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Wang L, Gao J, Liu B, Fu Y, Yao Z, Guo S, Song Z, Zhang Z, He J, Wang C, Ma W, Wu F. The association between lymphocyte-to-monocyte ratio and all-cause mortality in obese hypertensive patients with diabetes and without diabetes: results from the cohort study of NHANES 2001-2018. Front Endocrinol (Lausanne) 2024; 15:1387272. [PMID: 38686205 PMCID: PMC11056572 DOI: 10.3389/fendo.2024.1387272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 04/02/2024] [Indexed: 05/02/2024] Open
Abstract
Objective Obesity, hypertension and diabetes are high prevalent that are often associated with poor outcomes. They have become major global health concern. Little research has been done on the impact of lymphocyte-to-monocyte ratio (LMR) on outcomes in these patients. Thus, we aimed to explore the association between LMR and all-cause mortality in obese hypertensive patients with diabetes and without diabetes. Methods The researchers analyzed data from the National Health and Nutrition Examination Survey (2001-2018), which included 4,706 participants. Kaplan-Meier analysis was employed to compare survival rate between different groups. Multivariate Cox proportional hazards regression models with trend tests and restricted cubic splines (RCS) analysis and were used to investigate the relationship between the LMR and all-cause mortality. Subgroup analysis was performed to assess whether there was an interaction between the variables. Results The study included a total of 4706 participants with obese hypertension (48.78% male), of whom 960 cases (20.40%) died during follow-up (median follow-up of 90 months). Kaplan-Meier curves suggested a remarkable decrease in all-cause mortality with increasing LMR value in patients with diabetes and non-diabetes (P for log-rank test < 0.001). Moreover, multivariable Cox models demonstrated that the risk of mortality was considerably higher in the lowest quartile of the LMR and no linear trend was observed (P > 0.05). Furthermore, the RCS analysis indicated a non-linear decline in the risk of death as LMR values increased (P for nonlinearity < 0.001). Conclusions Increased LMR is independently related with reduced all-cause mortality in patients with obese hypertension, regardless of whether they have combined diabetes.
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Affiliation(s)
- Lixia Wang
- Department of Cardiology, Xi’an International Medical Center Hospital, Xi’an, Shaanxi, China
| | - Jie Gao
- Department of Cardiology, Xi’an International Medical Center Hospital, Xi’an, Shaanxi, China
| | - Bing Liu
- Department of Cardiology, Xi’an International Medical Center Hospital, Xi’an, Shaanxi, China
| | - Youliang Fu
- Department of Cardiology, Xi’an International Medical Center Hospital, Xi’an, Shaanxi, China
| | - Zhihui Yao
- Department of Cardiology, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Shanshan Guo
- Department of Cardiology, Xi’an International Medical Center Hospital, Xi’an, Shaanxi, China
| | - Ziwei Song
- Department of Cardiology, Xi’an International Medical Center Hospital, Xi’an, Shaanxi, China
| | - Zhaoyuan Zhang
- Department of Cardiology, Xi’an International Medical Center Hospital, Xi’an, Shaanxi, China
| | - Jiaojiao He
- Department of Cardiology, Xi’an International Medical Center Hospital, Xi’an, Shaanxi, China
| | - Congxia Wang
- Department of Cardiology, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Weidong Ma
- Department of Cardiology, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Feng Wu
- Department of Cardiology, Xi’an International Medical Center Hospital, Xi’an, Shaanxi, China
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Tian M, Yuan J, He P, Yu F, Long C, Zha Y. Monocyte-to-lymphocyte ratio and gastrointestinal disorder-related hospitalization in patients on maintenance hemodialysis. Ther Apher Dial 2024; 28:225-233. [PMID: 37833240 DOI: 10.1111/1744-9987.14073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/19/2023] [Accepted: 10/04/2023] [Indexed: 10/15/2023]
Abstract
INTRODUCTION To explore the association between monocyte-to-lymphocyte ratio (MLR) and the risk of hospitalization due to gastrointestinal (GI) disorder in hemodialysis (HD) patients. METHODS In this multicenter, observational cohort study, 1626 patients were enrolled in 2019 and followed up to 2 years. Cox regression models were performed to estimate the association of MLR with GI disorder-related hospitalization risk. Receiver-operating characteristic (ROC) analyses were conducted to evaluate the cutoff value of MLR in identifying GI disorder-related hospitalization. RESULTS During a median follow-up of 24 months, GI disorder-related hospitalization occurred in 107 patients. Higher MLR was independently associated with greater risks of GI disorder-related hospitalization. Furthermore, a cut-off value of 0.42 differentiated patients with GI disorder-related hospitalization from those without GI involvement. CONCLUSION MLR was associated with the occurrence of GI disorder-related hospitalization in HD patients. The blood MLR could be monitored as a useful marker to predict GI disorder-related hospitalization.
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Affiliation(s)
- Maolu Tian
- Department of Nephrology, Guizhou Provincial People's Hospital, Guiyang, China
- NHC Key Laboratory of Pulmonary Immunological Disease, Guizhou Provincial People's Hospital, Guiyang, China
| | - Jing Yuan
- Department of Nephrology, Guizhou Provincial People's Hospital, Guiyang, China
- NHC Key Laboratory of Pulmonary Immunological Disease, Guizhou Provincial People's Hospital, Guiyang, China
| | - Pinghong He
- Department of Nephrology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Fangfang Yu
- Department of Nephrology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Changzhu Long
- Department of Nephrology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Yan Zha
- Department of Nephrology, Guizhou Provincial People's Hospital, Guiyang, China
- NHC Key Laboratory of Pulmonary Immunological Disease, Guizhou Provincial People's Hospital, Guiyang, China
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Mangalesh S, Dudani S, Mahesh NK. Development of a Novel Inflammatory Index to Predict Coronary Artery Disease Severity in Patients With Acute Coronary Syndrome. Angiology 2024; 75:231-239. [PMID: 36629740 DOI: 10.1177/00033197231151564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) have previously demonstrated predictive value in coronary artery disease (CAD). We developed on an expanded, novel systemic immune-inflammation response index (SIIRI), calculated as peripheral neutrophil × monocyte × platelet ÷ lymphocyte count. We assessed 240 patients with an acute coronary syndrome that subsequently underwent percutaneous coronary intervention. CAD severity was measured using the SYNTAX score. Laboratory measurements, including cell counts, were obtained on admission. On multivariate analysis, the SIIRI was an independent predictor of severe CAD with an adjusted odds ratio (OR) of 1.666 [1.376-2.017] per 105-unit increase. The SIIRI had the highest area under the receiver operator curve of .771 [.709-.833] compared to the SII, SIRI neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio, and platelet-lymphocyte ratio. The optimal cut-off for SIIRI was 4.3 × 105, with sensitivity = 69.9% and specificity = 75.8%. Increment in model performance resulting from adding SIIRI versus other inflammatory indices was assessed using discrimination, calibration, and goodness-of-fit measures. When added to a baseline model, the SIIRI resulted in a significant increase in the c-statistic and significant net reclassification index (.808, P < .0001) and integrated discrimination index (.129, P < .0001), and a decrease in Akaike and Bayesian information criteria.
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Affiliation(s)
- Sridhar Mangalesh
- Department of Medicine, Army College of Medical Sciences, New Delhi, India
| | - Sharmila Dudani
- Department of Pathology, Army College of Medical Sciences, New Delhi, India
| | - Nalin K Mahesh
- Department of Cardiology, Army College of Medical Sciences, New Delhi, India
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Hao P, Feng S, Suo M, Wang S, Wu X. Platelet to albumin ratio: A risk factor related to prognosis in patients with non-ST-segment elevation acute coronary syndrome undergoing percutaneous coronary intervention. Int J Cardiol 2024; 395:131588. [PMID: 37989451 DOI: 10.1016/j.ijcard.2023.131588] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/26/2023] [Accepted: 11/10/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Atherosclerotic cardiovascular disease (ASCAD) is recognized as a chronic subclinical systemic inflammatory condition. The platelet-albumin ratio (PAR) has shown promise in prognosticating various inflammation-related disorders. Our study aimed to assess the connection between PAR and major adverse cardiovascular events (MACE) in percutaneous coronary intervention (PCI)-treated patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). METHODS PAR, derived from platelet and albumin counts, categorized participants into four quartiles. The primary outcome was composite MACE, encompassing all-cause mortality, non-fatal myocardial infarction (MI), and ischemia-driven revascularization. Secondary outcomes comprised individual MACE components. Multivariate Cox regression evaluated PAR's independent impact on adverse events. The non-linear relationship between the PAR value and MACE was explored using a restricted cubic spline (RCS). Receiver operating characteristic (ROC) analysis was conducted and the area under the curve (AUC) was calculated. Subgroup analysis was used to determine the effect of PAR on MACE in different subgroups. RESULTS Enrolling 1391 NSTE-ACS patients, high PAR quartiles were correlated with elevated MACE rates (quartile 4 vs. quartile 1: 33.5% vs. 10.2%, p < 0.001). PAR was revealed to be independently related to an increased risk of MACE (quartile 4 vs. quartile 1: HR, 2.04 [95% CI, 1.34-3.08], p = 0.001). RCS indicated a positive PAR-MACE relationship. The AUC of PAR for the 3-year MACE was 0.659 (95% CI: 0.626-0.677, P<0.001). Subgroup analysis showed no significant interactions across subsets. CONCLUSION PAR independently predicted MACE risk in PCI-treated NSTE-ACS patients.
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Affiliation(s)
- Peng Hao
- Integrated Ward of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Siting Feng
- Emergency & Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Min Suo
- Integrated Ward of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Shen Wang
- Integrated Ward of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Xiaofan Wu
- Integrated Ward of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
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Wu D, Nie J, Lin H, Zhang D, Ye Z, Zhang W, Xiao J. Characteristics and predictors of low-grade renal artery stenosis in female patients with CKD. Clin Exp Hypertens 2023; 45:2175849. [PMID: 36823499 DOI: 10.1080/10641963.2023.2175849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
AIM Renal artery stenosis (RAS) is an important cause of chronic kidney disease (CKD). The main purpose of this study was to explore the clinical characteristics and predictors of low-grade RAS in female patients with CKD. METHODS One hundred and five female CKD patients from Huadong Hospital affiliated with Fudan University who underwent 3 T non-contrast renal artery magnetic resonance angiography (MRA) were analyzed. Basic statistics methods were used in the study, such as independent-sample t test,non-parametric test, binary logistic regression analysis and ROC analysis. RESULTS In this cross-sectional study, there were 50 patients with RAS and 55 without RAS (47.6% versus 52.4%). Binary logistic regression analysis demonstrated that low-level ALB and lymphocyte count, high-level SP, BUN and NLR were independent risk factors for low-grade RAS in female patients with CKD. ROC analysis indicated that eGFR, FeNa and UBCR, ALB, lymphocyte count and NLR had the best predictive value for low-grade RAS, especially eGFR with a sensitivity of 65.50% and specificity of 72.00% and FeNa with a sensitivity of 71.10% and specificity of 72.20% and BUCR with a sensitivity of 71.10% and specificity of 68.10%. CONCLUSION In female patients with CKD, FeNa, eGFR, ALB, UBCR, lymphocyte count and NLR may be good predictors of low-grade RAS, especially eGFR, FeNa and BUCR.
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Affiliation(s)
- Deping Wu
- Department of Nephrology, Huadong Hospital Affiliated to Fudan University, Shanghai, P.R. China.,Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, P.R. China
| | - Jinli Nie
- Department of Nephrology, Huadong Hospital Affiliated to Fudan University, Shanghai, P.R. China
| | - Huagang Lin
- Department of Nephrology, Huadong Hospital Affiliated to Fudan University, Shanghai, P.R. China.,Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, P.R. China
| | - Dexian Zhang
- Department of Nephrology, Huadong Hospital Affiliated to Fudan University, Shanghai, P.R. China
| | - Zhibin Ye
- Department of Nephrology, Huadong Hospital Affiliated to Fudan University, Shanghai, P.R. China
| | - Wan Zhang
- Department of Vascular Surgery, Huadong Hospital Affiliated to Fudan University, Shanghai, P.R. China
| | - Jing Xiao
- Department of Nephrology, Huadong Hospital Affiliated to Fudan University, Shanghai, P.R. China.,Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, P.R. China
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Vakhshoori M, Nemati S, Sabouhi S, Shakarami M, Yavari B, Emami SA, Bondariyan N, Shafie D. Prognostic impact of monocyte-to-lymphocyte ratio in coronary heart disease: a systematic review and meta-analysis. J Int Med Res 2023; 51:3000605231204469. [PMID: 37848392 PMCID: PMC10586014 DOI: 10.1177/03000605231204469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 09/13/2023] [Indexed: 10/19/2023] Open
Abstract
OBJECTIVE Inflammatory biomarkers are novel tools to assess the prognosis of different cardiovascular diseases. We evaluated the impact of the monocyte-to-lymphocyte ratio (MLR) on clinical outcomes in patients with coronary heart disease (CHD). METHODS We systematically screened English-language articles in PubMed, Scopus, and Web of Science to 31 August 2022. Relevant articles reporting the MLR and its association with clinical outcomes (major adverse cardiovascular events (MACE), coronary artery disease (CAD) severity, mortality, cardiac rupture, subclinical CAD, acute coronary syndrome (ACS) prediction, thin-cap fibroatheroma, no-reflow phenomenon, MLR-related differences in percutaneous coronary intervention, heart failure hospitalization, and depression) in patients with CHD were collected for further analysis. RESULTS Nineteen articles were selected. The mean MLR was 0.34. A higher MLR was significantly associated with an increased risk of MACE among patients with CHD. The MLR was an independent predictor of MACE in patients with ACS. No significant association was found for CAD severity. A complementary analysis was not performed because of few studies focusing on the other predefined endpoints. CONCLUSIONS The MLR is a simple and widely available tool to predict MACE in patients with CHD. This biomarker can be utilized in emergency settings to prioritize high-risk patients and optimize therapeutic interventions.
