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23
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Taha SI, Samaan SF, Ibrahim RA, Moustafa NM, El-Sehsah EM, Youssef MK. Can Complete Blood Count Picture Tell Us More About the Activity of Rheumatological Diseases? CLINICAL MEDICINE INSIGHTS. ARTHRITIS AND MUSCULOSKELETAL DISORDERS 2022; 15:11795441221089182. [PMID: 35481333 PMCID: PMC9036329 DOI: 10.1177/11795441221089182] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/03/2022] [Indexed: 12/13/2022]
Abstract
Background: In clinical practice, distinguishing disease activity in patients with rheumatological illnesses is challenging. Objectives: We aimed to investigate clinical associations of hemogram-derived indices, namely: red cell distribution width (RDW), mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and systemic immune-inflammation index (SII) with disease activity in patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and ankylosing spondylitis (AS). Methods: In 250 patients with rheumatological disease and 100 healthy age-matched controls, we investigated disease activity scores and indicators and evaluated their association with hemogram-derived indices values. Results: Compared with the control group, RDW, MPV, and PLR significantly increased (P < .001) in the three studied disorders (RA, SLE, and AS), but LMR dramatically decreased. SII was considerably higher in RA and AS patients compared with controls but not in SLE patients. On the other hand, NLR rose dramatically in SLE patients compared with controls (P = .043), but did not change much in RA and AS patients (P > .05). RDW and MPV showed significant changes (P < .001) in the three studied diseases (RA, SLE, and AS) according to disease activity. They significantly increased across worsening activity scores. Only in the SLE group, PLR was significantly increased with disease activity (P < .001), while LMR showed a significant decrease (P = .016). Conclusions: Clinicians must pay close attention to complete blood count (CBC) analysis and its various derived ratios to better characterize the activity of rheumatological disorders and anticipate the disease course and prognosis.
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Affiliation(s)
- Sara I Taha
- Department of Clinical Pathology/Immunology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Sara F Samaan
- Department of Internal Medicine/ Rheumatology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Rehab Ali Ibrahim
- Department of Physical Medicine/Rheumatology and Rehabilitation, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Nouran M Moustafa
- Basic Medical Science Department, College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia.,Medical Microbiology and Immunology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Eman M El-Sehsah
- Department of Medical Microbiology and Immunology, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Mariam K Youssef
- Department of Clinical Pathology/Hematology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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24
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Aksoy Saraç G, İbiş S, Akdağ T. Evaluation of the association between platelet tests and thyroid stimulating hormone levels in patients with vitiligo. J Cosmet Dermatol 2022; 21:3593-3597. [PMID: 35156762 DOI: 10.1111/jocd.14848] [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: 01/09/2022] [Revised: 01/26/2022] [Accepted: 02/10/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Vitiligo is a common dermatological disease of unknown cause and progressing with depigmentation and affects approximately 1% of the world population. In the study, we aimed to compare plateletcrit (PCT), mean platelet volume (MPV), platelet (PLT), and thyroid-stimulating hormone (TSH) values in vitiligo patients. MATERIAL AND METHODS We retrospectively evaluated the medical data of 100 patients who were admitted to the dermatology outpatient clinic between January 2020 and December 2021 with a diagnosis of vitiligo. The control group was retrospectively constituted from medical records of 190 healthy individuals. PCT, MPV, PLT, and TSH levels of both groups were compared statistically. RESULTS A total of 190 participants (100 vitiligo patients and 90 healthy volunteers) were included in the study. The mean age of the patient group was 38.62±1.62, while the mean age of the control group was 41.52±1.54. There were no differences between the two groups in terms of age and gender. It was found that the mean MPV value in the patient group was lower than the control group (p=0.00). PLT and PCT values were significantly higher in the patient group than the control group (p=0.00, p=0.01, respectively). There was no statistically significant difference between the two groups in terms of TSH (p>0.05). A negative correlation between MPV and PLT values in the patient group (r=-0.218, p=0.029), and a negative correlation between MPV and TSH (r=-0.218, p=0.029). -0.230, p=0.021). CONCLUSION In the study, a comparison of the PCT, MPV, and PLT levels showed a difference between both groups, but no differences in TSH levels. To clarify these results, comprehensive studies with more samples are needed.
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Affiliation(s)
- Gülhan Aksoy Saraç
- Ufuk University Faculty of Medicine, Department of Dermatology, Ankara, Turkey
| | - Saadet İbiş
- 29 May State Hospital, Biochemistry Laboratory Ankara, Turkey
| | - Turan Akdağ
- Necmettin Erbakan University, Meram Vocational School, Konya, Turkey
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Cao YT, Zhang KY, Sun J, Lou Y, Lv TS, Yang X, Zhang WH, Yu JY, Wu QB, Zhou XQ. Platelet abnormalities in autoimmune thyroid diseases: A systematic review and meta-analysis. Front Immunol 2022; 13:1089469. [PMID: 36618418 PMCID: PMC9812954 DOI: 10.3389/fimmu.2022.1089469] [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] [Received: 11/04/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
Background Some degree of platelet index abnormality has been found clinically in the autoimmune thyroid disease (AITD), but the findings are not uniform. Methods The PubMed, Web of Science, Cochrane Library, and Embase databases were searched for relevant articles published up to August 16th, 2022, with no restrictions on the language of the articles. Reference lists of eligible articles were also searched. A random effect model was used to pool the standardized mean difference (SMD) and 95% confidence interval (95% CI) of platelet count (PLT), mean platelet volume (MPV), and platelet distribution width (PDW) between AITD patients and healthy controls, and subgroup analyses were performed. Results A total of 19 articles with 6173 people (3824 AITD patients and 2349 healthy people) were included in the meta-analysis. The results showed that PLT and MPV values were significantly increased in AITD patients when compared with healthy people (SMD: 0.164, 95% CI: 0.044 to 0.285; SMD: 0.256, 95% CI: 0.013 to 0.500), while no significant difference was found in PDW between the AITD group and the control group (SMD: 0.060, 95% CI: -0.164 to 0.284). Subgroup analysis according to disease type and thyroid function revealed that for PLT, this difference was only found in the Hashimoto's thyroiditis (HT) and hypothyroid groups, but not in the Graves' disease (GD) and hyperthyroid groups. For MPV, the results were the opposite of those for PLT: MPV was significantly higher in the GD, hyperthyroid, and euthyroid groups than in the control group, but not in the HT and hypothyroid groups. Sensitivity analysis showed that the stability of the pooled MPV was not good. No publication bias was found. Conclusions PLT and MPV are significantly elevated in patients with AITD, with PLT being more significantly elevated in HT and hypothyroidism, and MPV being more significantly increased in GD and hyperthyroidism. Appropriate clinical attention can be paid to the thyroid function of patients when abnormal platelet indices are found, and conversely, the consequences of abnormal platelet parameters such as elevated MPV lead to an increased occurrence of cardiovascular events, which should also be addressed in the AITD population. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022341823.
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Affiliation(s)
- Yu-Tian Cao
- The First Clinical Medical College of Nanjing University of Chinese Medicine, Nanjing, China.,Department of Endocrinology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Kai-Yu Zhang
- The First Clinical Medical College of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jing Sun
- The First Clinical Medical College of Nanjing University of Chinese Medicine, Nanjing, China.,Department of Endocrinology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Yan Lou
- Department of Endocrinology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Tian-Su Lv
- The First Clinical Medical College of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xinyi Yang
- The First Clinical Medical College of Nanjing University of Chinese Medicine, Nanjing, China.,Department of Endocrinology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Wen-Hui Zhang
- The First Clinical Medical College of Nanjing University of Chinese Medicine, Nanjing, China.,Department of Endocrinology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Jiang-Yi Yu
- Department of Endocrinology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Qi-Biao Wu
- State Key Laboratory of Quality Research in Chinese Medicines and Faculty of Chinese Medicine, Macau University of Science and Technology, Taipa, Macao, Macao SAR, China
| | - Xi-Qiao Zhou
- Department of Endocrinology, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
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26
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Mo M, Huang Z, Huo D, Pan L, Xia N, Liao Y, Yang Z. Influence of Red Blood Cell Distribution Width on All-Cause Death in Critical Diabetic Patients with Acute Kidney Injury. Diabetes Metab Syndr Obes 2022; 15:2301-2309. [PMID: 35942039 PMCID: PMC9356623 DOI: 10.2147/dmso.s377650] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/18/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE To explore the relationship between red blood cell distribution width (RDW) and all-cause death in critical diabetic patients with acute kidney injury (AKI). METHODS The clinical data of critical diabetic patients with AKI in MIMIC-III database were analyzed retrospectively. According to the survival status of 28-day after AKI and levels of RDW, patients were divided into survival and death groups, high RDW (RDW > 15.3%) and low RDW groups (RDW ≤ 15.3%). Kaplan-Meier curves were used to compare the survival rates of diabetic patients with AKI in different RDW and AKI stages, and Cox regression analysis was used to evaluate the risk factors of 28-day all-cause death in critical diabetic patients with AKI. RESULTS A total of 5200 patients with critical diabetic patients with AKI were included in this study with the male to female ratio of 1.53:1. The mean follow-up time was 24.97 ± 7.14 days, and the 28-day all-cause mortality was 17.9% (931/5200). Age, RDW, blood urea nitrogen, serum creatinine, lactic acid, proportion of AKI stage, sepsis and respiratory failure in the death group were higher than those in the survival group, while mean arterial pressure (MAP) and red blood cell count were lower than those in the survival group. Kaplan-Meier analysis showed that the 28-day survival rate of the high RDW group was significantly lower than that of the low RDW group (log-rank χ 2 = 9.970, P = 0.002). Multivariate Cox regression analysis showed that advanced age (HR = 1.042, 95% CI = 1.021-1.063), decreased MAP (HR = 0.984, 95% CI = 0.969-0.998), stage 3 AKI (HR = 3.318, 95% CI = 1.598-6.890) and increased RDW (HR = 1.255, 95% CI = 1.123-1.403) were independent risk factors of 28-day all-cause death in critical diabetic patients with AKI (P < 0.05). CONCLUSION High level of RDW is an important risk factor of all-cause death in critical diabetic patients with AKI, and it may be used as a valuable index to classify the mortality.
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Affiliation(s)
- Manqiu Mo
- Geriatric Department of Endocrinology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, People’s Republic of China
| | - Zichun Huang
- Department of Cardiovascular Thoracic Surgery, the Third Affiliated Hospital of Guangxi Medical University: Nanning Second People’s Hospital, Nanning, 530031, People’s Republic of China
| | - Dongmei Huo
- Department of Nephrology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, People’s Republic of China
| | - Ling Pan
- Department of Nephrology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, People’s Republic of China
| | - Ning Xia
- Geriatric Department of Endocrinology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, People’s Republic of China
| | - Yunhua Liao
- Department of Nephrology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, People’s Republic of China
| | - Zhenhua Yang
- Department of Nephrology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, People’s Republic of China
- Correspondence: Zhenhua Yang; Yunhua Liao, Department of Nephrology, the First Affiliated Hospital of Guangxi Medical University, No. 6, Shuangyong Road, Nanning, 530021, Guangxi, People’s Republic of China, Email ;
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Elevated platelet distribution width and red cell distribution width are associated with autoimmune liver diseases. Eur J Gastroenterol Hepatol 2021; 33:e905-e908. [PMID: 34643621 DOI: 10.1097/meg.0000000000002296] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVE Red blood cell distribution width (RDW) and platelet distribution width (PDW) are reported to be associated with inflammation. We aimed to determine the association between RDW and PDW with autoimmune liver disease (ALD). MATERIAL AND METHODS We retrospectively analyzed 126 patients who were diagnosed with ALD. Sixty-nine healthy individuals represented the control group. Characteristics and laboratory parameters of the ALD patients and control subjects were compared. RESULTS The aspartate transaminase (AST) (P < 0.001), alanine transaminase (ALT) (P < 0.001), C-reactive protein (CRP) (P < 0.001), RDW (P < 0.001) and PDW (P < 0.001) levels of the ALD group were significantly higher than those of the control subjects. RDW was significantly correlated with AST (r = 0.17, P = 0.02) and CRP (r = 0.19, P = 0.01) levels. Moreover, PDW was significantly correlated with AST (r = 0.23, P = 0.002), ALT (r = 0.23, P = 0.001) and CRP (r = 0.23, P = 0.001) levels. The sensitivity and specificity of RDW higher than 13.7% level were 76% and 62%, respectively [AUC: 0.74, P < 0.001, 95% confidence interval (CI): 0.67-0.81]. The sensitivity and specificity of PDW higher than 17.9% level were 80% and 71%, respectively (AUC: 0.85, P < 0.001, 95% CI: 0.79-0.90). The sensitivity and specificity of CRP higher than 2.9 U/l level were 92% and 85%, respectively (AUC: 0.91, P < 0.001, 95% CI: 0.86-0.95). CONCLUSION Our study demonstrates that RDW and PDW have considerable sensitivity and specificity in determining ALD.
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28
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Gu L, Xue S. The Association Between Red Blood Cell Distribution Width and the Severity of Diabetic Chronic Kidney Disease. Int J Gen Med 2021; 14:8355-8363. [PMID: 34815707 PMCID: PMC8605827 DOI: 10.2147/ijgm.s332848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 10/01/2021] [Indexed: 01/13/2023] Open
Abstract
Purpose Red cell distribution width (RDW) has been evidenced to be related to various diabetes-associated macrovascular and microvascular complications. However, the studies on the association between RDW and diabetic chronic kidney disease (CKD) are still scarce. The aim of the study is to explore whether there is any association between RDW and the severity of diabetic CKD. Patients and Methods The study recruited 396 patients diagnosed with diabetic CKD at People's Hospital of Gaochun from January 2006 to April 2021. Baseline characteristics were gathered and laboratory tests were performed to measure clinical indexes. Patients were also categorized into three groups based on their CKD stages. Correlation analysis and multivariate ordinal logistic regression were performed to investigate the association between RDW and the severity of diabetic CKD. The risk size was described as odds ratio (OR) and 95% confidence interval (CI). Results We found a significant association between RDW and the severity of CKD, with a correlation coefficient of 0.32 (P < 0.01). We used three models for multivariate ordinal logistic regression to investigate the relationship between RDW and the severity of CKD. Results showed that RDW is an independent and significant risk factor of diabetic CKD after adjustment for demographic data, physiological indexes, and drug history [Model 3 OR (95% CI) = 1.225 (1.023-1.467)]. In subgroup analysis, RDW remained a significant risk factor in all three models for patients who had diabetes of 5-10 years [Model 3 OR (95% CI) = 1.480 (1.067-2.052)] and had a HbA1c level >7% [(Model 3 OR (95% CI) = 1.478 (1.184-1.845)]. Conclusion RDW is significantly associated with the disease stages of diabetic CKD, and the risk is higher for people with 5-10 years of diabetes and for those who do not control the HbA1c level well. This study has implications for the diagnosis, monitoring, and timely treatment of the diabetic CKD.