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Affiliation(s)
- Mehrbod Vakhshoori
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sepehr Nemati
- School of Medicine, Tehran Azad University of Medical Sciences, Tehran, Iran
| | - Sadeq Sabouhi
- Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehrnaz Shakarami
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behzad Yavari
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sayed Ali Emami
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Niloofar Bondariyan
- Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Davood Shafie
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Jung MJ, Kim JH. Prognostic Efficacy of Complete Blood Count Indices for Assessing the Presence and the Progression of Myxomatous Mitral Valve Disease in Dogs. Animals (Basel) 2023; 13:2821. [PMID: 37760221 PMCID: PMC10525219 DOI: 10.3390/ani13182821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/25/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
This study investigated the complete blood count (CBC) indices, including neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) in dogs with myxomatous mitral valve disease (MMVD) and analyzed their correlation with conventional biomarkers, as well as the effect of CBC indices on survival time in dogs with MMVD. Medical records of 75 healthy controls and 249 dogs with MMVD from March 2015 to October 2022 were analyzed. The NLR, MLR, and PLR were calculated by dividing the absolute counts of the CBC parameters. Dogs with MMVD had significantly higher NLR, MLR, and PLR than healthy dogs (all p < 0.0001), especially those in the symptomatic MMVD group with pulmonary edema (p < 0.0001, p = 0.0002, and p = 0.0387, respectively). The NLR and MLR were significantly correlated with N-terminal pro-B type natriuretic peptide levels (both p < 0.0001). The CBC indices showed potential as biomarkers for detecting the presence of MMVD (all p < 0.0001) and severity of MMVD (p < 0.0001, p < 0.0001, and p = 0.006, respectively) using receiver operating characteristic curve analysis. The negative effects of increased NLR, MLR, and PLR on survival were confirmed using Kaplan-Meier curve analysis. In conclusion, NLR, MLR, and PLR could be cost-effective and readily available potential diagnostic and prognostic biomarkers for MMVD in dogs.
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Affiliation(s)
| | - Jung-Hyun Kim
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, #120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Republic of Korea;
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Yang Y, Song C, Jia L, Dong Q, Song W, Yin D, Dou K. Prognostic Value of Multiple Complete Blood Count-Derived Indices in Intermediate Coronary Lesions. Angiology 2023:33197231198678. [PMID: 37646226 DOI: 10.1177/00033197231198678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Complete blood count (CBC)-derived indices have been proposed as reliable inflammatory biomarkers to predict outcomes in the context of coronary artery disease. These indices have yet to be thoroughly validated in patients with intermediate coronary stenosis. Our study included 1527 patients only with intermediate coronary stenosis. The examined variables were neutrophil-lymphocyte ratio (NLR), derived NLR, monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), systemic immune inflammation index (SII), system inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI). The primary endpoint was the composite of major adverse cardiovascular events (MACEs), including all-cause death, non-fatal myocardial infarction, and unplanned revascularization. Over a follow-up of 6.11 (5.73-6.55) years, MACEs occurred in 189 patients. Receiver operator characteristic curve analysis showed that SIRI outperformed other indices with the most significant area under the curve. In the multivariable analysis, SIRI (hazard ratio [HR] 1.588, 95% confidence interval [CI] 1.138-2.212) and AISI (HR 1.673, 95% CI 1.217-2.300) were the most important prognostic factors among all the indices. The discrimination ability of each index was strengthened in patients with less burden of modifiable cardiovascular risk factors. SIRI also exhibited the best incremental value beyond the traditional cardiovascular risk model.
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Affiliation(s)
- Yuxiu Yang
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Chenxi Song
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Lei Jia
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Qiuting Dong
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Weihua Song
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Dong Yin
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Kefei Dou
- Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Du GL, Liu F, Liu H, Meng Q, Tang R, Li XM, Yang YN, Gao XM. Monocyte-to-High Density Lipoprotein Cholesterol Ratio Positively Predicts Coronary Artery Disease and Multi-Vessel Lesions in Acute Coronary Syndrome. Int J Gen Med 2023; 16:3857-3868. [PMID: 37662500 PMCID: PMC10473407 DOI: 10.2147/ijgm.s419579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/23/2023] [Indexed: 09/05/2023] Open
Abstract
Purpose We investigated the hypothesis that MHR (monocyte-to-high density lipoprotein cholesterol ratio) is related to the severity of coronary artery in ACS (acute coronary syndrome). Methods In this case-control study, we recruited 15,853 participants undergoing the first time percutaneous coronary intervention (PCI) including 4093 normal controls, 10,518 chronic coronary artery disease (CAD), and 1242 ACS cases. Examination of demographic clinical data and biochemical profiles, as well as MHR values, were performed before PCI. The relationship between MHR and severity of coronary artery lesion in ACS was analyzed. We also used a flow cytometric assay to distinguish CD14+/CD16- classical monocyte subsets in peripheral blood mononucleated cells from CAD patients. Results MHR was higher in patients with ACS compared with MHR in normal control and chronic CAD (normal control vs chronic CAD vs ACS: 0.46 ± 0.27 × 109/mmol vs 0.53 ± 0.29 × 109/mmol vs 0.73 ± 0.47 × 109/mmol, P < 0.001). MHR showed a significantly progressive increase as the angiographic severity of coronary lesions increased (single vessel lesion vs multi-vessel lesions in ACS: 0.54 ± 0.31 × 109/mmol vs 0.58 ± 0.35 × 109/mmol, P < 0.001), and classical monocyte subset to HDL-C ratio (CMHR) was increased in with CAD patients compared with control [4.69 (IQR, 1.06, 2.97) × 103/mmol vs 1.92 (IQR, 0.92, 3.04) × 103/mmol, P = 0.02]. Using a multivariate analysis, after adjusting for age, gender, body mass index (BMI), diabetes, and dyslipidemia, MHR was positively associated with multi-vessel lesions in ACS [OR (odds ratio): 1.28 (95% CI: 1.03-1.59, P = 0.029)]. Conclusion MHR level could be a potential predictor of coronary artery lesion severity in ACS.
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Affiliation(s)
- Guo-Li Du
- State Key Laboratory of Pathogenesis, Prevention, and Treatment of High Incidence Diseases in Central Asia, Urumqi, People’s Republic of China
- Department of Endocrinology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Fen Liu
- State Key Laboratory of Pathogenesis, Prevention, and Treatment of High Incidence Diseases in Central Asia, Urumqi, People’s Republic of China
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
- Xinjiang Key Laboratory of Medical Animal Model Research, Clinical Medical Research Institute of First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Hua Liu
- State Key Laboratory of Pathogenesis, Prevention, and Treatment of High Incidence Diseases in Central Asia, Urumqi, People’s Republic of China
- Department of Endocrinology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Qi Meng
- State Key Laboratory of Pathogenesis, Prevention, and Treatment of High Incidence Diseases in Central Asia, Urumqi, People’s Republic of China
- Department of Endocrinology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Ran Tang
- State Key Laboratory of Pathogenesis, Prevention, and Treatment of High Incidence Diseases in Central Asia, Urumqi, People’s Republic of China
- Department of Endocrinology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Xiao-Mei Li
- State Key Laboratory of Pathogenesis, Prevention, and Treatment of High Incidence Diseases in Central Asia, Urumqi, People’s Republic of China
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Yi-Ning Yang
- State Key Laboratory of Pathogenesis, Prevention, and Treatment of High Incidence Diseases in Central Asia, Urumqi, People’s Republic of China
- People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People’s Republic of China
| | - Xiao-Ming Gao
- State Key Laboratory of Pathogenesis, Prevention, and Treatment of High Incidence Diseases in Central Asia, Urumqi, People’s Republic of China
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
- Xinjiang Key Laboratory of Medical Animal Model Research, Clinical Medical Research Institute of First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
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Xie Y, Cen H, Wang L, Cheng K, Huang L, Lu H, Ji L, Chen Y, Zhou Z, Yang Z, Jing S, Zhu H, Chen K, Chen S, He W. Relationships Between Inflammatory Parameters Derived From Complete Blood Count and Quantitative Flow Ratio in Patients With Stable Coronary Artery Disease. Angiology 2023:33197231197804. [PMID: 37632217 DOI: 10.1177/00033197231197804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
To investigate the relationships between inflammatory parameters, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR) and systemic immune-inflammation index (SII), and quantitative flow ratio (QFR) in stable coronary artery disease (CAD) patients (n = 450) enrolled in this cross-sectional study. Logistic regression was performed to evaluate the associations of NLR, PLR, MLR, and SII evaluated as continuous and binary variables with QFR ≤0.80. When treated as continuous variables, lnNLR was associated with QFR ≤0.80 with borderline significance in univariable (odds ratio (OR) = 1.60, p = .05) and multivariable analysis (OR = 1.72, p = .05), while lnMLR was associated with QFR ≤0.80 significantly in univariable analysis (OR = 1.87, p = .03) and with borderline significance in multivariable analysis (OR = 1.91, p = .05). When treated as binary variables, high levels of MLR and SII were significantly associated with QFR ≤0.80 in univariable (MLR: OR = 1.91, p = .02; SII: OR = 2.42, p = .006) and multivariable analysis (MLR: OR = 1.83, p = .04; SII: OR = 2.19, p = .02). NLR, MLR, and SII, but not PLR, were significantly associated with the severity of coronary physiology in stable CAD patients.
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Affiliation(s)
- Yanqing Xie
- Department of Cardiology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- Institute of Geriatrics, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Han Cen
- Institute of Geriatrics, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Li Wang
- Department of Cardiology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Keai Cheng
- Department of Cardiology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Li Huang
- Department of Emergency Intensive Care Unit, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Haoxuan Lu
- Department of Cardiology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Lili Ji
- Department of Cardiology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Yudan Chen
- Department of Cardiology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Zhong Zhou
- Department of Cardiology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Zhuo Yang
- Department of Cardiology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Sheng Jing
- Department of Cardiology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Haibo Zhu
- Department of Cardiology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Kan Chen
- Department of Cardiology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Si Chen
- Department of Cardiology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Wenming He
- Department of Cardiology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
- Institute of Geriatrics, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
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11
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Chi R, Shan X, Guan C, Yang H, Wang X, Li B, Zhang Q. Association between systemic inflammatory response index and left ventricular remodeling and systolic dysfunction in atrial fibrillation patients. BMC Cardiovasc Disord 2023; 23:377. [PMID: 37507722 PMCID: PMC10386546 DOI: 10.1186/s12872-023-03403-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/16/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Cardiac remodeling and dysfunction can be caused by atrial fibrillation (AF). The aim of this research is to investigate the relationship between the systemic inflammatory response index (SIRI) and left ventricular (LV) remodeling and systolic function in individuals with AF. METHODS 416 patients with AF who were admitted to the Second Department of Cardiology in the East Ward of the Qingdao Municipal Hospital between January 2020 and May 2022 were included in the present retrospective research. The relationship between SIRI and various cardiac parameters was analyzed. The patients' left atrial (LA) enlargement and left ventricular (LV) hypertrophy and systolic dysfunction were evaluated. SIRI was calculated by the formula: neutrophil × monocyte/lymphocyte. RESULTS SIRI significantly correlated with LV end-diastolic diameter (LVDd), LV posterior wall thickness at end-diastole (LVPWTd), interventricular septal thickness at end-diastole (IVSTd), LV mass index (LVMI), LV ejection fraction (LVEF), LA diameter (LAD), C-reactive protein (CRP), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with AF. In multivariate linear regression analyses, SIRI was discovered to be significantly related to LVMI (ln-transformed) (p = 0.025), LVEF (ln-transformed) (p = 0.005), and LAD (ln-transformed) (p = 0.007). In multivariate logistic regression, the highest quartile of SIRI (SIRI > 1.62) was significantly associated with LV hypertrophy (p = 0.026), impaired LV systolic function (p = 0.002), and LA enlargement (p = 0.025). CONCLUSIONS SIRI was significantly associated with LV remodeling and systolic function impairment in patients with AF. SIRI may serve as a reliable and convenient inflammatory biomarker for detecting impaired cardiac structure and systolic function in patients with AF.
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Affiliation(s)
- Runze Chi
- Qingdao Municipal Hospital, Qingdao University Affiliated Qingdao Municipal Hospital, 266011, Qingdao, Shandong, China
| | - Xiaoli Shan
- Qingdao Municipal Hospital, Qingdao University Affiliated Qingdao Municipal Hospital, 266011, Qingdao, Shandong, China
| | - ChunPing Guan
- Qingdao Municipal Hospital, Qingdao University Affiliated Qingdao Municipal Hospital, 266011, Qingdao, Shandong, China
| | - Hao Yang
- Weifang Medical University, 261000, Weifang, Shandong, China
| | - Xiangkun Wang
- Qingdao Municipal Hospital, Qingdao University Affiliated Qingdao Municipal Hospital, 266011, Qingdao, Shandong, China
| | - Bingong Li
- Department of Cardiology, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), 266011, Qingdao, Shandong, China.
| | - Qing Zhang
- Department of Cardiology, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), 266011, Qingdao, Shandong, China.
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12
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Zuo P, Xu R, Hu L, Hu W, Tong S. Association between monocyte lymphocyte ratio and abdominal aortic calcification in US adults: A cross-sectional study. Clinics (Sao Paulo) 2023; 78:100232. [PMID: 37364352 DOI: 10.1016/j.clinsp.2023.100232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 05/09/2023] [Accepted: 06/01/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the association between Monocyte Lymphocyte Ratio (MLR) and Abdominal Aortic Calcification (AAC) in adults over 40 years of age in the United States. METHODS Data were collected from the 2013-2014 National Health and Nutrition Examination Survey (NHANES). AAC was quantified by the Kauppila score system based on dual-energy X-Ray absorptiometry. Severe AAC was defined as a total AAC score > 6. The lymphocyte count and monocyte count can be directly obtained from laboratory data files. Multivariable logistic regression models were used to determine the association between MLR and the AAC score and severe AAC. RESULTS A total of 3,045 participants were included in the present study. After adjusting for multiple covariates, MLR was positively associated with higher AAC score (β = 0.21, 95% CI 0.07, 0.34, p = 0.0032) and the odds of severe AAC increased by 14% per 0.1 unit increase in the MLR (OR = 1.14, 95% CI 1.00, 1.31, p = 0.0541). The Odds Ratio (OR) (95% CI) of severe AAC for participants in MLR tertile 3 was 1.88 (1.02, 3.47) compared with those in tertile 1 (p for trend = 0.0341). Subgroup analyses showed that a stronger association was detected in the elderly compared with non-elderly (p for interaction = 0.0346) and diabetes compared with non-diabetes (borderline significant p for interaction = 0.0578). CONCLUSION In adults in the United States, MLR was associated with higher AAC scores and a higher probability of severe AAC. MLR may become a promising tool to predict the risk of AAC.
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Affiliation(s)
- Peiyuan Zuo
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ranran Xu
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liya Hu
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Hu
- Department of Pediatric, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Song Tong
- Department of Thoracic Surgery, Union Hospital Tongji Medical College Huazhong University of Science and Technology, China.