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Affiliation(s)
- Li Gu
- Department of Endocrinology, People's Hospital of Gaochun, Nanjing, 211300, People's Republic of China
| | - Song Xue
- Department of Pathology, People's Hospital of Gaochun, Nanjing, 211300, People's Republic of China
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Turan Ç, Metin N, Utlu Z, Tezcan D. Mean platelet volume as a predictor in the differentiation of Behçet's disease from recurrent aphthous stomatitis - A single centre, prospective, case-control study. Int J Clin Pract 2021; 75:e14866. [PMID: 34519145 DOI: 10.1111/ijcp.14866] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 09/10/2021] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Recurrent oral ulcers (ROUs) are the most common disorder of the oral cavity in the community. The most challenging issue for the clinician to deal with in the diagnosis is to distinguish whether ROUs are associated with primarily Behçet's disease (BD). We aimed to investigate whether hemogram parameters contribute to reinforce BD suspicion in the differential diagnosis of recurrent aphthous stomatitis (RAS) and BD. METHODS A total of 260 participants were recruited from the dermatology department in this single-centre, prospective, case-control study. Participants meeting eligibility criteria were divided into three groups as healthy control (n = 90), RAS (n = 97) and mucocutaneous BD (n = 73). The mean platelet volume (MPV), red cell distribution width (RDW), haemoglobin, neutrophils, monocyte, lymphocytes and platelet counts were evaluated with the complete blood count. Furthermore, the neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio and platelet/lymphocyte ratio were calculated. Erythrocyte sedimentation rate (ESR) and C-reactive protein were recorded. The contribution of hemogram parameters to the differentiation of BD from RAS was analysed. RESULTS The healthy control, RAS and BD groups were matched in terms of mean age (29.3 ± 5.8, 28.7 ± 5.6 and 29.9 ± 6.8 years; respectively) and sex distribution (women/men rate: 1.4, 1.6 and 1.7; respectively). ESR, neutrophil count and NLR were significantly higher in BD patients. (P = .032, P = .010, P = .019; respectively). MPV is significantly decreased in BD patients than in healthy control and RAS patients (P < .001). Decreased MPV (≤10 fL) and increased RDW (≥13.0%) were useful in predicting BD in patients evaluated with complaints of ROUs (OR = 9.98, 95% CI: [4.65-21.42], P < .001 and OR = 2.23, 95% CI: [1.14-3.36], P = .019, respectively). CONCLUSIONS Decreased MPV may be predictive for BD in selected patients with ROUs. We consider that more attention is required in terms of BD especially if MPV ≤10.0 fL.
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Affiliation(s)
- Çağrı Turan
- Department of Dermatology and Venereology, The Republic of Turkey, Health Sciences University Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Nurcan Metin
- Department of Dermatology and Venereology, The Republic of Turkey, Health Sciences University Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Zeynep Utlu
- Department of Dermatology and Venereology, The Republic of Turkey, Health Sciences University Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Dilek Tezcan
- Department of Rheumatology, The Republic of Turkey, Selçuk University Faculty of Medicine, Selcuklu, Konya, Turkey
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Alparslan Bekir S, Tuncay E, Gungor S, Yalcinsoy M, Sogukpinar Ö, Gundogus B, Aksoy E, Agca M, Agca Altunbey S, Turker H, Karakurt Z. Can red blood cell distribution width (RDW) level predict the severity of acute exacerbation of chronic obstructive pulmonary disease (AECOPD)? Int J Clin Pract 2021; 75:e14730. [PMID: 34383359 DOI: 10.1111/ijcp.14730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/09/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Elevated red blood cell distribution width (RDW) levels were associated with mortality in patients with stable chronic obstructive lung pulmonary diseases (COPD). There are limited data about RDW levels in acute exacerbation of COPD (AECOPD). AIM/OBJECTIVE The association of the RDW levels with the severity of AECOPD was evaluated according to admission location, (outpatient-clinic, ward and intensive care unit (ICU)). METHODS Cross sectional retrospective study was designed in tertiary care hospital for chest diseases in 2015. Previously COPD diagnosed patients admitted to hospital outpatient-clinic, ward and ICU due to AECOPD were included in the study. Patients demographics, RDW, biomarkers (CRP, RDW, Neutrophil to lymphocyte ratio (NLR), platelet to mean platelet volume (PLT-MPV)) C-CRP, biochemistry values were recorded from hospital electronic system. RDW values were subdivided below 0.11% (low), above and equal 0.15% (high) and between 0.11%-0.15% (normal). Neutrophil to lymphocyte ratio (NLR) and platelet to mean platelet volume (PLT-MPV) were also calculated. Biomarker values were compared according to where AECOPD was treated. RESULTS 2771 COPD patients (33% female) and 1429 outpatients-clinic, 1156 ward and 186 ICU were enrolled in the study. The median RDW values in outpatients-clinic, ward and ICU were 0.16 (0.09-0.26), 0.07 (0.01-0.14) and 0.01 (0.00-0.07) respectively (P < .001). In outpatient to ward and ICU, low RDW values were significantly increased (31%, 66%, 83%, respectively) and high RDW values significantly decreased (54%, 24%, 10%) (P < .001). According to attack severity, low RDW values were determined. CONCLUSION Patients with AECOPD, lower RDW values should be considered carefully. Lower RDW can be used for decision of COPD exacerbation severity and follow up treatment response.
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Affiliation(s)
- Sumeyye Alparslan Bekir
- Department of Pulmonary Diseases, Health Sciences University Sureyyapasa Pulmonary Disease and Pulmonary Surgery Training and Research Hospital, Istanbul, Turkey
| | - Eylem Tuncay
- Department of Pulmonary Diseases, Health Sciences University Sureyyapasa Pulmonary Disease and Pulmonary Surgery Training and Research Hospital, Istanbul, Turkey
| | - Sinem Gungor
- Department of Pulmonary Diseases, Health Sciences University Sureyyapasa Pulmonary Disease and Pulmonary Surgery Training and Research Hospital, Istanbul, Turkey
| | - Murat Yalcinsoy
- Department of Pulmonary Disease, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Özlem Sogukpinar
- Department of Pulmonary Diseases, Health Sciences University Sureyyapasa Pulmonary Disease and Pulmonary Surgery Training and Research Hospital, Istanbul, Turkey
| | - Baran Gundogus
- Department of Pulmonary Diseases, Health Sciences University Sureyyapasa Pulmonary Disease and Pulmonary Surgery Training and Research Hospital, Istanbul, Turkey
| | - Emine Aksoy
- Department of Pulmonary Diseases, Health Sciences University Sureyyapasa Pulmonary Disease and Pulmonary Surgery Training and Research Hospital, Istanbul, Turkey
| | - Meltem Agca
- Department of Pulmonary Diseases, Health Sciences University Sureyyapasa Pulmonary Disease and Pulmonary Surgery Training and Research Hospital, Istanbul, Turkey
| | | | - Hatice Turker
- Department of Pulmonary Diseases, Health Sciences University Sureyyapasa Pulmonary Disease and Pulmonary Surgery Training and Research Hospital, Istanbul, Turkey
| | - Zuhal Karakurt
- Department of Pulmonary Diseases, Health Sciences University Sureyyapasa Pulmonary Disease and Pulmonary Surgery Training and Research Hospital, Istanbul, Turkey
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Ling J, Liao T, Wu Y, Wang Z, Jin H, Lu F, Fang M. Predictive value of red blood cell distribution width in septic shock patients with thrombocytopenia: A retrospective study using machine learning. J Clin Lab Anal 2021; 35:e24053. [PMID: 34674393 PMCID: PMC8649348 DOI: 10.1002/jcla.24053] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 12/30/2022] Open
Abstract
Background Sepsis‐associated thrombocytopenia (SAT) is common in critical patients and results in the elevation of mortality. Red cell distribution width (RDW) can reflect body response to inflammation and oxidative stress. We try to investigate the relationship between the RDW and the prognosis of patients with SAT through machine learning. Methods 809 patients were retrospectively analyzed from the Medical Information Mart for Intensive Care III (MIMIC‐III) database. The eXtreme Gradient Boosting (XGBoost) and SHapley Additive exPlanations (SHAP) were used to analyze the impact of each feature. Logistic regression analysis, propensity score matching (PSM), receiver‐operating characteristics (ROC) curve analysis, and the Kaplan‐Meier method were used for data processing. Results The patients with thrombocytopenia had higher 28‐day mortality (48.2%). Machine learning indicated that RDW was the second most important in predicting 28‐day mortality. The RDW was significantly increased in non‐survivors by logistic regression and PSM. ROC curve shows that RDW has moderate predictive power for 28‐day mortality. The patients with RDW>16.05 exhibited higher mortality through Kaplan‐Meier analysis. Conclusions Interpretable machine learning can be applied in clinical research. Elevated RDW is not only common in patients with SAT but is also associated with a poor prognosis.