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13
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Yang Y, Xu Y, Lu P, Zhou H, Yang M, Xiang L. The prognostic value of monocyte-to-lymphocyte ratio in peritoneal dialysis patients. Eur J Med Res 2023; 28:152. [PMID: 37038225 PMCID: PMC10084613 DOI: 10.1186/s40001-023-01073-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 02/16/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND The monocyte-to-lymphocyte ratio (MLR) is considered as a new inflammation marker. This study was aimed to investigate the prognostic value of MLR for all-cause mortality and new-onset cardiovascular disease (CVD) events in peritoneal dialysis (PD) patients. METHODS This study enrolled patients receiving PD treatment for ≥ 3 months. Baseline characteristics were obtained within 1 week before PD catheterization. The receiver operating characteristic curve analysis was conducted to determine the optimal cut-off value of MLR. The Kaplan-Meier curve estimated the cumulative survival rate and new CVD free survival rate. Univariate and multivariate Cox regression models were preformed to investigate the association between MLR and clinical outcomes. RESULTS A total of 369 PD patients participated in this study. During a median follow-up period of 32.83 months, 65 patients (24.2%) died, and 141 patients (52.4%) occurred new-onset CVD events. The Kaplan-Meier curve revealed that survival rate in high MLR group (MLR > 0.2168) was significantly lower than in low MLR group (P = 0.008). Patients in high MLR group were more likely to experience CVD events (P = 0.002). Even after adjustment of traditional risk factors, including age, diabetes mellitus, CVD history, smoking, hyperlipidemia, high MLR remained an independent predictor of all-cause mortality [hazard ration (HR) = 2.518, 95% confidence intervals (CI) = 1.020-6.214, P = 0.045] and new-onset CVD events (HR = 1.815, 95% CI = 1.157-2.849, P = 0.010). CONCLUSIONS This study suggested that high MLR was significantly and independently associated with all-cause mortality and CVD events in PD patients. The MLR is an inexpensive and straightforward indicator to reflect systemic inflammation status and help clinicians improve PD management.
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Affiliation(s)
- Yan Yang
- Department of Nephrology, The Third Affiliated Hospital of Soochow University, No. 185 Juqian Road, Changzhou, 213003, Jiangsu, China
| | - Yuanyuan Xu
- Department of Nephrology, The Third Affiliated Hospital of Soochow University, No. 185 Juqian Road, Changzhou, 213003, Jiangsu, China
| | - Peiyu Lu
- Department of Nephrology, The Third Affiliated Hospital of Soochow University, No. 185 Juqian Road, Changzhou, 213003, Jiangsu, China
| | - Hua Zhou
- Department of Nephrology, The Third Affiliated Hospital of Soochow University, No. 185 Juqian Road, Changzhou, 213003, Jiangsu, China
| | - Min Yang
- Department of Nephrology, The Third Affiliated Hospital of Soochow University, No. 185 Juqian Road, Changzhou, 213003, Jiangsu, China
| | - Li Xiang
- Department of Nephrology, The Third Affiliated Hospital of Soochow University, No. 185 Juqian Road, Changzhou, 213003, Jiangsu, China.
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Hambly R, Kearney N, Hughes R, Fletcher JM, Kirby B. Metformin Treatment of Hidradenitis Suppurativa: Effect on Metabolic Parameters, Inflammation, Cardiovascular Risk Biomarkers, and Immune Mediators. Int J Mol Sci 2023; 24:ijms24086969. [PMID: 37108132 PMCID: PMC10138328 DOI: 10.3390/ijms24086969] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
Hidradenitis suppurativa (HS) is a common cutaneous and systemic inflammatory disease with a significant impact on mental health and quality of life. It is associated with obesity, insulin resistance, metabolic syndrome, cardiovascular (CV) disease, and increased all-cause mortality. Metformin is used frequently in HS treatment and is effective for some patients. The mechanism of action of metformin in HS is unknown. A case-control study of 40 patients with HS (20 on metformin and 20 controls) was conducted to assess differences in metabolic markers, inflammation (C-reactive protein [CRP], serum adipokines, and CV risk biomarkers), and serum immune mediators. Body mass index (BMI), insulin resistance (77%), and metabolic syndrome (44%) were high overall, but not significantly different between the groups. This highlights the need for co-morbidity screening and management. A significant reduction in fasting insulin and a trend towards a reduction in insulin resistance were identified in the metformin group compared with pre-treatment levels. CV risk biomarkers were significantly favourable in the metformin group (lymphocytes, monocyte-lymphocyte ratio, neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio). CRP was lower in the metformin group but was not statistically significant. Adipokines were dysregulated overall but were not different between the two groups. Serum IFN-γ, IL-8, TNF-α, and CXCL1 trended lower in the metformin group but did not reach significance. These results suggest that metformin improves CV risk biomarkers and insulin resistance in patients with HS. When the results of this study are considered alongside other studies in HS and related conditions, it is likely that metformin also has beneficial effects on metabolic markers and systemic inflammation in HS (CRP, serum adipokines, and immune mediators), warranting further research.
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Affiliation(s)
- Roisin Hambly
- The Charles Centre, Department of Dermatology, St Vincent's University Hospital, D04 T6F4 Dublin, Ireland
- Charles Institute of Dermatology, School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Niamh Kearney
- The Charles Centre, Department of Dermatology, St Vincent's University Hospital, D04 T6F4 Dublin, Ireland
- Charles Institute of Dermatology, School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Rosalind Hughes
- The Charles Centre, Department of Dermatology, St Vincent's University Hospital, D04 T6F4 Dublin, Ireland
| | - Jean M Fletcher
- School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, D02 R590 Dublin, Ireland
- School of Medicine, Trinity Biomedical Sciences Institute, Trinity College Dublin, D02 R590 Dublin, Ireland
| | - Brian Kirby
- The Charles Centre, Department of Dermatology, St Vincent's University Hospital, D04 T6F4 Dublin, Ireland
- Charles Institute of Dermatology, School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
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15
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Zhang C, Bai H, Lin G, Zhang Y, Zhang L, Chen X, Shi R, Zhang G, Fu Z, Xu Q. Association of preoperative monocyte/lymphocyte ratio with postoperative oxygenation impairment in patients with acute aortic syndrome. Int Immunopharmacol 2023; 118:110067. [PMID: 37028273 DOI: 10.1016/j.intimp.2023.110067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/06/2023] [Accepted: 03/20/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND Postoperative oxygenation impairment represents a common complication in patients with the acute aortic syndrome (AAS). The study aimed to explore the relationship between inflammatory indicators and AAS patients with oxygenation impairment after operation. METHODS In this study, 330 AAS patients who underwent surgery were enrolled and divided into 2 groups based on postoperative oxygenation impairment (non-oxygenation impairment group and oxygenation impairment group). Regression analysis was performed to assess the relationship between inflammatory indicators and postoperative oxygenation impairment. A smooth curve and interaction analysis were further conducted. Stratified analysis was used according to preoperative monocyte/lymphocyte ratio (MLR) (Tertiles). RESULTS Multivariate analysis showed that preoperative MLR was independently related to oxygenation impairment after surgery in AAS patients (OR, 95% CI, P: 2.77, 1.10-7.00, 0.031). The smooth curve indicated the risk of postoperative oxygenation impairment was higher with the elevated preoperative MLR. Interaction analysis revealed that patients with AAS with high preoperative MLR who had coronary artery disease (CAD) had a higher risk of oxygenation impairment after operation. Moreover, stratified analysis was performed according to baseline MLR (Tertiles), and a higher baseline MLR level in AAS patients was correlated with a lower arterial oxygen tension (PaO2) / inspiratory oxygen fraction (FiO2) ratio perioperatively. CONCLUSIONS In AAS patients, preoperative MLR level was independently related to postoperative oxygenation impairment.
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Affiliation(s)
- Chiyuan Zhang
- Department of Cardiovascular Surgery, Xiangya Hospital, Central South University, Xiangya Rd 87, Changsha, Hunan, China
| | - Hui Bai
- Department of Cardiovascular Surgery, Xiangya Hospital, Central South University, Xiangya Rd 87, Changsha, Hunan, China
| | - Guoqiang Lin
- Department of Cardiovascular Surgery, Xiangya Hospital, Central South University, Xiangya Rd 87, Changsha, Hunan, China
| | - Yanfeng Zhang
- Department of Cardiovascular Surgery, Xiangya Hospital, Central South University, Xiangya Rd 87, Changsha, Hunan, China
| | - Lei Zhang
- Department of Cardiovascular Surgery, Xiangya Hospital, Central South University, Xiangya Rd 87, Changsha, Hunan, China
| | - Xuliang Chen
- Department of Cardiovascular Surgery, Xiangya Hospital, Central South University, Xiangya Rd 87, Changsha, Hunan, China
| | - Ruizheng Shi
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Xiangya Rd 87, Changsha, Hunan, China
| | - Guogang Zhang
- Department of Cardiovascular Medicine, the Third Xiangya Hospital, Central South University, Tongzipo Rd 138, Changsha, Hunan, China
| | - Zuli Fu
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Xiangya Rd 87, Changsha, Hunan, China
| | - Qian Xu
- Department of Cardiovascular Surgery, Xiangya Hospital, Central South University, Xiangya Rd 87, Changsha, Hunan, China.
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Abus S, Koparal M, Kaya H, Kapıcı OB, Tasolar MH, Tibilli H. Evaluation of frontal QRS-T angle values in electrocardiography in patients with chronic rhinosinusitis. BMC Cardiovasc Disord 2023; 23:160. [PMID: 36973652 PMCID: PMC10045228 DOI: 10.1186/s12872-023-03175-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 03/09/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Chronic Rhinosinusitis (CRS) refers to inflammation of the paranasal sinuses and nasal mucosa. Electrocardiographic indicators of ventricular repolarization have been shown to correlate with systemic inflammation parameters. Recently, the frontal QRS-T (fQRS-T) angle has been accepted as a new indicator of ventricular depolarization and repolarization heterogeneity. The (fQRS-T) angle is recommended in predicting the risk of malignant ventricular arrhythmia. In this study, we aimed to evaluate the ventricular arrhythmia potential in patients with chronic rhinosinusitis by examining the relationship between fQRS-T angle on ECG and inflammation markers. METHODS Inflammatory markers as well as electrocardiographc (ECG) f(QRS-T) angle, QRS duration, QT interval and corrected QT interval were examined in 54 patients with CRS versus 56 healthy control subjects. RESULTS The f(QRS-T) angle was significantly higher in CRS patients than in healthy controls (p < .001). The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and monocyte-to-lymphocyte ratio (MLR) were significantly higher in CRS patients compared to healthy controls (p < .001, for all). Based on correlation analysis, NLR and f(QRS-T) angles were highly correlated (r = .845, p < .001), and according to the results of linear regression analysis, NLR was independently associated with the f(QRS-T) angle (t = 5.149, Beta = 0.595, p = < 0.001). CONCLUSION Both f(QRS-T) angle and NLR are significantly increased in CRS patients compared to healthy controls, with increases in NLR also independently associating with increases in f(QRS-T) angle. While the increases in f(QRS-T) angle did not result in clinically alarming absolute values for f(QRS-T), CRS patients might nonetheless be at relatively higher risk for malignant cardiac arrhythmias.
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Affiliation(s)
- Sabri Abus
- Department of Cardiology, Adiyaman University Education and Research Hospital, Adiyaman, Turkey
| | - Mehtap Koparal
- Department of Otorhinolaryngology, Adiyaman University Education and Research Hospital, Adiyaman, Turkey
| | - Hakan Kaya
- Department of Cardiology, Adiyaman University Education and Research Hospital, Adiyaman, Turkey.
- Department of Cardiology, Adıyaman Univesity, 416100, Adıyaman, Turkey.
| | - Olga Bayar Kapıcı
- Department of Radiology, Adiyaman University Education and Research Hospital, Adiyaman, Turkey
| | | | - Hakan Tibilli
- Department of Cardiology, Adiyaman University Education and Research Hospital, Adiyaman, Turkey
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DEMİR YENİGURBUZ F, SÖBÜ E, BERK AKBEYAZ B. The comparison of inflammatory hematological parameters in obese and non-obese children. Fam Pract Palliat Care 2023. [DOI: 10.22391/fppc.1197997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Introduction: Obesity is an increasing health problem in the whole world, and it has an important inflammatory component related to the insulin resistance (IR), hypertension, atherosclerosis and some cancers. This study aims to evaluate the inflammatory hematological parameters in childhood obesity.Methods: Sixty-four obese and 50 normal weight cases were included in the study. The physical examination features and laboratory data of the patients were evaluated retrospectively from the patient’s files. Laboratory tests, hematological parameters, gender were compared between the groups. Correlations between Homeostasis model evaluation for insulin resistance (HOMA-IR) and other laboratory parameters in the obese group were examined.Results: The leukocyte, neutrophile, monocyte, lymphocyte, thrombocyte and MPV values of the obese group were found to be statistically higher than the control group (p: 0.006, p:0.015, p:0.014, p:0.001, p<0.001). There was no statistically significant difference between the two groups for Neutrophile/Lymphocyte ratio (NLR), Monocyte/Lymphocyte ratio (MLR) and Platelet/Lymphocyte ratio (PLR) (p:0.642, p:0.989, 0.982). Also, there was no statistically significant correlation between Homa IR and age, BMI, Neutrophil, Lymphocyte, Monocyte, Thrombocyte, Neutrophil/Lymphocyte, Monocyte/Lymphocyte and Thrombocyte/Lymphocyte values.Conclusion: The current study showed that there was no significant difference between obese and controls in terms of NLR, PLR, and MLR values. However, the leukocyte, neutrophile, monocyte, lymphocyte, thrombocyte and MPV values were statistically higher in obese group than controls. Nevertheless, these findings can point relation between obesity and inflammation.Keywords: obesity, children, inflammation, hematological parameters
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Affiliation(s)
- Fatma DEMİR YENİGURBUZ
- Department of Pediatric Hematology/Oncology & Bone Marrow Transplantation Unit, Faculty of Medicine, Acibadem University, Istanbul
| | - Elif SÖBÜ
- Department of Pediatric Endocrinology, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul
| | - Berkin BERK AKBEYAZ
- Department of Pediatric Hematology/Oncology, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul
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Kearney N, McCourt C, Hambly R, Hughes R, O’Kane D, Kirby B. Association of Biologic Treatment in Hidradenitis Suppurativa With Reduced Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio. JAMA Dermatol 2023; 159:222-224. [PMID: 36576747 PMCID: PMC9857331 DOI: 10.1001/jamadermatol.2022.5710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 11/01/2022] [Indexed: 12/29/2022]
Abstract
This cohort study assesses whether an association exists between biologic treatment for hidradenitis suppurativa and neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and monocyte-lymphocyte ratio.