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Affiliation(s)
- Jianmin Ling
- Department of Emergency and Intensive Care Unit, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tongzhou Liao
- Services Computing Technology and System Lab, Cluster and Grid Computing Lab, National Engineering Research Center for Big Data Technology and System, School of Computer Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Yanqing Wu
- Department of Neurology, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhaohua Wang
- Department of Emergency and Intensive Care Unit, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hai Jin
- Services Computing Technology and System Lab, Cluster and Grid Computing Lab, National Engineering Research Center for Big Data Technology and System, School of Computer Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Feng Lu
- Services Computing Technology and System Lab, Cluster and Grid Computing Lab, National Engineering Research Center for Big Data Technology and System, School of Computer Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Minghao Fang
- Department of Emergency and Intensive Care Unit, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Demir AD. Relationship of the platelet distribution width/platelet count ratio with thyroid antibody levels in patients with Hashimoto's thyroiditis. J Int Med Res 2021; 49:3000605211043241. [PMID: 34586923 PMCID: PMC8485304 DOI: 10.1177/03000605211043241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Objective I investigated whether the platelet distribution width/platelet count (PDW/PC) ratio, which is an inexpensive and simple test performed for almost all patients, is applicable in the follow-up of patients with Hashimoto’s thyroiditis and examined the relationship of this ratio with thyroperoxidase and thyroglobulin antibody levels. Materials and methods The study groups consisted of 67 patients with Hashimoto’s thyroiditis and 17 controls. All participants were aged 20 to 75 and treated the Internal Medicine outpatient clinic of my institution. The PDW/PC ratio and thyroid antibody levels were retrospectively evaluated in patients with normal liver and renal function and normal white blood cell counts, hemoglobin levels, and hematocrit levels. Results Thyroid antibody levels were significantly higher in patients with Hashimoto’s thyroiditis than in controls. PC was higher in patients with Hashimoto’s thyroiditis, whereas the PDW/PC ratio was lower. However, these differences were not statistically significant. Conclusion In this study, I did not find a statistically significant relationship between thyroid antibody levels and PDW/PC. However, a weak correlation between these variables was identified.
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Affiliation(s)
- Aslıhan Dilara Demir
- Department of Internal Medicine, Amasya University Research Hospital, Amasya, Turkey
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Torales J, Castaldelli-Maia JM, Ventriglio A, Almirón-Santacruz J, Barrios I, O'Higgins M, García O, Navarro R, Melgarejo O, Jafferany M. Alopecia areata: A psychodermatological perspective. J Cosmet Dermatol 2021; 21:2318-2323. [PMID: 34449973 DOI: 10.1111/jocd.14416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 08/16/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Alopecia Areata (AA) is an autoimmune dermatological disease that could be influenced by psychological factors as part of the pathophysiology of the illness. AIMS This review article aims to report on psychodermatological and psychopathological aspects involved in the etiopathogenesis and comorbidities of AA, as well as on the psychiatric and psychological management of affected patients. METHODS We conducted a literature search on PubMed and Google Scholar from January 1980 to May 2021 employing the search terms of alopecia areata, psychological factors, psychological impact, psychodermatology, and psychopathology. All lists of references from the identified articles were screened for further relevant studies. The search was limited to English and Spanish language articles and was supplemented with themed books and book chapters. No specific quality criteria were used for the studies selection. RESULTS Several authors have found a high comorbidity rate between AA and mental disorders, concluding that stress and psychological factors are involved in both the development and exacerbation of the illness. More evidences are needed in order to describe the associations between the immune response, stress, and the physiological factors observed in AA patients. CONCLUSION AA is a complex illness characterized by multifactorial etiology. An interaction between genetic, autoimmune, hormonal, neural, and psychological factors is supposed. Psychopathological aspects of illness need to be better described and considered in the clinical setting.
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Affiliation(s)
- Julio Torales
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - João Mauricio Castaldelli-Maia
- Department of Neuroscience, Medical School, Fundação do ABC, Santo André, SP, Brazil.,Department of Psychiatry, Medical School, University of São Paulo, São Paulo, SP, Brazil
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - José Almirón-Santacruz
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Iván Barrios
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Marcelo O'Higgins
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Oscar García
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Rodrigo Navarro
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Osvaldo Melgarejo
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Mohammad Jafferany
- Department of Psychiatry, Central Michigan University, Mount Pleasant, MI, USA
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Xi Y, Bai Y. Diagnostic value of red blood cell distribution width, platelet distribution width, and red blood cell distribution width to platelet ratio in children with hemophagocytic lymphohistiocytosis. J Clin Lab Anal 2021; 35:e23909. [PMID: 34273201 PMCID: PMC8418495 DOI: 10.1002/jcla.23909] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/26/2021] [Accepted: 07/05/2021] [Indexed: 11/17/2022] Open
Abstract
Background To investigate whether red blood cell distribution width (RDW), platelet distribution width (PDW), and red blood cell distribution width to platelet ratio (RPR) can serve as biomarkers to distinguish hemophagocytic lymphohistiocytosis (HLH) from sepsis in children. Methods This is a retrospective study, involving 71 HLH patients, 105 sepsis patients, and 88 normal controls from January 2018 to December 2019. RDW, PDW, and RPR values were obtained from peripheral blood samples before standard treatment. The clinical differential diagnostic values of RDW, PDW, and RPR were analyzed by receiver operating characteristic (ROC) curve. In addition, peripheral blood samples after treatment from HLH patients were also collected for the same analyses. Results RDW, PDW, and RPR levels of the HLH patients were significantly higher than those of sepsis and normal controls (p < 0.001). In ROC curve analysis of the RDW, PDW, and RPR for diagnosis of HLH, the area under the curve (AUC) could reach to 0.7799 (95% CI = 0.7113–0.8486), 0.7835 (95% CI = 0.7093–0.8577), and 0.9268 (95% CI = 0.8886–0.9649), respectively. When using the criteria of RDW >13.75, PDW >13.30, and RPR >0.08, the sensitivity was 76.06%, 67.61%, and 84.51%, while the specificity was 68.57%, 85.71%, and 87.62%, respectively. After treatment of HLH patients, PDW and RPR were significantly reduced (p < 0.001). Conclusions This study shows that RDW, PDW, and RPR, which can be easily and cheaply detected, are novel indicators for differential diagnosis of HLH. PDW and RPR are useful indices for monitoring the effects of treatment on HLH.
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Affiliation(s)
- Ya Xi
- Department of Central Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Yongying Bai
- Department of Clinical Laboratory, Branch of National Clinical Research Center for Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Association between Red Blood Cell Distribution Width and Diabetic Retinopathy: A 5-Year Retrospective Case-Control Study. J Ophthalmol 2021; 2021:6653969. [PMID: 34327012 PMCID: PMC8277500 DOI: 10.1155/2021/6653969] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 06/22/2021] [Indexed: 01/07/2023] Open
Abstract
Purpose Red blood cell distribution width (RDW) has been regarded as an emerging biomarker of the general population and cardiovascular disease. In this study, we aimed to evaluate the association between RDW and diabetic retinopathy (DR). Methods This case-control study included 167 patients with DR, 131 patients with diabetes mellitus (DM), and 170 age- and sex-matched healthy controls from April 2014 to May 2019. Demographic data, laboratory parameters, and ocular examinations were collected. Results RDW values of the DR group were significantly higher than those of the healthy control (p < 0.001) and DM group (p=0.002). A similar trend was observed when RDW was compared among the 3 groups with respect to age and gender. Logistic regression analysis has shown the OR of RDW was 3.791 (2.33–6.168; p < 0.001) against the control group and was 1.348 (0.997–1.823; p=0.047) against the DM group. Conclusion RDW values were significantly elevated in DR patients, and an elevated RDW was associated with an increased incidence of DR in patients with DM.
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Hashimoto's thyroiditis is associated with elevated serum uric acid to High Density Lipoprotein-Cholesterol ratio. ACTA ACUST UNITED AC 2021; 59:403-408. [PMID: 34142519 DOI: 10.2478/rjim-2021-0023] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Indexed: 01/13/2023]
Abstract
Background . Hashimoto's thyroiditis (HT) is an auto-immune condition characterized with lymphocytic and fibroblastic infiltration of the thyroid gland. The rate of uric acid and HDL cholesterol; so called as uric acid to HDL ratio (UHR) has been shown to be elevated in inflammatory conditions diseases. We aimed to compare UHR and other laboratory parameters of the patients with HT to those values in healthy controls. Methods . The patients whom diagnosed with HT by medical history, physical examination, elevated thyroid autoantibodies in serum and characteristic sonographic findings in outpatient internal medicine clinics of our institution were enrolled to the present retrospective study. Age and sex matched healthy volunteers were enrolled as controls. UHR of the HT patients and control subjects were compared. Results . Mean UHR of the HT group was 11% ± 4 %, while UHR of the control group was 8% ± 2% (p<0.001). UHR was significantly and positively correlated with thyroid stimulating hormone (TSH) (r=0.26, p=0.01) and negatively correlated with free T4 (FT4) (r=-0.22, p=0.04) levels. The sensitivity and specificity of the UHR level greater than 8.3% were 74% and 52%, respectively (AUC: 0.74, p<0.001, 95% CI: 0.64-0.84). Conclusion . We suggest that UHR is a reliable and useful marker for HT. Therefore, it may be helpful in establishing the diagnosis of HT in addition to other diagnostic tools.
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Varma A, Dergaa I, Mohammed AR, Abubaker M, Al Naama A, Mohammed S, Rafique MA, Manu L, Vedasalam S, Parveze P, Hammouda O, Ammar A. Covid-19 and diabetes in primary care - How do hematological parameters present in this cohort? Expert Rev Endocrinol Metab 2021; 16:147-153. [PMID: 33818239 DOI: 10.1080/17446651.2021.1909472] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 03/24/2021] [Indexed: 02/08/2023]
Abstract
Objectives: Changes in hematological parameters are becoming evident as important early markers of COVID-19. Type 2 Diabetes Mellitus (T2DM) has been shown to be associated with increased severity of COVID-19. In this study, we aim to explore the various hematological variables in COVID-19 positive patients with T2DM, so as to act early and improve patient outcomes.Methods: Medical e-records of seventy adult patients with T2DM who were COVID-19 positive have been analyzed in this retrospective cohort study. Demographic, clinical and laboratory parameters for these patients were examined.Results: Of the seventy patients with T2DM, 48.88% had poorly controlled diabetes. 70.69% were pyrexial, 56.25% were tachycardic and 38.58% were asymptomatic on presentation. Amongst the hematological parameters, anemia was seen in 10% of males and 15.38% of females. 20% had a high red-blood-cell-distribution-width (RDW). 7.27% had thrombocytosis and 3.64% had thrombocytopenia. 73.3% had a high platelet-distribution-width (PDW) and 44.44% had an increased mean-platelet-volume (MPV). 16.36% were neutropenic and 16.67% had lymphocytopenia.Conclusion: Diabetic COVID-19 positive patients have been shown to have prominent manifestations of the hemopoietic-system with varied hematological profiles. Recognizing the implications of these variables early in primary-care, can help clinicians aid management decisions and dictate early referral to secondary-care services, to help improve prognosis.
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Affiliation(s)
- Amit Varma
- PHCC, Primary Health Care Corporation, Doha, Qatar
| | | | | | | | | | | | | | - Lelna Manu
- PHCC, Primary Health Care Corporation, Doha, Qatar
| | | | | | - Omar Hammouda
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UFR STAPS, UPL, Paris Nanterre University, Nanterre, France
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Achraf Ammar
- Institute of Sport Sciences, Otto-von-Guericke University, Magdeburg, Germany
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Tolunay HE, Elci E. Importance of haemogram parameters for prediction of the time of birth in women diagnosed with threatened preterm labour. J Int Med Res 2021; 48:300060520918432. [PMID: 32295437 PMCID: PMC7163240 DOI: 10.1177/0300060520918432] [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] [Indexed: 12/12/2022] Open
Abstract
Objective This study aimed to estimate the importance of complete blood count
parameters for predicting the timing of birth in threatened preterm labour
cases. Methods We performed a retrospective study of 92 patients who were diagnosed with
threatened preterm labour (24–34 gestational weeks). The patients were
divided into two groups according to the time of birth (group 1: delivered
within the first week after diagnosis; group 2: delivered later than 1
week). We compared characteristics and complete blood count parameters
between these two groups. Results There were no significant differences in maternal age, body mass index,
gravida, parity, haemoglobin levels, and gestational weeks between the two
groups. The mean cervical length was 24.24 ± 3.60 mm in group 1 and
30.70 ± 5.32 mm in group 2. There were significant differences in the
neutrophil to lymphocyte ratio, white blood cell count, red cell
distribution width (RDW), absolute lymphocyte cell count, and absolute
neutrophil cell count between the two groups. Conclusion Maternal serum RDW, the neutrophil to lymphocyte ratio, white blood cell
count, absolute lymphocyte cell count, and the absolute neutrophil cell
count profile could guide clinicians in predicting the time of birth in
threatened preterm labour cases.
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Affiliation(s)
- Harun Egemen Tolunay
- Department of Perinatology, Etlik Zübeyde Hanım Maternity and Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - Erkan Elci
- Van Training and Research Hospital, Department of Obstetrics and Gynecology, Van, Turkey
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Zhou G, Ai Y, Guo S, Chen Q, Feng X, Xu K, Wang G, Ma C. Association Between Red Blood Cell Distribution Width and Thyroid Function. Front Endocrinol (Lausanne) 2021; 12:807482. [PMID: 35116009 PMCID: PMC8805204 DOI: 10.3389/fendo.2021.807482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/17/2021] [Indexed: 11/16/2022] Open
Abstract
AIM Red blood cell distribution width (RDW) is an important parameter with broad biological implications. However, the study investigating the association between RDW and thyroid function remains sparse and inconsistent. We aimed to investigate the association between RDW and thyroid function in the US population. METHODS A cross-sectional analysis was performed using the data from the National Health and Nutrition Examination Survey (NHANES) conducted from 2007 to 2010. The thyroid parameters investigated were mainly free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone (TSH), antithyroglobulin antibody (TgAb), and antithyroperoxidase antibody (TPOAb). In the 6,895 adults aged 18 years or older, logistic regression modeling was applied to estimate the association between RDW quartiles and thyroid parameters. Smooth curve fittings and generalized additive models were then performed to address the nonlinear relationship. RESULTS The association between RDW and TSH followed a J-shaped curve, and a significant positive relationship existed in the 12.5%-17.5% range of RDW (β = 0.350, 95% confidence interval (CI): 0.225 to 0.474), which was prominent in females. We further demonstrated a negative association (β = -0.018, 95% CI: -0.030 to -0.005) between RDW and fT3. Moreover, elevated RDW was more likely to be subclinical hypothyroidism. However, there was no obvious association between RDW and fT4. CONCLUSION This study confirmed a significant association between RDW and TSH, and future studies are needed to elucidate the underlying mechanisms of the peculiar RDW-fT3 relationship. RDW may be a significant clinical marker of subclinical hypothyroidism.