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Affiliation(s)
- Niamh Kearney
- Department of Dermatology, St Vincent’s University Hospital, Dublin, Ireland
- Department of Dermatology, Belfast Health and Social Care Trust, Belfast, United Kingdom
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Collette McCourt
- Department of Dermatology, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Roisin Hambly
- Department of Dermatology, St Vincent’s University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Rosalind Hughes
- Department of Dermatology, St Vincent’s University Hospital, Dublin, Ireland
- Charles Institute of Dermatology, University College Dublin, Dublin, Ireland
| | - Donal O’Kane
- Department of Dermatology, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Brian Kirby
- Department of Dermatology, St Vincent’s University Hospital, Dublin, Ireland
- Charles Institute of Dermatology, University College Dublin, Dublin, Ireland
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Errigo A, Bitti A, Galistu F, Salis R, Pes GM, Dore MP. Relationship between Glucose-6-Phosphate Dehydrogenase Deficiency, X-Chromosome Inactivation and Inflammatory Markers. Antioxidants (Basel) 2023; 12. [PMID: 36829893 DOI: 10.3390/antiox12020334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/21/2023] [Accepted: 01/27/2023] [Indexed: 02/04/2023] Open
Abstract
Recent studies suggest that X-linked glucose-6-phosphate dehydrogenase (G6PD) deficiency entails a proinflammatory state that may increase the risk of several disease conditions. However, it is not clear how this relates to the degree of enzyme insufficiency and, in heterozygous females, to skewed inactivation of the X chromosome. This study aimed to (i) investigate the enzyme activity in a cohort of 232 subjects (54.3% females) from Northern Sardinia, Italy, further stratified into three subgroups (G6PD normal, partial deficiency and total deficiency); (ii) measure the levels of some non-specific inflammatory markers, such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and those derived from cell counts, such as neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR), in relation to the underlying molecular defect and X inactivation. G6PD activity was measured in red blood cells according to G6PD/6PGD ratio, and X-chromosome inactivation was assessed by the HUMARA method. Overall, ESR was increased in males with total deficiency compared with normal males (15.0 ± 7.2 vs. 11.9 ± 6.2, p = 0.002, Tukey's test), albeit not in males with partial deficiency. High-sensitivity CRP was slightly increased in males with total deficiency, compared to males with normal G6PD activity (5.96 ± 3.39 vs. 3.95 ± 2.96, p = 0.048). In females, neither marker showed significant differences across the subgroups. MLR was significantly and progressively increased from normal to totally deficient subjects with intermediate values in partially deficient subjects (0.18, 0.31 and 0.37, ANOVA p = 0.008). The NLR and PLR were not different in the three subgroups. Our findings show that G6PD deficiency may be associated with a proinflammatory profile, especially in elderly females, and worsened by the concomitant asymmetric inactivation of the X chromosome.
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Ali A, Abdelhafiz AS, Saleh MM, Salem H, Rakha MA, Ezzat S. Monocyte to eosinophil ratio as a diagnostic biomarker for overlap syndrome and predictor of disease exacerbation. Int J Immunopathol Pharmacol 2023; 37:3946320231216321. [PMID: 37977558 PMCID: PMC10657538 DOI: 10.1177/03946320231216321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023] Open
Abstract
Objectives: Chronic Obstructive Pulmonary Disease (COPD) is one of the most common pulmonary diseases. The concomitant association of Obstructive Sleep Apnea (OSA) and COPD is known as the Overlap Syndrome (OS). This study aimed to identify markers for predicting OS, among routine laboratory tests, including differential blood counts.Methods: One hundred twenty-five patients with exacerbated COPD were enrolled in the study and screened for OSA using the Epworth Sleepiness Scale (ESS). Those with a positive ESS score underwent polysomnography (PSG) for confirmation. All patients were followed for 90 days to monitor for subsequent exacerbations.Results: Out of the 125 patients with exacerbated COPD, 25 were confirmed to have OSA. Those with OS had a significantly higher body mass index (BMI) (p < 0.001). The monocyte to eosinophil ratio (MER) was significantly higher in the OS group, while the neutrophil to monocyte (NMR) ratio and platelets to monocyte (PMR) ratio were significantly lower. Younger age, male sex, and higher body mass index (BMI) were all associated with OS. During the 90-day follow-up period after hospital discharge, 60% of patients with OS were re-admitted due to acute exacerbations. The hazard ratio for a second exacerbation increased by two-fold for every one-unit increase MER. The MER demonstrated excellent utility in predicting a second exacerbation, with an area under the curve (AUC) of 83% and a p-value of .005.Conclusion: The monocyte to eosinophil ratio (MER) was independent predictors of OS among exacerbated COPD patients and had a very good prognostic utility for predicting the next exacerbation episodes. Long term follow up is recommended to evaluate the severity of exacerbations and the effect of complications of OS on the morbidity and mortality of these patients.
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Affiliation(s)
- Asmaa Ali
- Department of Pulmonary Medicine, Abbassia Chest Hospital, Egypt Ministry of Health and Population, Cairo, Egypt
| | - Ahmed Samir Abdelhafiz
- Department of Clinical Pathology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Mai M Saleh
- Department of Chest Disease, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Heba Salem
- Department of Chest Disease, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Mohammed A Rakha
- Department of Chest Disease, Faculty of Medicine, Alazhar University, Cairo, Egypt
| | - Seham Ezzat
- Department of Chest Disease, Faculty of Medicine, Tanta University, Tanta, Egypt
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Mohanty V, Sharma S, Goswami S, Kaushik A, Choudhary R, Yadav D, Deora S, Singh K. Association of Novel Hematological Indices with Severity of Coronary Artery Disease using SYNTAX Score in Patients with Acute Coronary Syndrome. Cardiovasc Hematol Disord Drug Targets 2023; 23:202-211. [PMID: 37953615 DOI: 10.2174/011871529x269740231102045028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 10/06/2023] [Accepted: 10/18/2023] [Indexed: 11/14/2023]
Abstract
INTRODUCTION Recent evidence suggests that systemic inflammation not only plays an important role in the pathogenesis of Acute Coronary Syndrome but also correlates with disease severity. Monocyte-to-high-density lipoprotein cholesterol ratio (MHR), Neutrophil-Lymphocyte Ratio (NLR), and Monocyte-Lymphocyte Ratio (MLR) are novel systemic inflammation markers used for predicting the burden of coronary artery disease (CAD) based on SYNTAX Score. This single-center, cross-sectional, observational study compared the association of these novel hematological indices with CAD severity using the SYNTAX Score in ACS patients and aimed to determine the best predictor of the severity of CAD. METHODS A total of 403 consecutive patients with ACS who underwent coronary angiography were enrolled. On the basis of the SYNTAX Score, patients were divided into three groups: Low: <22, Moderate 22 - 32 and High ≥ 32. MHR, MLR, and NLR were calculated and correlated with SYNTAX Score. RESULTS All three indices: MHR (r=0.511; p <0.001), MLR (r=0.373; p <0.001), and NLR (r=0.292; p =0.001) showed significant correlation with SYNTAX Score. The MHR ROC was significantly higher than that of MLR (difference between area: 0.158; 95% CI: 0.079-0.259) and NLR (difference between area: 0.279; 95% CI: 0.172-0.419) for the SYNTAX Score. Analysis showed a strong correlation between these indices with SYNTAX Score >22 compared to low scores <22 and that these also related to the LAD as an infarct artery. Multiple regression analysis showed that diabetes mellitus, eGFR, Infarct-related artery left anterior descending (IRALAD), MHR, MLR, and NLR were predictors of the severity of CAD in ACS patients based on SYNTAX Score. CONCLUSION In ACS patients MHR, MLR, and NLR showed significant correlation with SYNTAX score >22 which may be indicative of severity of disease. MHR is a better predictor of the severity of CAD than MLR and NLR in ACS patients.
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Affiliation(s)
- Vivek Mohanty
- Senior Resident of Cardiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Shubham Sharma
- Senior Resident of Cardiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Sourabh Goswami
- Senior Resident of Cardiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Atul Kaushik
- Associate Professor of Cardiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Rahul Choudhary
- Associate Professor of Cardiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Dharamveer Yadav
- Additional Professor of Biochemistry, All India Institute of Medical Sciences, Jodhpur, India
| | - Surender Deora
- Additional Professor of Cardiology, All India Institute of Medical Sciences, Jodhpur, India
| | - Kuldeep Singh
- Professor of Paediatrics and Genetic Medicine, All India Institute of Medical Sciences, Jodhpur, India
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22
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Nakayama K, Furuyama T, Matsubara Y, Morisaki K, Onohara T, Ikeda T, Yoshizumi T. Gut dysbiosis and bacterial translocation in the aneurysmal wall and blood in patients with abdominal aortic aneurysm. PLoS One 2022; 17:e0278995. [PMID: 36516156 PMCID: PMC9749999 DOI: 10.1371/journal.pone.0278995] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
Inflammation plays a part in the development of abdominal aortic aneurysm (AAA), and the gut microbiota affects host inflammation by bacterial translocation. The relationship between abdominal aortic aneurysm and the gut microbiota remains unknown. This study aimed to detect bacterial translocation in the aneurysmal wall and blood of patients with abdominal aortic aneurysm, and to investigate the effect of the gut microbiota on abdominal aortic aneurysm. We investigated 30 patients with abdominal aortic aneurysm from 2017 to 2019. We analysed the aneurysmal wall and blood using highly sensitive reverse transcription-quantitative polymerase chain reaction, and the gut microbiota was investigated using next-generation sequencing. In the 30 patients, bacteria were detected by reverse transcription- quantitative polymerase chain reaction in 19 blood samples (detection rate, 63%) and in 11 aneurysmal wall samples (detection rate, 37%). In the gut microbiota analysis, the Firmicutes/Bacteroidetes ratio was increased. The neutrophil-lymphocyte ratio was higher (2.94 ± 1.77 vs 1.96 ± 0.61, P < 0.05) and the lymphocyte-monocyte ratio was lower (4.02 ± 1.25 vs 5.86 ± 1.38, P < 0.01) in the bacterial carrier group than in the bacterial non-carrier group in blood samples. The volume of intraluminal thrombus was significantly higher in the bacterial carrier group than in the bacterial non-carrier group in aneurysmal wall samples (64.0% vs 34.7%, P < 0.05). We confirmed gut dysbiosis and bacterial translocation to the blood and aneurysmal wall in patients with abdominal aortic aneurysm. There appears to be a relationship between the gut microbiota and abdominal aortic aneurysm.
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Affiliation(s)
- Ken Nakayama
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tadashi Furuyama
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- * E-mail:
| | - Yutaka Matsubara
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koichi Morisaki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshihiro Onohara
- Department of Vascular Surgery, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Tetsuo Ikeda
- Department of Surgery and Endoscope Center, Oral Medicine Research Center, Fukuoka Dental College, Fukuoka, Japan
| | - Tomoharu Yoshizumi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Liao J, Wei D, Sun C, Yang Y, Wei Y, Liu X. Prognostic value of the combination of neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio and platelet-to-lymphocyte ratio on mortality in patients on maintenance hemodialysis. BMC Nephrol 2022; 23:393. [PMID: 36482367 PMCID: PMC9730573 DOI: 10.1186/s12882-022-03020-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 11/25/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Hemodialysis (HD) is the most important renal replacement therapy for patients with end-stage kidney disease (ESKD). Systemic inflammation is a risk factor of mortality in HD patients. Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) are new inflammatory markers. However, previous studies have inconsistent conclusions about the predictive value of NLR, MLR and PLR on mortality of HD patients. The aim of this study was to establish an inflammation scoring system by including NLR, MLR and PLR, and evaluate the association between the inflammation score and all-cause and cardiovascular mortality in HD patients. METHODS In this single center retrospective cohort study, 213 incident HD patients from January 1, 2015 to December 31, 2020 were included. Baseline demographic and clinical data and laboratory measurements were collected. According to the optimal cut-off values, NLR, MLR and PLR were assigned 0 or 1 point, respectively. Then, the inflammation score was obtained by adding the NLR, MLR and PLR scores. All patients were followed until July 31, 2021. The associations of the inflammation score with all-cause and cardiovascular mortality were assessed by multivariable-adjusted Cox models. RESULTS Of 213 patients, the mean (± SD) age was 56.8 ± 14.4 years, 66.2% were men, and 32.9% with diabetes. The primary cause of ESKD was mainly chronic glomerulonephritis (46.5%) and diabetic nephropathy (28.6%). The median inflammation score was 2 (interquartile range = 1-3). During a median 30 months (interquartile range = 17-50 months) follow-up period, 53 patients had died, of which 33 deaths were caused by cardiovascular disease. After adjusting for demographics, primary diseases and other confounders in multivariable model, the inflammation score = 3 was associated with a hazard ratio for all-cause mortality of 4.562 (95% confidence interval, 1.342-15.504, P = 0.015) and a hazard ratio for cardiovascular mortality of 4.027 (95% confidence interval, 0.882-18.384, P = 0.072). CONCLUSION In conclusion, an inflammation scoring system was established by including NLR, MLR and PLR, and the higher inflammation score was independently associated with all-cause mortality in HD patients.
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Affiliation(s)
- Jiaxian Liao
- grid.464460.4Department of Nephrology, Hechi Traditional Chinese Medicine Hospital, Hechi, Guangxi China
| | - Dongyan Wei
- grid.464460.4Department of Nephrology, Hechi Traditional Chinese Medicine Hospital, Hechi, Guangxi China
| | - Chenghui Sun
- grid.464460.4Department of Nephrology, Hechi Traditional Chinese Medicine Hospital, Hechi, Guangxi China
| | - Yuqi Yang
- grid.464460.4Department of Nephrology, Hechi Traditional Chinese Medicine Hospital, Hechi, Guangxi China
| | - Yinxia Wei
- grid.464460.4Department of Nephrology, Hechi Traditional Chinese Medicine Hospital, Hechi, Guangxi China
| | - Xinhui Liu
- grid.411866.c0000 0000 8848 7685Department of Nephrology, Shenzhen Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong China
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24
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Lin CH, Li YR, Lin PR, Wang BY, Lin SH, Huang KY, Kor CT. Blood monocyte levels predict the risk of acute exacerbations of chronic obstructive pulmonary disease: a retrospective case-control study. Sci Rep 2022; 12:21057. [PMID: 36473925 DOI: 10.1038/s41598-022-25520-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
Monocytes were critical cells in the innate immune system. Monocyte recruitment to the lungs is a crucial process of pathophysiology in chronic obstructive pulmonary disease (COPD). Current evidence on the association between the occurrence of acute exacerbations of COPD (AECOPD) and monocytes was unclear. This study aimed to examine whether blood monocytes are associated with the occurrence of AECOPD and to determine the specific blood monocyte level to predict AECOPD. A retrospective case-control study was conducted at Changhua Christian Hospital. A total of 444 eligible patients with COPD were included between January 2017 and December 2019. Restricted cubic splines were used to analyze the nonlinear relationships between continuous white blood cell values and the occurrence of AECOPD. The association between monocytes and the occurrence of AECOPD was assessed using the logistic, lasso, and ridge regression models. Restricted cubic splines revealed nonlinear associations among the monocyte level, the continuous value of the eosinophil-to-lymphocyte ratio, and the occurrence of AECOPD. The lowest risk of occurrence of AECOPD ranged from 7.4 to 10%; < 7.4% with an absolute count < 0.62 or > 10% indicated significant risk. No significant association was noted between the eosinophil-to-lymphocyte ratio categories in the tertiles (< 0.049, 0.049 to < 0.122, and ≥ 0.122) and the risk of AECOPD. A significantly higher risk was noted in the association of the occurrence of AECOPD with the CAT score; mMRC score; wheezing cough; preexisting chronic pulmonary disease; hypertension and malignancy; use of dual- and triple, and oral long-acting bronchodilators for COPD treatment; and WBC count. We reported a nonlinear relationship between monocytes and the occurrence of AECOPD. Patients with monocyte percentage of > 10% or < 7.4% with an absolute count < 0.62 had higher risk of occurrence of AECOPD. Overall, our study demonstrated the specific value of monocytes in identifying high risks of the occurrence of AECOPD; this value is an easy-to-obtain, inexpensive biomarker in patients with AECOPD and should be further investigated in future prospective clinical studies.
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25
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Han K, Shi D, Yang L, Wang Z, Li Y, Gao F, Liu Y, Ma X, Zhou Y. Prognostic value of systemic inflammatory response index in patients with acute coronary syndrome undergoing percutaneous coronary intervention. Ann Med 2022; 54:1667-1677. [PMID: 35695557 PMCID: PMC9225721 DOI: 10.1080/07853890.2022.2083671] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The systemic inflammatory response index (SIRI) is a novel inflammatory biomarker in many diseases. OBJECTIVES The aim of this study was to examine the association between SIRI and adverse events in patients with the acute coronary syndrome (ACS) undergoing percutaneous coronary intervention. METHODS A total of 1724 patients with ACS enrolled from June 2016 to November 2017 at a single centre were included in this study, and SIRI was calculated for each patient. The primary endpoint was the composite of major adverse cardiovascular events (MACE), including overall death, non-fatal myocardial infarction, non-fatal stroke, and unplanned repeat revascularization. RESULTS During a median follow-up of 927 days, 355 patients had MACE. Multivariate Cox analysis showed that SIRI was significantly associated with MACE (hazard ratio: 1.127, 95% confidence interval: 1.034-1.229 p = .007). The results were consistent in multiple sensitivity analyses. The addition of SIRI had an incremental effect on the predictive ability of the Global Registry of Acute Coronary Events risk score for MACE (integrated discrimination improvement: 0.007, p = .040; net reclassification improvement: 0.175, p = .020; likelihood ratio test: p < .001). The restricted cubic spline showed a monotonic increase with a greater SIRI value for MACE (p < .001). CONCLUSION SIRI was an independent risk factor for MACE and provided incremental prognostic information in patients with ACS undergoing percutaneous coronary intervention. KEY MESSAGESThe SIRI is a strong and independent risk factor for adverse outcomes in patients with ACS undergoing percutaneous coronary intervention.Higher SIRI is associated with a more severe disease status.The SIRI could increase the prognostic value of the GRACE risk score.
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Affiliation(s)
- Kangning Han
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
| | - Dongmei Shi
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
| | - Lixia Yang
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
| | - Zhijian Wang
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
| | - Yueping Li
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
| | - Fei Gao
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
| | - Yuyang Liu
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
| | - Xiaoteng Ma
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
| | - Yujie Zhou
- Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
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26
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Ryan KM, Lynch M, McLoughlin DM. Blood cell ratios in mood and cognitive outcomes following electroconvulsive therapy. J Psychiatr Res 2022; 156:729-736. [PMID: 36413934 DOI: 10.1016/j.jpsychires.2022.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/21/2022] [Accepted: 11/12/2022] [Indexed: 11/18/2022]
Abstract
Systemic inflammation is commonly reported in depression, with dysregulation of both the innate and adaptive arms of the immune system documented. Obtaining ratios of neutrophils, platelets, and monocytes to counts of lymphocytes (NLR, PLR, MLR, respectively) represents a low-cost and easily reproducible measure of an individual's inflammatory burden that can be calculated effortlessly from routine clinical full white blood cell counts. Electroconvulsive therapy (ECT) remains the most effective acute antidepressant treatment for depression but is often limited by its cognitive side-effects. Here, we examined differences in blood cell ratios in subgroups of depressed patients (unipolar/bipolar, psychotic/non-psychotic, early-onset/late-onset) and ECT-related subgroups (responder/non-responder, remitter/non-remitter). We also explored the relationships between blood cell ratios and depression severity and immediate cognitive outcomes post-ECT. Our results show baseline NLR was raised in patients with psychotic depression. In the entire group of patients, significant negative correlations were noted between the PLR and SII and baseline HAM-D24 score, signifying that lower systemic inflammation is associated with more severe depressive symptoms. Significant positive correlations were noted between various blood cell ratios and mean time to recovery of orientation in the entire group of patients and in depression subgroups, indicating that increased peripheral inflammation is linked to worse cognitive outcomes post-ECT. Overall, our results suggest that assessment of blood cell ratios could be useful for predicting mood changes in patients at risk of developing depressive episodes or relapse following successful treatment or for identifying those at risk for cognitive side-effects following ECT.
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Affiliation(s)
- Karen M Ryan
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland; Department of Psychiatry, Trinity College Dublin, St. Patrick's University Hospital, James Street, Dublin 8, Ireland
| | - Marie Lynch
- Department of Psychiatry, Trinity College Dublin, St. Patrick's University Hospital, James Street, Dublin 8, Ireland
| | - Declan M McLoughlin
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland; Department of Psychiatry, Trinity College Dublin, St. Patrick's University Hospital, James Street, Dublin 8, Ireland.
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Gao J, Lu J, Sha W, Xu B, Zhang C, Wang H, Xia J, Zhang H, Tang W, Lei T. Relationship between the neutrophil to high-density lipoprotein cholesterol ratio and severity of coronary artery disease in patients with stable coronary artery disease. Front Cardiovasc Med 2022; 9:1015398. [PMID: 36505389 PMCID: PMC9729241 DOI: 10.3389/fcvm.2022.1015398] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/04/2022] [Indexed: 11/25/2022] Open
Abstract
Objective To evaluate the link between the neutrophil to HDL-C ratio (NHR) and the degree of coronary stenosis in patients with stable coronary artery disease (CAD). Materials and methods Totally 766 individuals who attended our clinic for coronary angiography between January 2019 and January 2021 were included in this study. The participants were divided into two groups, including the CAD group and control group. Spearman correlation analysis was used to investigate the association between NHR and Gensini score and logistic regression analysis was performed to determine the influence of NHR on CAD and severe CAD. Receiver operating characteristic (ROC) curve was constructed to analyze the predictive value of NHR for severe CAD. Results The CAD group had a substantially higher median NHR than the control group (3.7 vs. 3.2, P < 0.01). There was a positive correlation between NHR and Gensini score, as well as the frequency of coronary artery plaques. Logistic regression demonstrated that NHR was an independent contributor for CAD and severe CAD. In ROC analysis, the area under the ROC curve (AUC) for NHR was larger than that for neutrophil, HDL-C or LDL-C/HDL-C, and the differences were statistically significant (all P < 0.05). The NHR limit that offered the most accurate prediction of severe CAD according to the greatest possible value of the Youden index, was 3.88, with a sensitivity of 62.6% and a specificity of 66.2%. Conclusion NHR was not only associated with the occurrence and seriousness of CAD, but also a better predictor of severe CAD than neutrophil, HDL-C or LDL-C/HDL-C.
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Affiliation(s)
- Jie Gao
- Department of Endocrinology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jun Lu
- Department of Endocrinology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenjun Sha
- Department of Endocrinology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bilin Xu
- Department of Endocrinology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Cuiping Zhang
- Department of Endocrinology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hongping Wang
- Department of Endocrinology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Juan Xia
- Department of Endocrinology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hong Zhang
- Department of Cardiology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenjun Tang
- Heart Function Examination Room, Tongji Hospital, Tongji University, Shanghai, China
| | - Tao Lei
- Department of Endocrinology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Alfhili MA, Alsughayyir J, Basudan AM, Alsubki R, Alqahtani S, Awan ZA, Algethami MR, Al-Sheikh YA. Monocyte-Lymphocyte Ratio and Dysglycemia: A Retrospective, Cross-Sectional Study of the Saudi Population. Healthcare (Basel) 2022; 10. [PMID: 36421613 DOI: 10.3390/healthcare10112289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/10/2022] [Accepted: 11/13/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Abnormalities in fasting blood glucose (FBG) resulting in hypoglycemia (OG), impaired fasting glycemia (IFG), or hyperglycemia (HG) arise from disordered metabolic regulation caused in part by inflammation. To date, there is a dearth of evidence regarding the clinical utility of the monocyte−lymphocyte ratio (MLR), an emerging inflammatory index, in the management of dysglycemia. Methods: This retrospective, cross-sectional study explored MLR fluctuations as a function of glycemic control in 14,173 Saudi subjects. Data collected from 11 August 2014 to 18 July 2020 were retrieved from Al-Borg Medical Laboratories. Medians were compared by Mann−Whitney U or Kruskal−Wallis tests and the prevalence, relative risk (RR), and odds ratio (OR) were calculated. Results: MLR was significantly elevated in IFG (p < 0.0001) and HG (p < 0.05) groups compared to the normoglycemia (NG) group, and individuals with elevated MLR (>0.191) had significantly increased FBG (p < 0.001). The risk of IFG (RR = 1.12, 95% CI: 1.06−1.19, p < 0.0002) and HG (RR = 1.10, 95% CI: 1.01−1.20, p < 0.0216) was significantly increased if MLR was elevated, and individuals with elevated MLR were 1.17 times more likely to have IFG (OR = 1.17, 95% CI: 1.08−1.26, p < 0.0002) and 1.13 times more likely to have HG (OR = 1.13, 95% CI: 1.02−1.24, p < 0.0216). Conclusion: Elevated MLR is correlated with and carries a greater risk for IFG and HG. However, large prospective cohort studies are needed to establish the temporal relationship between MLR and FBG and to examine the prognostic value of this novel marker.
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Chen X, Xiong S, Chen Y, Cheng L, Chen Q, Yang S, Qi L, Liu H, Cai L. The Predictive Value of Different Nutritional Indices Combined with the GRACE Score in Predicting the Risk of Long-Term Death in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention. J Cardiovasc Dev Dis 2022; 9:jcdd9100358. [PMID: 36286310 PMCID: PMC9604676 DOI: 10.3390/jcdd9100358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 11/16/2022] Open
Abstract
Nutritional status is associated with prognosis in acute coronary syndrome (ACS) patients. Although the Global Registry of Acute Coronary Events (GRACE) risk score is regarded as a relevant risk predictor for the prognosis of ACS patients, nutritional variables are not included in the GRACE score. This study aimed to compare the prognostic ability of the Geriatric Nutritional Risk Index (GNRI) and Prognostic Nutritional Index (PNI) in predicting long-term all-cause death in ACS patients undergoing percutaneous coronary intervention (PCI) and to determine whether the GNRI or PNI could improve the predictive value of the GRACE score. A total of 799 patients with ACS who underwent PCI from May 2018 to December 2019 were included and regularly followed up. The performance of the PNI in predicting all-cause death was better than that of the GNRI [C-index, 0.677 vs. 0.638, p = 0.038]. The addition of the PNI significantly improved the predictive value of the GRACE score for all-cause death [increase in C-index from 0.722 to 0.740; IDI 0.006; NRI 0.095; p < 0.05]. The PNI was superior to the GNRI in predicting long-term all-cause death in ACS patients undergoing PCI. The addition of the PNI to the GRACE score could significantly improve the prediction of long-term all-cause death.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Lin Cai
- Correspondence: (H.L.); (L.C.)
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Wang CJ, Pang CY, Huan-Yu, Cheng YF, Wang H, Deng BB, Huang HJ. Monocyte-to-lymphocyte ratio affects prognosis in LAA-type stroke patients. Heliyon 2022; 8:e10948. [PMID: 36247122 PMCID: PMC9561738 DOI: 10.1016/j.heliyon.2022.e10948] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/04/2022] [Accepted: 09/29/2022] [Indexed: 11/02/2022] Open
Abstract
Nowadays, the prognostic prediction of acute ischemic stroke (AIS) patients is still challenging because of the limited predictive properties of existing models. Blood-based biomarkers may provide additional information to the established prognostic factors. Markers of atherosclerosis have been identified as one of the most promising biomarkers for predicting prognosis, and inflammation, in turn, affects atherosclerosis. According to previous studies, the ratio of monocytes to lymphocytes (MLR) has been reported as a novel indicator of inflammation. Thus, our study was the first to conduct more in-depth research on the relationship between MLR and the prognosis of large artery atherosclerosis (LAA)-type AIS patients. A total of 296 patients with LAA-type stroke were recruited. Of these, 202 patients were assigned to the development cohort, and 94 patients were assigned to the validation cohort. In the development cohort, 202 patients were divided into groups A, B, C, and D according to the quartile method of MLR levels. The one-year prognosis of patients was tracked, and the modified Rankin scale (MRS, with a score ranging from 0 to 6) was mainly selected as the measurement result of the function. The relationship between MLR and prognosis was analyzed by building logistics regression models. The models showed that MLR made significant predictions in poor outcomes of LAA-type stroke patients (odds ratio: 4.037; p = 0.048). At the same time, receiver operating characteristics (ROC) curves were used to compare the predictive values between MLR and clinical prediction score (Barthel Index). This study demonstrated that patients with LAA-type stroke and high MLR had a poor prognosis. MLR might be a reliable, inexpensive, and novel predictor of LAA-type stroke prognosis.
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Ng WW, Lam S, Yan W, Shum H. NLR, MLR, PLR and RDW to predict outcome and differentiate between viral and bacterial pneumonia in the intensive care unit. Sci Rep 2022; 12. [PMID: 36153405 PMCID: PMC9509334 DOI: 10.1038/s41598-022-20385-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 09/13/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractThe neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and red cell distribution width (RDW) are emerging biomarkers to predict outcomes in general ward patients. However, their role in the prognostication of critically ill patients with pneumonia is unclear. A total of 216 adult patients were enrolled over 2 years. They were classified into viral and bacterial pneumonia groups, as represented by influenza A virus and Streptococcus pneumoniae, respectively. Demographics, outcomes, and laboratory parameters were analysed. The prognostic power of blood parameters was determined by the respective area under the receiver operating characteristic curve (AUROC). Performance was compared using the APACHE IV score. Discriminant ability in differentiating viral and bacterial aetiologies was examined. Viral and bacterial pneumonia were identified in 111 and 105 patients, respectively. In predicting hospital mortality, the APACHE IV score was the best prognostic score compared with all blood parameters studied (AUC 0.769, 95% CI 0.705–0.833). In classification tree analysis, the most significant predictor of hospital mortality was the APACHE IV score (adjusted P = 0.000, χ2 = 35.591). Mechanical ventilation was associated with higher hospital mortality in patients with low APACHE IV scores ≤ 70 (adjusted P = 0.014, χ2 = 5.999). In patients with high APACHE IV scores > 90, age > 78 (adjusted P = 0.007, χ2 = 11.221) and thrombocytopaenia (platelet count ≤ 128, adjusted P = 0.004, χ2 = 12.316) were predictive of higher hospital mortality. The APACHE IV score is superior to all blood parameters studied in predicting hospital mortality. The single inflammatory marker with comparable prognostic performance to the APACHE IV score is platelet count at 48 h. However, there is no ideal biomarker for differentiating between viral and bacterial pneumonia.