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Affiliation(s)
- Guowei Zhou
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yueqin Ai
- Department of Pneumology, Jinling Hospital, Nanjing, China
| | - Song Guo
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Quan Chen
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xiao Feng
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Kun Xu
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Gaoyuan Wang
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- *Correspondence: Gaoyuan Wang, ; Chaoqun Ma,
| | - Chaoqun Ma
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- *Correspondence: Gaoyuan Wang, ; Chaoqun Ma,
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Liang J, Nong S, Jiang L, Chi X, Bi D, Cao J, Mo L, Luo X, Huang H. Correlations of disease severity and age with hematology parameter variations in patients with COVID-19 pre- and post-treatment. J Clin Lab Anal 2020; 35:e23609. [PMID: 33222271 PMCID: PMC7744896 DOI: 10.1002/jcla.23609] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/06/2020] [Accepted: 09/21/2020] [Indexed: 01/08/2023] Open
Abstract
Background For better understanding of the pathological changes of COVID‐19, benefiting clinical management of the disease and the preparation for future waves of similar pandemics. Methods Hematology parameters from a total of 52 cases of COVID‐19 admitted for treatment in a designated hospital were retrospectively analyzed. Data were analyzed by SPSS statistical software. Results Pre‐treatment T‐cell subsets, total lymphocytes, red blood cell distribution width (RDW), eosinophils, and basophils were significantly lower than that of post‐treatment, while the inflammatory indexes neutrophils, neutrophil to lymphocyte ratio (NLR), and C‐reactive protein (CRP) levels, as well as red blood cell (RBC) and hemoglobin, were significantly reduced after treatment. The T‐cell subsets, total lymphocytes, and basophils in severely and critically ill patients were significantly lower than those in moderately ill patients. Neutrophils, NLR, eosinophils, procalcitonin (PCT), and CRP was significantly higher in severely and critically ill patients than in moderately ill patients. CD3+, CD8+, total lymphocytes, platelets, and basophils in patients older than 50 were lower than that of those younger than 50, while neutrophils, NLR, CRP, and RDW in patients older than 50 were higher than that of younger than 50. There was a positive correlation among prothrombin time (PT), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) in severely and critically ill patients. Conclusions T‐cell subsets, lymphocyte count, RDW, neutrophils, eosinophils, NLR, CRP, PT, ALT, and AST are important indicators in the management especially for severely and critically ill patients with COVID‐19.
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Affiliation(s)
- Juanying Liang
- Department of Laboratory Medicine, The Forth People's Hospital of Nanning City, Nanning, China
| | - Shaoyun Nong
- Department of Laboratory Medicine, Guangxi Nationalities Hospital, Nanning, China
| | - Liejun Jiang
- Department of Laboratory Medicine, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xiaowei Chi
- Department of Laboratory Medicine, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Dewu Bi
- Department of Laboratory Medicine, The Forth People's Hospital of Nanning City, Nanning, China
| | - Jun Cao
- Department of Laboratory Medicine, The Forth People's Hospital of Nanning City, Nanning, China
| | - Lida Mo
- Department of Laboratory Medicine, The Forth People's Hospital of Nanning City, Nanning, China
| | - Xiaolu Luo
- Department of Laboratory Medicine, The Forth People's Hospital of Nanning City, Nanning, China
| | - Huayi Huang
- School of Medical Laboratory, Youjiang Medical University for Nationalities, Baise, China.,Mindray North America, Mahwah, NJ, USA.,Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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Initial red cell distribution width as a predictor of poor neurological outcomes in out-of-hospital cardiac arrest survivors in a prospective, multicenter observational study (the KoCARC study). Sci Rep 2020; 10:17549. [PMID: 33067528 PMCID: PMC7568563 DOI: 10.1038/s41598-020-74842-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 10/06/2020] [Indexed: 12/29/2022] Open
Abstract
This study aimed to investigate whether the initial red cell distribution width (RDW) at the emergency department (ED) is associated with poor neurological outcomes in out-of-hospital cardiac arrest (OHCA) survivors. We performed a prospective observational analysis of patients admitted to the ED between October 2015 and June 2018 from the Korean Cardiac Arrest Research Consortium registry. We included OHCA patients who visited the ED and achieved return of spontaneous circulation. Initial RDW values were measured at the time of the ED visit. The primary outcome was a poor neurological (Cerebral Performance Category, or CPC) score of 3–5. A total of 1008 patients were ultimately included in this study, of whom 712 (70.6%) had poor CPC scores with unfavorable outcomes. Higher RDW quartiles (RDW 13.6–14.9%, RDW ≥ 15.0%), older age, female sex, nonshockable initial rhythm at the scene, unwitnessed cardiac arrest, bystander cardiopulmonary resuscitation (CPR), medical history, low white blood cell counts and high glucose levels were associated with poor neurological outcomes in univariate analysis. In multivariate analysis, the highest RDW quartile was independently associated with poor neurological outcomes (odds ratio 2.04; 95% confidence interval 1.12–3.69; p = 0.019) at hospital discharge after adjusting for other confounding factors. Other independent factors including age, initial rhythm, bystander CPR and high glucose were also associated with poor neurological outcomes. These results show that an initial RDW in the highest quartile as of the ED visit is associated with poor neurological outcomes at hospital discharge among OHCA survivors.
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Red Blood Cell Distribution Width, Neutrophil-to-Lymphocyte Ratio, and In-Hospital Mortality in Dyspneic Patients Admitted to the Emergency Department. DISEASE MARKERS 2020; 2020:8839506. [PMID: 32655721 PMCID: PMC7321522 DOI: 10.1155/2020/8839506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/01/2020] [Accepted: 06/03/2020] [Indexed: 02/06/2023]
Abstract
Red blood cell distribution width (RDW) and neutrophil-to-lymphocyte ratio (NLR) have shown a prognostic value in various clinical settings. We aimed to investigate the association between RDW, NLR, and in-hospital mortality in patients with dyspnea. In this retrospective study with the Medical Information Mart for Intensive Care III database (version 1.4), adult patients who came to the emergency department with dyspnea were included. Patients' comorbidities, hematological parameters within the first 48 hours after admission to the emergency department, and in-hospital mortality were extracted. The relationships between RDW, NLR, and in-hospital mortality were analyzed with the receiver operating characteristic (ROC) curve analysis and multivariate logistic regression model. We found that hospital survivors had significantly lower NLR than those who died. However, RDW was not significantly increased in patients who died during the hospitalization. The area under the ROC curve of NLR for predicting in-hospital mortality was 0.62. On multivariate analysis, NLR was not independently associated with in-hospital mortality. On further analysis, lymphocyte percentage was independently associated with in-hospital mortality, with an odds ratio of 0.56. Therefore, we concluded that RDW and NLR are not reliable parameters to predict in-hospital mortality in critically ill patients admitted to the emergency department with dyspnea.