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Bilik MZ, Oylumlu M, Oylumlu M, Acun B, Arik B, Arslan B, Acet H, Polat N, Akil MA. Novel predictor of pulmonary arterial hypertension: Monocyte to HDL cholesterol ratio. Medicine (Baltimore) 2022; 101:e29973. [PMID: 36042653 PMCID: PMC9410685 DOI: 10.1097/md.0000000000029973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Monocyte to HDL cholesterol ratio (MHR), lymphocyte to monocyte ratio (LMR), and neutrophil to lymphocyte ratio (NLR) have been proposed as novel systemic inflammatory markers. The aim of this study was to explore the association between MHR, LMR and NLR with pulmonary arterial hypertension (PAH). The study is a single-center, retrospective Cross-sectional study. The study group consisted of 73 patients with PAH and the control group 77 participants without cardiac pathology as determined by echocardiography. On admission, blood sampling to calculate MHR, LMR, NLR, and detailed clinical data were obtained. According to the Pearson test, systolic pulmonary artery pressure (PAP) value Higher MHR, NLR and lower LMR that indicates an enhanced inflammation were significantly increased in patients with PAH when compared with controls. Compared to many other inflammatory markers, these markers are widely available. positively correlated with the MHR and NLR (r:.35, P < .001 and r:.33, P < .001, respectively), but negatively correlated with LMR (r: -.26, P = .001). After multivariate logistic regression analysis, MHR, LMR, and NLR remained as significant predictors of PAH (OR: 2.651, 95% CI: 1.227-5.755, P = .007; OR: 0.647, 95% CI:0.450-0.931, P = .005; OR: 1.350, 95% CI: 1.054-1.650 P = .030, respectively).
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Affiliation(s)
- Mehmet Zihni Bilik
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
- *Correspondence: Mehmet Zihni Bilik, Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey (e-mail: )
| | - Muhammed Oylumlu
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
| | - Mustafa Oylumlu
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
| | - Baris Acun
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
| | - Baran Arik
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
| | - Bayram Arslan
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
| | - Halit Acet
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
| | - Nihat Polat
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
| | - Mehmet Ata Akil
- Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakir, Turkey
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Song P, Yang D, Li J, Zhuo N, Fu X, Zhang L, Zhang H, Liu H, Sun L, Liu Y. Dynamic serum albumin and outcome of peritoneal dialysis patients: A retrospective study in China. Front Med (Lausanne) 2022; 9:917603. [PMID: 35983095 PMCID: PMC9381003 DOI: 10.3389/fmed.2022.917603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/06/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Serum albumin levels at a single time point have been shown to predict mortality in peritoneal dialysis (PD) patients. However, we believe that the dynamic change in albumin after PD may be more significant. In this study, we investigated the relationship between dynamic serum albumin and the clinical outcome of patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Methods The participants in this study enrolled 586 patients who underwent CAPD at the peritoneal dialysis center of Second Xiangya Hospital in China. We retrospectively reviewed medical records from January 1, 2010, to December 31, 2019. Baseline serum albumin (Alb), time-averaged albumin level (TA-ALB) and serum albumin reach rate (SR: defined as the percentage of serum albumin measurements that reached ≥ 35 g/L) were applied as the predictor variables. All-cause mortality and cardiovascular mortality were used as the outcome variables. Hazard function of all-cause mortality and cardiovascular mortality in the study participants were examined by using Cox proportional hazard regression models. Results Age (HR = 1.03, 95% CI 1.00–1.05), cardiovascular disease (HR = 1.80, 95% CI 1.07–3.03) and TA-ALB (HR = 0.92, 95% CI 0.85–0.99) were independent risk factors for all-cause mortality in PD patients. Patients with TA-ALB of <33 g/L (HR = 2.33, 95% CI 1.17–4.62) exhibited a higher risk for all-cause mortality than those with TA-ALB ≥ 36 g/L. Stratified SR showed a similar trend. Patients with a <25% SR exhibited a significantly increased risk for all-cause mortality (HR = 2.72, 95% CI, 1.24–5.96) by fully adjusted analysis. However, neither TA-ALB nor SR were associated with the risk of cardiovascular mortality after adjusted analysis. Conclusion This study demonstrated that age, cardiovascular disease, and TA-ALB were independent risk factors for all-cause mortality in PD patients. TA-ALB and SR can better predict the prognosis of PD patients than baseline Alb. Dynamic changes in Alb are more clinically significant than baseline Alb in predicting mortality risk.
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Küçükkarapınar M, Ünal B, Candansayar S. Clinical Characteristics of Patients With Delirium Consulted During the First Year of the COVID-19 Pandemic, and the Role of Monocyte to Lymphocyte Ratio in Survival of COVID-19-Positive Patients With Delirium. Psychiatr Ann 2022. [DOI: 10.3928/00485713-20220516-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Song BW, Kim AR, Moon DH, Kim YK, Kim GT, Ahn EY, So MW, Lee SG. Associations of Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio and Monocyte-to-Lymphocyte Ratio with Osteoporosis and Incident Vertebral Fracture in Postmenopausal Women with Rheumatoid Arthritis: A Single-Center Retrospective Cohort Study. Medicina (Kaunas) 2022; 58:medicina58070852. [PMID: 35888571 PMCID: PMC9321011 DOI: 10.3390/medicina58070852] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/13/2022] [Accepted: 06/24/2022] [Indexed: 11/30/2022]
Abstract
Background and Objectives: We investigated whether nutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphoycte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) are associated with the presence of osteoporosis (OP) and vertebral fractures in patients with rheumatoid arthritis (RA). Materials and Methods: This retrospective cohort study included 413 postmenopausal patients with RA and 200 healthy controls who underwent dual-energy X-ray absorptiometry (DEXA) between January 2005 and December 2017. DEXA examination data were defined as the index date, and all laboratory values were measured within one month from the index date. OP was defined as a T-score < −2.5, and incident vertebral fractures were defined as the first occurrence of non-traumatic fractures after the index date. NLR, PLR, and MLR measures were dichotomized by a median split (low vs. high). Results: The median NLR, PLR, and MLR in RA patients were significantly higher than those in controls. The frequencies of OP of the lumbar spine, hip, and either site in postmenopausal patients with RA were 24.7%, 15.5%, and 32%, respectively, and were significantly higher than those in controls. After adjusting for confounding factors, a high baseline NLR was significantly associated with OP at either site (OR = 1.61, p = 0.041). In addition, high baseline NLR (OR = 2.11, p = 0.025) and PLR (OR = 2.3, p = 0.011) were related with the presence OP at hip. During the follow-up period, 53 (12.8%) patients with RA developed vertebral fractures incidentally. In multivariable Cox regression models, a high baseline NLR (HR = 4.72, p < 0.001), PLR (HR = 1.96, p = 0.024), and MLR (HR = 2.64, p = 0.002) were independently associated with a higher risk of incidental vertebral fractures. Conclusions: Our data suggest that NLR, PLR, and MLR can be used as potential markers of systemic bone loss among individuals with RA.
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Affiliation(s)
- Byung-Wook Song
- Division of Rheumatology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Korea; (B.-W.S.); (A.-R.K.); (D.-H.M.)
- Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Korea
| | - A-Ran Kim
- Division of Rheumatology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Korea; (B.-W.S.); (A.-R.K.); (D.-H.M.)
- Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Korea
| | - Dong-Hyuk Moon
- Division of Rheumatology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Korea; (B.-W.S.); (A.-R.K.); (D.-H.M.)
- Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Korea
| | - Yun-Kyung Kim
- Division of Rheumatology, Department of Internal Medicine, Kosin University College of Medicine, Busan 49267, Korea; (Y.-K.K.); (G.-T.K.)
| | - Geun-Tae Kim
- Division of Rheumatology, Department of Internal Medicine, Kosin University College of Medicine, Busan 49267, Korea; (Y.-K.K.); (G.-T.K.)
| | - Eun-Young Ahn
- Division of Rheumatology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Korea; (E.-Y.A.); (M.-W.S.)
| | - Min-Wook So
- Division of Rheumatology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Korea; (E.-Y.A.); (M.-W.S.)
| | - Seung-Geun Lee
- Division of Rheumatology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Korea; (B.-W.S.); (A.-R.K.); (D.-H.M.)
- Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Korea
- Correspondence:
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Keskin Ç, Dilekçi EN, Üç ZA, Cengiz D, Duran C. Can the systemic immune-inflammation index be used as a novel diagnostic tool in the diagnosis of subacute thyroiditis? Biomark Med 2022; 16:791-797. [PMID: 35748139 DOI: 10.2217/bmm-2022-0095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To evaluate systemic inflammatory parameters derived from hematological parameters in the diagnosis and prognosis of subacute thyroiditis (SAT). Methods: Demographic and laboratory data of 170 patients with SAT and 91 healthy control subjects were analysed retrospectively. The authors compared inflammatory parameters and thyroid function tests between SAT and control groups. Results: The erythrocyte sedimentation rate, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and systemic immune-inflammatory index (SII) were significantly higher in patients with SAT (p < 0.001). There was a significant positive correlation between the SII and erythrocyte sedimentation rate (r: 0.448; p < 0.001), CRP (r: 0.449; p < 0.01), neutrophil-to-lymphocyte ratio (r: 0.861; p < 0.001) and platelet-to-lymphocyte ratio (r: 0.782, p < 0.001). The thyroid stimulating hormone levels were higher in patients with recurrence when compared with those without recurrence (p = 0.007). Conclusions: As a practical biomarker, SII was significantly higher in patients with SAT compared with the control group. SII may be a new diagnostic tool for SAT.
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Affiliation(s)
- Çağlar Keskin
- Department of Endocrinology & Metabolism, Bolu Abant İzzet Baysal University School of Medicine, Bolu, 14030, Turkey
| | - Esra Na Dilekçi
- Department of Endocrinology & Metabolism, Bolu Abant İzzet Baysal University School of Medicine, Bolu, 14030, Turkey
| | - Ziynet A Üç
- The Department of Internal Medicine, The Division of Endocrinology & Metabolism, Uşak University School of Medicine, Uşak, 64200, Turkey
| | - Deniz Cengiz
- Department of Internal Medicine, Bolu Abant İzzet Baysal University School of Medicine, Bolu, 14030, Turkey
| | - Cevdet Duran
- The Department of Internal Medicine, The Division of Endocrinology & Metabolism, Uşak University School of Medicine, Uşak, 64200, Turkey
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Li F, Ye P, Hao Y, Du J, Zhang H, Wang Z, Wang X, Zeng H, Ma Y, Lin J. A PCSK9 inhibitor induces a transient decrease in the neutrophil-lymphocyte ratio and monocyte-lymphocyte ratio in homozygous familial hypercholesterolemia patients. Atheroscler Plus 2022; 49:12-19. [PMID: 36644203 PMCID: PMC9833253 DOI: 10.1016/j.athplu.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/24/2022] [Accepted: 05/09/2022] [Indexed: 01/18/2023]
Abstract
Background and aims Extremely elevated levels of low-density lipoprotein-cholesterol (LDL-C) contribute to long-term chronic systemic inflammation in homozygous familial hypercholesterolemia (HoFH) patients. The aims of this study is to describe the inflammatory profile of HoFH patients and explore the effect of a PCSK9 inhibitor (PCSK9i) on a series of inflammatory biomarkers, including the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-HDL ratio (MHR), monocyte-lymphocyte ratio (MLR) and mean platelet volume-lymphocyte ratio (MPVLR). Methods In this prospective cohort study, 25 definitive HoFH patients on high-intensity statins plus ezetimibe were administered subcutaneous injections of 420 mg PCSK9i every 4 weeks (Q4W). The biochemical parameters and inflammatory profile were analyzed on the day before PCSK9i therapy and 3 months and 6 months after PCSK9i therapy. Results HoFH on the maximum tolerated statin dose plus ezetimibe displayed elevated lipid and disturbed blood biomarker profiles. After 3 months of add-on PCSK9i therapy, a significant reduction in LDL-C was observed. Moreover, the percentage and count of neutrophils, monocyte counts, MPV, and two inflammatory biomarkers, the NLR and MLR, were reduced. However, at 6 months of PCSK9i treatment, the NLR and MLR returned to pre-PCSK9i treatment levels. Conclusions PCSK9i induces a transient decrease in the NLR and MLR in HoFH patients in a lipid-lowering independent manner.
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Affiliation(s)
- Fangyuan Li
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Peking University Ditan Teaching Hospital, Beijing, China
| | - Pucong Ye
- Department of Critical Care Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Yu Hao
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Juan Du
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Hang Zhang
- Department of Atherosclerosis, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Zengtao Wang
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Xumin Wang
- College of Life Sciences, Yantai University, Yantai, China
| | - Hui Zeng
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Peking University Ditan Teaching Hospital, Beijing, China,Corresponding author.. Beijing Ditan Hospital, Jingshundongjie 8, Beijing, 100015, China.
| | - Yaluan Ma
- The Institute of Basic Medical Theory of Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China,Corresponding author.
| | - Jie Lin
- Department of Atherosclerosis, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China,Corresponding author.. Department of Atherosclerosis, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, 100029, China.
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Li Q, Ma X, Shao Q, Yang Z, Wang Y, Gao F, Zhou Y, Yang L, Wang Z. Prognostic Impact of Multiple Lymphocyte-Based Inflammatory Indices in Acute Coronary Syndrome Patients. Front Cardiovasc Med 2022; 9:811790. [PMID: 35592392 PMCID: PMC9110784 DOI: 10.3389/fcvm.2022.811790] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 02/18/2022] [Indexed: 12/14/2022] Open
Abstract
Background The aim of this study was to evaluate the prognostic values of five lymphocyte-based inflammatory indices (platelet-lymphocyte ratio [PLR], neutrophil-lymphocyte ratio [NLR], monocyte-lymphocyte ratio [MLR], systemic immune inflammation index [SII], and system inflammation response index [SIRI]) in patients with acute coronary syndrome (ACS). Methods A total of 1,701 ACS patients who underwent percutaneous coronary intervention (PCI) were included in this study and followed up for major adverse cardiovascular events (MACE) including all-cause death, non-fatal ischemic stroke, and non-fatal myocardial infarction. The five indices were stratified by the optimal cutoff value for comparison. The association between each of the lymphocyte-based inflammatory indices and MACE was assessed by the Cox proportional hazards regression analysis. Results During the median follow-up of 30 months, 107 (6.3%) MACE were identified. The multivariate COX analysis showed that all five indices were independent predictors of MACE, and SIRI seemingly performed best (Hazard ratio [HR]: 3.847; 95% confidence interval [CI]: [2.623–5.641]; p < 0.001; C-statistic: 0.794 [0.731–0.856]). The addition of NLR, MLR, SII, or SIRI to the Global Registry of Acute Coronary Events (GRACE) risk score, especially SIRI (C-statistic: 0.699 [0.646–0.753], p < 0.001; net reclassification improvement [NRI]: 0.311 [0.209–0.407], p < 0.001; integrated discrimination improvement [IDI]: 0.024 [0.010–0.046], p < 0.001), outperformed the GRACE risk score alone in the risk predictive performance. Conclusion Lymphocyte-based inflammatory indices were significantly and independently associated with MACE in ACS patients who underwent PCI. SIRI seemed to be better than the other four indices in predicting MACE, and the combination of SIRI with the GRACE risk score could predict MACE more accurately.
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Oh ES, You Z, Nowak KL, Jovanovich AJ. Association of Monocyte Count and Monocyte/Lymphocyte Ratio with the Risk of Cardiovascular Outcomes in Patients with CKD. Kidney360 2022; 3:657-665. [PMID: 35721602 PMCID: PMC9136887 DOI: 10.34067/kid.0007922021] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/03/2022] [Indexed: 01/08/2023]
Abstract
BackgroundEmerging evidence suggests an association of higher monocyte count and monocyte/lymphocyte ratio (MLR) with the risk of cardiovascular disease (CVD) in individuals without chronic kidney disease (CKD); however, limited studies have examined if this association translates to the CKD population. This study examined whether monocyte count and MLR are associated with the risk of CVD, CVD death, and all-cause death in patients with nondialysis CKD who participated in the Chronic Renal Insufficiency Cohort observational study.MethodsBaseline monocyte count and MLR were categorized into tertiles and also modeled continuously. Cox proportional hazards models were used to examine the association between monocyte count (primary predictor) and MLR (secondary predictor) at baseline and time to a composite of CVD events, including heart failure, myocardial infarction, ischemic stroke, and peripheral artery disease (primary outcome). Secondary outcomes were time to CVD death and all-cause death.ResultsThe median follow-up time was 9 years for CVD events and 11.7 years for death. In the fully adjusted model, participants with a higher monocyte count and MLR had a greater risk of CVD events (hazard ratio [HR] per doubling of monocyte count=1.2 [95% CI, 1.1 to 1.31]; HR per doubling of MLR=1.26 [95% CI, 1.16 to 1.36]), CVD death (HR=1.18 [95% CI, 0.99 to 1.41]; HR=1.27 [95% CI, 1.1 to 1.48]), and all-cause death (HR=1.17 [95% CI, 1.06 to 1.3]; HR=1.18 [95% CI, 1.09 to 1.29]).ConclusionsThese results suggest that monocyte count and MLR may have the potential to be cost-effective, clinically available indicators of CVD risk in the CKD population.
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Fahiem RA, Mekkawy LH. A New Perspective of Attention Deficit Hyperactivity Disorder Associated With Delayed Language Development: An Egyptian Sample. Psychiatry Investig 2022; 19:164-170. [PMID: 35196826 PMCID: PMC8958202 DOI: 10.30773/pi.2021.0232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/04/2021] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE The current study aimed to get an easy objective method to detect attention deficit hyperactivity disorder (ADHD) by investigating the simple inflammatory blood ratios platelet/lymphocyte ratio (PRL), neutrophil/lymphocyte ratio (NLR) & the monocyte/lymphocyte ratio (MLR), for the sake of receiving early management to such cases and overcoming language affection as a comorbid symptom. METHODS This study was conducted on two groups: Group 1 (SG) consisted of 70 ADHD children who had delayed language development (DLD), freshly diagnosed, according to DSM-V criteria, and those patients were not on medical treatment. Group 2 healthy group (HG) consisted of 44 healthy control normal children that were both physically and mentally free of the same socio-demographic characters of the first group. RESULTS The PLR, NLR and MLR, were significantly higher in the ADHD group than the healthy control group (HG) group, although the simple blood indices were average. CONCLUSION Inflammation has a role as a comorbid cause of ADHD. Simple blood inflammatory mediators may be used as comorbid factors in ADHD. This study explained that the language abilities must be taken in consideration when assessing children with ADHD. The screening tools for inflammatory markers are important when dealing with ADHD children with/ without delayed language development (DLD). Also, working memory assessment is mandatory in ADHD with DLD to assign a special program in language therapy for each child.
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Affiliation(s)
- Reham Ahmed Fahiem
- Department of Medical Studies for Children, Faculty of Postgraduate Childhood Studies, Ain Shams University, Cairo, Egypt
| | - Lamis H Mekkawy
- Department of Medical Studies for Children, Faculty of Postgraduate Childhood Studies, Ain Shams University, Cairo, Egypt
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Dai K, Li Z, Luo Y, Xiong Q, Xiong Y, Song Z, Xiong W. The Predictive Value of the Monocyte-to-Lymphocyte Ratio and Monocyte-to-Haematocrit Ratio for Cardiac Rupture Patients with Acute Myocardial Infarction: A Propensity Score Matching Analysis. Healthc Policy 2022; 15:37-44. [PMID: 35079225 PMCID: PMC8776727 DOI: 10.2147/rmhp.s348894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/06/2022] [Indexed: 12/03/2022] Open
Abstract
Background Cardiac rupture (CR) is a serious complication of acute myocardial infarction (AMI). We aimed to explore the predictive value of blood cell parameters for identifying CR in patients with AMI using the introduction of propensity score matching (PSM). Methods This retrospective study enrolled patients who were diagnosed with AMI from January 2013 to May 2020. A total of 109 patients with CR were included, and 327 hospitalized non-CR patients were randomly selected at a 1:3 ratio. Based on the 1:1 nearest neighbour matching method by using SPSS, the covariances of the two groups were balanced. After PSM, the independent risk factors for CR were selected by using multivariate logistic regression analysis, and receiver operating characteristic (ROC) curve analysis was applied to evaluate the predictive value of blood cell parameters for CR. Ninety cases were matched successfully in each of the two groups. Results Among the 180 patients with AMI after PSM, the results of multivariate logistic regression analysis showed that the monocyte-to-lymphocyte ratio (MLR) (OR = 3.57, 95% CI: 1.28–9.97, P = 0.015) and monocyte-to-haematocrit ratio (MHR) (OR = 1.80, 95% CI: 1.02–3.20, P = 0.043) were independently related to the risk of CR. Additionally, the MLR (area under the curve (AUC): 0.74) and MHR (AUC: 0.73) were useful for distinguishing CR patients after PSM. To differentiate CR patients from the control subjects, the optimal cut-offs of the MLR and MHR were 0.61 (63% sensitivity and 80% specificity) and 2.06 (57% sensitivity and 81% specificity), respectively. Conclusion The blood cell parameters MLR and MHR were independently correlated with CR. Additional, the MLR and MHR were useful to predict CR in patients with AMI.
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Affiliation(s)
- Kai Dai
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Nanchang University, Medical Department of Nanchang University, Nanchang, 330006, Jiangxi, People’s Republic of China
| | - Zhibing Li
- Department of Intensive Care Unit, The First Affiliated Hospital of Nanchang University, Medical Department of Nanchang University, Nanchang, 330006, Jiangxi, People’s Republic of China
| | - Yafei Luo
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Nanchang University, Medical Department of Nanchang University, Nanchang, 330006, Jiangxi, People’s Republic of China
| | - Qianhui Xiong
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Nanchang University, Medical Department of Nanchang University, Nanchang, 330006, Jiangxi, People’s Republic of China
| | - Yao Xiong
- Department of Cardiovascular Medicine, Jiangxi Provincial People’s Hospital Affiliated to Nanchang University, Medical Department of Nanchang University, Nanchang, 330006, Jiangxi, People’s Republic of China
| | - Zhifang Song
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Nanchang University, Medical Department of Nanchang University, Nanchang, 330006, Jiangxi, People’s Republic of China
| | - Wenjun Xiong
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Nanchang University, Medical Department of Nanchang University, Nanchang, 330006, Jiangxi, People’s Republic of China
- Correspondence: Wenjun Xiong, Department of Cardiovascular Medicine, The First Affiliated Hospital of Nanchang University, Medical Department of Nanchang University, No. 461 Bayi Avenue, Nanchang, 330006, Jiangxi, People’s Republic of China, Tel +8613767970074, Email
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Urbanowicz T, Olasińska-Wiśniewska A, Michalak M, Rodzki M, Witkowska A, Straburzyńska-Migaj E, Perek B, Jemielity M. The Prognostic Significance of Neutrophil to Lymphocyte Ratio (NLR), Monocyte to Lymphocyte Ratio (MLR) and Platelet to Lymphocyte Ratio (PLR) on Long-Term Survival in Off-Pump Coronary Artery Bypass Grafting (OPCAB) Procedures. Biology (Basel) 2021; 11:34. [PMID: 35053032 DOI: 10.3390/biology11010034] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/18/2021] [Accepted: 12/22/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Cardiovascular diseases, apart from commonly known risk factors, are related to inflammation. There are several simple novel markers proposed to present the relation between inflammatory reactions activation and atherosclerotic changes. They are easily available from whole blood count and include neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), and platelets to lymphocyte ratio (PLR). The RDW results were excluded from the analysis. METHOD AND RESULTS The study based on retrospective single-centre analysis of 682 consecutive patients (131 (19%) females and 551 (81%) males) with median age of 66 years (60-71) who underwent off-pump coronary artery bypass grafting (OPCAB) procedure. During the median 5.3 +/- 1.9 years follow-up, there was a 87% cumulative survival rate. The laboratory parameters including preoperative MLR > 0.2 (HR 2.46, 95% CI 1.33-4.55, p = 0.004) and postoperative NLR > 3.5 (HR 1.75, 95% CI 1.09-2.79, p = 0.019) were found significant for long-term mortality prediction in multivariable analysis. CONCLUSION Hematological indices NLR and MLR can be regarded as significant predictors of all-cause long-term mortality after OPCAB revascularization. Multivariable analysis revealed preoperative values of MLR > 0.2 and postoperative values of NLR > 3.5 as simple, reliable factors which may be applied into clinical practice for meticulous postoperative monitoring of patients in higher risk of worse prognosis.
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Urbanowicz T, Michalak M, Olasińska-Wiśniewska A, Witkowska A, Rodzki M, Błażejowska E, Gąsecka A, Perek B, Jemielity M. Monocyte-to-Lymphocyte Ratio as a Predictor of Worse Long-Term Survival after Off-Pump Surgical Revascularization-Initial Report. Medicina (B Aires) 2021; 57:medicina57121324. [PMID: 34946269 PMCID: PMC8706717 DOI: 10.3390/medicina57121324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/28/2021] [Accepted: 11/29/2021] [Indexed: 11/16/2022] Open
Abstract
Background and objective: Coronary artery disease is one of the leading causes of deaths nowadays and the trends in diagnosis and revascularization are still in plateau despite well-known factors. Simple whole blood count parameters may be used to measure inflammatory reactions that are involved in processes of atherosclerosis progression. The aim of our study was to analyse the association between simply available hematologic indices and long-term mortality following off-pump coronary artery bypass grafting (OPCAB). Material and Methods: The study group comprised 129 consecutive patients (16 females and 113 males, mean age 66 ± 6 years) who underwent surgical revascularization with off-pump technique between January 2014 and September 2019. The mean follow-up was 4.7 +/−1.9 years. A receiver operating characteristics curve was applied to estimate demographical and perioperative parameters including MLR for mortality. Results: Cox regression analysis revealed chronic pulmonary obstructive disease (HR = 2.86, 95%CI 1.05–7.78), MLR (HR = 3.81, 95%CI 1.45–10.06) and right coronary artery blood flow (HR = 1.06, 95%CI 1.00–1.10) as significant factors predicting increased mortality risk. In the presented model, the MLR > 1.44 on 1st postoperative day was a significant predictor of late mortality after the OPCAB procedure (HR = 3.82, 95%CI 1.45–10.06). Conclusions: Pronounced inflammatory reaction after off-pump surgery measured by MLR > 1.44 can be regarded as a worse long-term prognostic factor.
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Affiliation(s)
- Tomasz Urbanowicz
- Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (A.O.-W.); (A.W.); (M.R.); (B.P.); (M.J.)
- Correspondence: ; Tel.: +48-61-854-9210
| | - Michał Michalak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
| | - Anna Olasińska-Wiśniewska
- Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (A.O.-W.); (A.W.); (M.R.); (B.P.); (M.J.)
| | - Anna Witkowska
- Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (A.O.-W.); (A.W.); (M.R.); (B.P.); (M.J.)
| | - Michał Rodzki
- Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (A.O.-W.); (A.W.); (M.R.); (B.P.); (M.J.)
| | - Ewelina Błażejowska
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland; (E.B.); (A.G.)
| | - Aleksandra Gąsecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland; (E.B.); (A.G.)
| | - Bartłomiej Perek
- Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (A.O.-W.); (A.W.); (M.R.); (B.P.); (M.J.)
| | - Marek Jemielity
- Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (A.O.-W.); (A.W.); (M.R.); (B.P.); (M.J.)
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Muto R, Kato S, Lindholm B, Qureshi AR, Ishimoto T, Kosugi T, Maruyama S. Increased Monocyte/Lymphocyte Ratio as Risk Marker for Cardiovascular Events and Infectious Disease Hospitalization in Dialysis Patients. Blood Purif 2021; 51:747-755. [PMID: 34814140 PMCID: PMC9533453 DOI: 10.1159/000519289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 08/22/2021] [Indexed: 11/23/2022]
Abstract
Introduction In dialysis patients, cardiovascular disease (CVD) and infectious disease contribute to poor clinical outcomes. We investigated if a higher monocyte/lymphocyte ratio (MLR) is associated with an increased risk of CVD events and infectious disease hospitalizations in incident dialysis patients. Methods In an ongoing observational prospective cohort study, 132 Japanese dialysis patients (age 58.7 ± 11.7 years; 70% men) starting dialysis therapy were enrolled and followed up for a median of 48.7 months. Laboratory biomarkers, including white blood cell count and its differential count, were determined at baseline. Event-free time and relative risks (RRs) were calculated using the Kaplan-Meier curves and Cox models, respectively. Results When divided into 2 groups according to median MLR (0.35 [range, 0.27–0.46]), the periods without CVD events were significantly shorter in the high MLR group than in the low MLR group (log-rank test = 5.60, p = 0.018). The RR of CVD events, after adjusting for age, sex, and diabetes, was 2.43 (1.22–4.84) in the high MLR group compared to the low MLR group. The periods without infections requiring hospitalization were also shorter (log-rank test = 4.16, p = 0.041). The RR of infections requiring hospitalization was 1.98 (1.02–3.83) after the same adjustments. The number of CVD events was higher in the high MLR group (18.6 events per 100 person-years at risk [pyr]) than the low MLR group (11.1 events per 100 pyr). The duration of infectious disease hospitalization was longer in the high MLR group (6.3 days per pyr) than in the low MLR group (2.8 days per pyr). Conclusion A higher MLR is associated with increased risks of both CVD events and infectious disease hospitalization in dialysis patients.