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Al-Shafei AI, Musa SM, Rayis DA, Lutfi MF, El-Gendy OA, Adam I. Heart rate variability and hematological parameters in pregnant women. J Clin Lab Anal 2020; 34:e23250. [PMID: 32091186 PMCID: PMC7307359 DOI: 10.1002/jcla.23250] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 01/26/2020] [Accepted: 01/30/2020] [Indexed: 12/25/2022] Open
Abstract
Background There are few researches on hematological parameters (hemoglobin, red cell distribution width [RDW], white blood cells [WBCs], mean platelets volume [MPV], and heart rate variability [HRV]). There are no published data on this concept (HRV and hematological parameters) during pregnancy. Methods A cross‐sectional study was conducted at Saad Abul Ela hospital in Khartoum, Sudan during the period of July to August 2018. Pregnant women with singleton, a live baby, were enrolled in this study. Clinical history and examination were performed. HRV (autonomic modulation) was assessed using time and frequency domain HRV indices. Results One hundred and five pregnant women were enrolled. The median (quartile) of the age, parity, and gestational age was 30.0 (25.0‐35.0) years, 1.0 (0‐3.0), and 38.0 (32.0‐39.0) weeks, respectively. While there were positive correlations between hemoglobin and low frequency (LF), RDW and high frequency (HF), WBCs and HF Norm, WBCs and LF/HF, MPV and HF Norm, LF Norm and LF/HF, there was no significant correlation between the hematological (hemoglobin, WBCs, RDW, and MPV) and HRV parameters. Linear regression analysis showed no significant association between age, parity, gestational age, body mass index, hemoglobin, RDW, and HRV variables. The Log10 WBCs were negatively associated with Log10 HF (ms2/Hz). MPV was positively associated with LF Norm and negatively associated with HF Norm. Conclusion The study failed to show significant associations between age, parity, gestational age, hemoglobin, RDW, and HRV variables. The WBCs were negatively associated with HF. MPV was positively associated with LF Norm, and it was negatively associated with HF Norm.
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Affiliation(s)
- Ahmad I Al-Shafei
- Unaizah College of Medicine, Qassim University, Unaizah, Saudi Arabia
| | - Shaza M Musa
- Faculty of medicine, Najran University, Saudi Arabia
| | - Duria A Rayis
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Mohamed F Lutfi
- College of Medicine, Qassim University, Qassim, Saudi Arabia
| | - Ola A El-Gendy
- Unaizah College of Medicine, Qassim University, Unaizah, Saudi Arabia
| | - Ishag Adam
- College of Medicine, Qassim University, Qassim, Saudi Arabia.,Department of Obstetrics and Gynecology, Unaizah College of Medicine, Qassim University, Unaizah, Saudi Arabia
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Krygier A, Szczepanek-Parulska E, Filipowicz D, Ruchała M. Changes in serum hepcidin according to thyrometabolic status in patients with Graves' disease. Endocr Connect 2020; 9:EC-20-0017. [PMID: 32069222 PMCID: PMC7077520 DOI: 10.1530/ec-20-0017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 02/18/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Hepcidin is an acute-phase protein and a key regulator of iron homeostasis. Anaemia frequently occurs in patients with thyroid dysfunction, and hepcidin may be a potential link. OBJECTIVES Prospective assessment of hepcidin serum concentration and other parameters related to Fe homeostasis in hyperthyroid patients in the course of GD at diagnosis and during remission. PATIENTS AND METHODS Out of 70 patients recruited, 42 (32 women, 10 men), aged 42.5±15.1 years, met the inclusion criteria. Clinical and biochemical assessment, including hepcidin measurement by ELISA, was performed at baseline (T0) and after restoration of euthyroidism (T1). RESULTS Hepcidin concentration at T0 in the 24 patients who completed the study was significantly higher than the value during euthyroidism (28.7 (8.1-39.4) ng/mL vs. 7.9 (4.3-12.9) ng/mL, p<0.001). Hepcidin level was most significantly correlated with ferritin (rho = 0.723) in women at T0. In both men (377 (171-411) vs. 165 (84-237) ng/mL, p=0.001) and women (84 (23-104) vs. 35 (16-64) ng/mL, p=0.001), a significant decrease in ferritin level was demonstrated following therapy. A significant (p<0.001) increase in mean corpuscular volume (MCV) (83.5 (82.5-87.1) vs. 89.5 (88.8-90.0) fL) and mean concentration of haemoglobin (MCH) (29.0 (28.0-29.4) vs. 30.4 (29.5-31.1) pg) was observed. CONCLUSIONS Hepcidin and ferritin decrease significantly during the transition from a hyperthyroid state to euthyroidism in patients with GD. The observed changes occur in parallel to iron homeostasis fluctuations. During the transition from the hyperthyroid state to euthyroidism, the improvement of haematological status is reflected mainly by the increase in MCV and MCH.
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Affiliation(s)
- Aleksandra Krygier
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Ewelina Szczepanek-Parulska
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Dorota Filipowicz
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Marek Ruchała
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
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Li Z, Huang Y, Chen X, Wei C, Yang P, Xu W. The Effect of Inflammation on the Formation of Thyroid Nodules. Int J Endocrinol 2020; 2020:9827349. [PMID: 32695162 PMCID: PMC7368952 DOI: 10.1155/2020/9827349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 06/18/2020] [Accepted: 06/20/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Some studies have demonstrated that inflammation is highly associated with the prevalence of thyroid nodules (TNs). However, more confounders, such as metabolic diseases, should be adjusted. METHODS A clinical study collecting 2722 subjects was conducted to confirm the association between inflammation and TNs. The underlying mechanism was investigated in combination with bioinformatics analysis. RESULTS In the clinical study, propensity score matching was used to match metabolic parameters and other confounders, and it is observed that subjects with high inflammation had a higher prevalence of TNs and thyroid-stimulating hormone (TSH) than those with low inflammation. After further matching TNs, it is found that inflammation was positively associated with TSH, which was also demonstrated in a population without TNs. In bioinformatics study, inflammation did not promote TNs formation directly. Instead, it inhibited the synthesis of thyroid hormone, which might be the cause of the elevated TSH coexisting with inflammation. CONCLUSION Inflammation promotes the development of TNs disease, probably due to its indirect effect through inhibiting the synthesis of thyroid hormone, which results in the elevation of TSH.
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Affiliation(s)
- Zexin Li
- Health Care Center, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - Yiteng Huang
- Health Care Center, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - Xiang Chen
- Health Care Center, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - Chiju Wei
- Multidisciplinary Research Center, Shantou University, Shantou 515041, China
| | - Peixuan Yang
- Health Care Center, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - Wencan Xu
- Department of Endocrinology, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
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Hernik A, Szczepanek-Parulska E, Filipowicz D, Abdolall A, Borowczyk M, Wrotkowska E, Czarnywojtek A, Krasiński Z, Ruchała M. The hepcidin concentration decreases in hypothyroid patients with Hashimoto's thyroiditis following restoration of euthyroidism. Sci Rep 2019; 9:16222. [PMID: 31700042 PMCID: PMC6838327 DOI: 10.1038/s41598-019-52715-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 10/21/2019] [Indexed: 11/16/2022] Open
Abstract
The purpose of the study was to measure the hepcidin concentration and evaluate Fe homeostasis indices in a prospective study on patients with newly diagnosed hypothyroidism in the course of Hashimoto’s thyroiditis (HT) and following successful therapy. The prospective observational study consisted of 34 patients. The clinical evaluation and laboratory tests were performed at diagnosis (T0) and after restoration of euthyreosis 12 weeks later (T1). The median level of hepcidin was significantly lower (p = 0.002) after recovery (7.7 [6.2–13.0] ng/mL) than that before treatment (17.4 [7.6–20.4] ng/mL), while creatinine (p = 0.011) and GFR (p < 0.001) significantly improved after euthyroidism was achieved. A positive correlation was observed between hepcidin and fT3 (p = 0.033, r = 0.465) at T0. In the females, the level of hepcidin positively correlated with ferritin concentration before (p < 0.001, r = 0.928) and after treatment (p < 0.001, r = 0.835). A statistically significant difference was observed in RDW-CV (red blood cell distribution width - coefficient of variation) between the hypothyroid and euthyroid states. In conclusion, a decrease in hepcidin concentration during the transition from the hypothyroid state to euthyroidism in patients with HT is associated with the observed dynamics in iron homeostasis, mainly reflected by improvement in RDW-CV and significant correlations between ferritin and hepcidin as well as between hepcidin and fT3.
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Affiliation(s)
- Aleksandra Hernik
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Ewelina Szczepanek-Parulska
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland.
| | - Dorota Filipowicz
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Ali Abdolall
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Martyna Borowczyk
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Elżbieta Wrotkowska
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Agata Czarnywojtek
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Zbigniew Krasiński
- Department of Vascular and Endovascular Surgery, Angiology and Phlebology, Poznan University of Medical Sciences, Poznan, Poland
| | - Marek Ruchała
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
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Wang P, Huang C, Meng Z, Zhang W, Li Y, Yu X, Du X, Liu M, Sun J, Zhang Q, Gao Y, Song K, Wang X, Fan Y, Zhao L. No obvious association exists between red blood cell distribution width and thyroid function. Biomark Med 2019; 13:1363-1372. [PMID: 31599643 DOI: 10.2217/bmm-2018-0476] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Aim: We aimed to explore gender impacts on the associations between red blood cell distribution width (RDW) and thyroid function in the Chinese population. Methods/results: Gender impacts on the associations between RDW and thyroid function in 8424 males and 5198 females were investigated. RDW was found significantly lower in males than in females. An increasing trend of RDW along with aging was demonstrated in males. For females, an obvious decrease was shown during menopause period. From binary logistic regression, RDW displayed negative relationship with hypothyroidism in both genders as a single factor. However, if RDW was analyzed as a categorical variable (in RDW width quartiles) and as a continuous variable in models with covariates, all the odds ratios were negative, except for a weak-negative relationship with hypothyroidism in women in a continuous RDW model. Conclusion: The current study suggests that anisocytosis could be a contributing factor in thyroid dysfunction.
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Affiliation(s)
- Peng Wang
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, PR China
| | - Chao Huang
- Hull York Medical School, University of Hull, Heslington, YO10 5DD, UK
| | - Zhaowei Meng
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, PR China
| | - Wenjuan Zhang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, PR China
| | - Yongle Li
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, PR China
| | - Xuefang Yu
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, PR China
| | - Xin Du
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, PR China
| | - Ming Liu
- Department of Endocrinology & Metabolism, Tianjin Medical University General Hospital, Tianjin, PR China
| | - Jinhong Sun
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, PR China
| | - Qing Zhang
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, PR China
| | - Ying Gao
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, PR China
| | - Kun Song
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, PR China
| | - Xing Wang
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, PR China
| | - Yaguang Fan
- Tianjin Key Laboratory of Lung Cancer Metastasis & Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, PR China
| | - Li Zhao
- Department of Biochemistry & Molecular Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, PR China
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Karagoz I, Yoldas H. Platelet to lymphocyte and neutrophil to lymphocyte ratios as strong predictors of mortality in intensive care population. ACTA ACUST UNITED AC 2019; 65:633-636. [PMID: 31166439 DOI: 10.1590/1806-9282.65.5.633] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 05/27/2018] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Patients in intensive care units (ICU) have greater morbidity and mortality. We aimed to study neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in the ICU population. METHODS Medical and laboratory data of patients treated in ICU were retrospectively analyzed. Patients were divided into deceased and survived groups. RESULTS The NLR of survived and deceased groups were 3.6 (0.2-31) and 9.5 (1-40), respectively (p<0.001). The PLR of the survived group (111 [16-537]) was significantly lower than the PLR of the deceased (209 [52-1143]), (p<0.001). An NLR higher than 4.9 had 84% sensitivity and 67% specificity is selecting deceased patients (AUC:0.80, p<0.001). A PLR higher than 112 had 83% sensitivity and 52% specificity in predicting deadly cases (AUC:0.76, p<0.001). Both PLR and NLR were significantly and positively correlated with c reactive protein levels. CONCLUSION We suggest that physicians should pay particular attention to the treatment of patients in ICU with elevated NLR and PLR.
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Affiliation(s)
- Ibrahim Karagoz
- Training and Research Hospital, Department of Anesthesiology and Reanimation, Bolu, Turkey
| | - Hamit Yoldas
- Training and Research Hospital, Department of Anesthesiology and Reanimation, Bolu, Turkey
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Zhang L, Xie Y, Zhan L. The potential value of red blood cell distribution width in patients with invasive hydatidiform mole. J Clin Lab Anal 2019; 33:e22846. [PMID: 30883924 PMCID: PMC6528643 DOI: 10.1002/jcla.22846] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 11/28/2018] [Accepted: 12/05/2018] [Indexed: 12/29/2022] Open
Abstract
Background Red blood cell distribution width (RDW) has attracted increasing attention in cancer. The aim of this study was to assess the changes of RDW in patients with invasive hydatidiform mole and analyze the relationship between RDW and invasive hydatidiform mole. Methods A retrospective analysis was performed on 102 patients diagnosed as invasive hydatidiform mole in the First Affiliated Hospital of Guangxi Medical University from January 2009 to March 2018. A total of 120 healthy subjects were used as a control group. The Mann‐Whitney U test was used for comparison between the invasive hydatidiform mole and control groups. Comparison of RDW with other blood parameters was performed using Spearman's. The area under the ROC curve (AUC) and 95% confidence interval (95% CI) were also determined. Results The RDW, platelet‐lymphocyte ratio (PLR), neutrophil‐lymphocyte ratio (NLR), and absolute lymphocyte count were significantly elevated in the invasive hydatidiform mole group compared with control group. The hemoglobin (Hb) concentration, mean red blood cell volume (MCV) and platelet count (PLT) were significantly lower in invasive hydatidiform mole group than control group. Grade III and above invasive hydatidiform mole patients had higher levels of RDW than grade I and II patients. Correlation analysis showed that RDW was negatively correlated with Hb, MCV, NLR, and neutrophil count, but positively correlated with PDW and different stages of invasive hydatidiform mole. The ROC curve showed that the AUC of the RDW was 0.660 (95% CI 0.581‐0.740; P < 0.01). Conclusion This study reveals the potential value of RDW in invasive hydatidiform mole.
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Affiliation(s)
- Lingling Zhang
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Youjun Xie
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Lingling Zhan
- The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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Hepcidin and Iron Homeostasis in Patients with Subacute Thyroiditis and Healthy Subjects. Mediators Inflamm 2019; 2019:5764061. [PMID: 30936776 PMCID: PMC6415316 DOI: 10.1155/2019/5764061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 01/16/2019] [Indexed: 12/30/2022] Open
Abstract
Purpose Hepcidin is an acute-phase protein involved also in regulation of iron homeostasis. The aim of the study was to prospectively assess for the first time the hepcidinEL concentration in patients with subacute thyroiditis (SAT), to identify biochemical determinants of hepcidinEL concentration and evaluate the potential role of hepcidin in SAT diagnosis and monitoring. Methods Out of 40 patients with SAT initially recruited, restrictive inclusion criteria fulfilled 21 subjects aged 45 ± 10 years and 21 healthy control subjects (CS). HepcidinEL concentration, thyroid status, and iron homeostasis were evaluated at SAT diagnosis and following therapy and compared with CS. Results The median hepcidinEL concentration at SAT diagnosis is higher than that in CS (48.8 (15.9-74.5) ng/mL vs. 18.2 (10.2-23.3) ng/mL, p = 0.009) and is significantly lower after treatment (4.0 (1.2-10.0) ng/mL, p = 0.007) compared with CS. The ROC analysis for hepcidinEL at SAT diagnosis revealed that area under the curve (AUC) is 0.735 (p = 0.009), and the cut-off for hepcidinEL concentration is 48.8 ng/mL (sensitivity 0.52 and specificity 0.95). HepcidinEL in SAT patients correlated with CRP (r = 0.614, p = 0.003), ferritin (r = 0.815, p < 0.001), and aTPO (r = -0.491, p = 0.024). On multiple regression, the correlation between hepcidinEL and ferritin was confirmed (p < 0.001). Conclusions SAT is accompanied by a significant increase in hepcidin, which reflects an acute-phase inflammatory process. Parameters of iron homeostasis improved significantly while inflammatory indices got lower following recovery. The potential role of hepcidin as a predictive factor of the risk of SAT relapse needs to be assessed in studies on larger groups of SAT patients.
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