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Affiliation(s)
- Reiko Muto
- Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sawako Kato
- Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Bengt Lindholm
- Baxter Novum & Renal Medicine Karolinska Institutet, Stockholm, Sweden
| | | | - Takuji Ishimoto
- Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomoki Kosugi
- Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shoichi Maruyama
- Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Hu S, Wang D, Ma T, Yuan F, Zhang Y, Gao X, Lei Q, Cheng J. Association between Preoperative Monocyte-to-Lymphocyte Ratio and Late Arteriovenous Fistula Dysfunction in Hemodialysis Patients: A Cohort Study. Am J Nephrol 2021; 52:854-860. [PMID: 34749361 DOI: 10.1159/000519822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 09/15/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Inflammation appears to be at the biological core of arteriovenous fistula (AVF) dysfunction, and the occurrence of AVF dysfunction is related to high death and disability in hemodialysis (HD) patients. Despite several studies on the correlations between AVF dysfunction and inflammatory indicators, how AVF dysfunction is related to the monocyte-to-lymphocyte ratio (MLR) is much unclear. We hypothesize that preoperative MLR is associated with AVF dysfunction in Chinese HD patients. METHODS In this single-center retrospective cohort study, totally 769 adult HD patients with a new AVF created between 2011 and 2019 were included. Association of preoperative MLR with AVF dysfunction (thrombosis or decrease of normal vessel diameter by >50%, requiring either surgical revision or percutaneous transluminal angioplasty) was assessed by multivariable Cox proportional hazard regression. RESULTS The patients were aged 55.8 ± 12.2 years and were mostly males (55%). During the average 32-month follow-up (maximum 119 months), 223 (29.0%) patients had permanent vascular access dysfunction. In adjusted multivariable Cox proportional hazard regression analyses, the risk of AVF dysfunction was 4.32 times higher with 1 unit increase in MLR (hazard ratio [HR]: 5.32; 95% confidence interval [CI]: 3.1-9.11). Compared with patients with MLR <0.28, HRs associated with an MLR of 0.28-0.41 and ≥0.41 are 1.54 (95% CI: 1.02-2.32) and 3.17 (2.18-4.62), respectively. CONCLUSIONS A higher preoperative MLR is independently connected with a severer risk of AVF dysfunction in HD patients. Its clinical value should be determined in the future.
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Affiliation(s)
- Shouliang Hu
- Division of Nephrology, The First Hospital of Yangtze University, Jingzhou, China,
| | - Dan Wang
- Central Laboratory, The First Hospital of Yangtze University, Jingzhou, China
| | - Tean Ma
- Division of Nephrology, The First Hospital of Yangtze University, Jingzhou, China
| | - Fanli Yuan
- Division of Nephrology, The First Hospital of Yangtze University, Jingzhou, China
| | - Yong Zhang
- Division of Nephrology, Jianli County People's Hospital, Jingzhou, China
| | - Xiaoli Gao
- Division of Nephrology, The First Hospital of Yangtze University, Jingzhou, China
| | - Qingfeng Lei
- Division of Nephrology, The First Hospital of Yangtze University, Jingzhou, China
| | - Junzhang Cheng
- Division of Nephrology, The First Hospital of Yangtze University, Jingzhou, China
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Maleki M, Tajlil A, Separham A, Sohrabi B, Pourafkari L, Roshanravan N, Aslanabadi N, Najjarian F, Mashayekhi S, Ghaffari S. Association of neutrophil to lymphocyte ratio (NLR) with angiographic SYNTAX score in patients with non-ST-Segment elevation acute coronary syndrome (NSTE-ACS). J Cardiovasc Thorac Res 2021; 13:216-221. [PMID: 34630969 PMCID: PMC8493237 DOI: 10.34172/jcvtr.2021.40] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 07/18/2021] [Indexed: 12/24/2022] Open
Abstract
Introduction: Considering the role of inflammation in pathogenesis of atherosclerosis, we aimed to investigate the association of presentation neutrophil to lymphocyte ratio (NLR) with complexity of coronary artery lesions determined by SYNTAX score in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). Methods: From March 2018 to March 2019, we recruited 202 consecutive patients, who were hospitalized for NSTE-ACS and had undergone percutaneous coronary intervention in our hospital. The association of presentation NLR with SYNTAX score was determined in univariate and multivariate linear regression analysis. Results: Higher NLR was significantly associated with higher SYNTAX score (beta = 0.162, P = 0.021). In addition, older age, having hypertension, higher TIMI score, and lower ejection fraction on echocardiographic examination were significantly associated with higher SYNTAX score. TIMI score had the largest beta coefficient among the studied variables (TIMI score beta = 0.302, P < 0.001). In two separate multivariate linear regression models, we assessed the unique contribution of NLR in predicting SYNTAX score in patients with NSTE-ACS. In the first model, NLR was significantly contributed to predicting SYNTAX score after adjustment for age, sex, and hypertension as covariates available on patient presentation (beta = 0.142, P = 0.040). In the second model, NLR was not an independent predictor of SYNTAX score after adjustment for TIMI score (beta = 0.121, P = 0.076). Conclusion: In NSTE-ACS, presentation NLR is associated with SYNTAX score. However, NLR does not contribute significantly to the prediction of SYNTAX score after adjustment for TIMI score. TIMI risk score might be a better predictor of the SYNTAX score in comparison to NLR.
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Affiliation(s)
- Mehdi Maleki
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Arezou Tajlil
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Separham
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Bahram Sohrabi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leili Pourafkari
- Catholic Health System, Sisters of Charity Hospital, University at Buffalo, NY, USA
| | - Neda Roshanravan
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Naser Aslanabadi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farima Najjarian
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sina Mashayekhi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samad Ghaffari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Natakusuma TISD, Mahadewa TGB, Mardhika PE, Maliawan S, Senapathi TGA, Ryalino C. Role of Monocyte-to-lymphocyte Ratio, Mean Platelet Volume-to-Platelet Count Ratio, C-Reactive Protein and Erythrocyte Sedimentation Rate as Predictor of Severity in Secondary Traumatic Brain Injury: A Literature Review. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Secondary traumatic brain injury (TBI) is injury to the brain following primary TBI because of neuroinflammation as consequences of neuronal and glial cell injury which cause release of various inflammation cytokine and chemokine. Biomarker examination to predict the severity of secondary TBI is important to provide appropriate treatment to the patient. This article reviews possibility several common laboratory parameter such as monocyte-to-lymphocyte ratio (MLR), mean platelet volume-to-platelet count (PC) ratio (MPV-PCR), c-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) to predict severity of secondary TBI.
LITERATURE REVIEW: TBI activates microglia which increase infiltration and proliferation of monocyte. Neuroinflammation also increases thrombopoiesis which leads to increase megakaryocytes production. In the other hand, due to disruption of brain blood vessels because of trauma, coagulation cascade is also activated and leads to consumptive coagulopathy. These are reflected as high monocyte count, low PC, and high MPV. Lymphocyte count is reported low in TBI especially in poor outcome patients. CRP is an acute phase reactant that increased in inflammation condition. In TBI, increased production of Interleukin-6 leads to increase CRP production. In head injured patients, ESR level does not increase significantly in the acute phase of inflammation but last longer when compared to CRP.
CONCLUSION: MLR, MPV-PCR, CRP, and ESR could be predictor of severity in secondary TBI.
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Shumilah AM, Othman AM, Al-Madhagi AK. Accuracy of neutrophil to lymphocyte and monocyte to lymphocyte ratios as new inflammatory markers in acute coronary syndrome. BMC Cardiovasc Disord 2021; 21:422. [PMID: 34493205 PMCID: PMC8424963 DOI: 10.1186/s12872-021-02236-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 08/31/2021] [Indexed: 11/16/2022] Open
Abstract
Background Inflammation plays a key role in the development of atherosclerosis and in the pathogenesis of acute coronary syndrome (ACS). Leukocytes and leukocytes ratios were recognized as inflammatory markers in predicting the presence and severity of ACS. Methods This study aimed to investigate the diagnostic accuracy of neutrophil to lymphocyte ratio (NLR) and monocyte to lymphocyte ratio (MLR) with ACS. One hundred patients admitted to the Cardiac Center who were confirmed to have ACS and 100 healthy controls confirmed not to have ACS were enrolled in this study. ECG and troponin I test were used as gold standards to make sure that the participants with or without ACS. Total white blood cells (WBCs) count, NLR, and MLR values were estimated.
Results Total WBCs, neutrophil, and monocyte counts were significantly higher while lymphocyte counts were significantly lower in ACS patients than in the healthy controls (p < 0.001). NLR and MLR were significantly higher in ACS patients than in the healthy controls (p < 0.001). Among all the studied markers, NLR was found to be the strongest predictive marker of ACS (OR: 3.3, p < 0.001), whereas MLR was non-significant (p > 0.05). A cut-off value of 2.9 of NLR had 90% sensitivity and 88% specificity while 0.375 cut-off value of MLR had 79% sensitivity, 91% specificity for predicting ACS presence. Conclusions NLR is a simple, widely available, and inexpensive inflammatory marker which can be an auxiliary biomarker in the diagnosis of ACS with a cut-off value of 2.9 in our population.
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Affiliation(s)
- Ahmed Mohammed Shumilah
- Microbiology and Immunology Department, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen.
| | - Arwa Mohammed Othman
- Microbiology and Immunology Department, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
| | - Anwar Kasim Al-Madhagi
- Microbiology and Immunology Department, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
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Xie XS, Zhao YF, Xu DD, Wang EC, Shu XL, Guo DQ, Fu WG, Wang LX. Preoperative high lymphocyte-to-monocyte ratio is associated with intraoperative type I endoleak in patients with TAA with TEVAR. Vascular 2021; 30:977-987. [PMID: 34455818 DOI: 10.1177/17085381211039939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Various inflammatory factors are closely associated with the incidence of thoracic aortic aneurysms (TAAs). Furthermore, the severity of inflammation is closely related to the absolute value and proportion of each leukocyte subgroup. Only few reports have analyzed the importance of lymphocyte-monocyte ratio (LMR) as a potential inflammatory marker in vascular diseases. Therefore, we aimed to investigate the effect of peripheral blood LMR on thoracic endovascular aortic repair (TEVAR) in patients with TAA. METHODS A retrospective study of the clinical data collected in our hospital between January 2016 and January 2021 was performed on 162 patients with TAA treated with TEVAR, based on the inclusion and exclusion criteria for patient selection. Based on whether the patient had the clinical symptoms at admission and the occurrence of type I endoleaks during operation, patients were divided into two groups, respectively: an intraoperative type I endoleak group (n = 34) and a group without intraoperative type I endoleak (n = 128), and a group with clinical symptoms (n = 31) and a group without clinical symptoms (n = 131). The clinical data of these two groups were compared, the free from second intervention rates related to endoleak and the preoperatively LMR of the two groups was calculated. LMR was calculated preoperatively. Receiver-operating characteristic curve analysis was used to determine the cut-off for preoperative LMR values. Based on the cut-off point, patients were divided into a high LMR group (n = 34) and a low LMR group (n = 128). The clinical data of the two groups were compared, and further stratified analysis was performed. RESULTS A total of 162 patients were included in the analysis. All patients were successfully implanted with a thoracic aorta stent graft. The preoperative LMR level and postoperative endoleak-related secondary intervention rate were higher in the type I endoleak group than those in the group without intraoperative type I endoleaks. The preoperative C-reactive protein (CRP) level of patients with TAA with clinical symptoms was higher than that of asymptomatic patients. There was a negative correlation between preoperative CRP and LMR levels. In addition, in symptomatic or asymptomatic patients, the LMR level was associated with the occurrence of intraoperative type I endoleaks. After excluding the influence of type of endografts, our results showed that the clinical symptoms did not affect the occurrence of the intraoperative type I endoleak, and patients with intraoperative type I endoleak had a higher rate of postoperative secondary intervention. CONCLUSION Patients with TAA with type I endoleaks during TEVAR had an increased rate of secondary intervention related to endoleaks. Patients with TAA with high LMR levels before TEVAR were more likely to have endoleaks during operation.
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Affiliation(s)
- Xin-Sheng Xie
- Department of Vascular Surgery, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, China
| | - Yu-Fei Zhao
- Department of Vascular Surgery, Zhongshan Hospital, 92323Fudan University, Shanghai, China
| | - Dan-Dan Xu
- Department of Neurology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China
| | - En-Ci Wang
- Department of Vascular Surgery, Zhongshan Hospital, 92323Fudan University, Shanghai, China
| | - Xiao-Long Shu
- Department of Vascular Surgery, Zhongshan Hospital, 92323Fudan University, Shanghai, China
| | - Da-Qiao Guo
- Department of Vascular Surgery, Zhongshan Hospital, 92323Fudan University, Shanghai, China
| | - Wei-Guo Fu
- Department of Vascular Surgery, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, China.,Department of Vascular Surgery, Zhongshan Hospital, 92323Fudan University, Shanghai, China
| | - Li-Xin Wang
- Department of Vascular Surgery, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, China.,Department of Vascular Surgery, Zhongshan Hospital, 92323Fudan University, Shanghai, China
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Abstract
BACKGROUND White blood cell (WBC) subtypes have been associated with major adverse cardiovascular events (MACEs) in acute myocardial infarction (AMI). More recently, combining neutrophil and lymphocyte counts or lymphocyte and monocyte counts into a ratio has found to be promising for predicting MACE. This study aimed to confirm the association between MACE and the following WBC subtypes: neutrophils, lymphocytes, monocytes, neutrophil-lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR). METHODS In a cohort of 860 AMI patients, we collected levels of WBC subtypes from the earliest blood tests recorded prior to angiography. Data on baseline demographics and one-year outcomes were also collected. RESULTS At one year, 130 patients (15.1%) developed MACE. NLR and LMR were significantly associated with MACE on univariate analysis (P = 0.006 and 0.005, respectively). However, when combined into a multivariate model with age, hypertension, prior myocardial infarction and Type 2 diabetes, neither NLR nor LMR had significant associations (odds ratio = 1.058 and 0.966, P = 0.069 and 0.612, respectively). CONCLUSION As NLR and LMR were correlated with MACE only on univariate analysis, we do not believe that they are predictive enough to be used alone in a clinical setting. Further studies are required to assess the prognostic ability of these ratios in combination with other inflammatory markers.
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