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Koroglu M, Ayvaz MA, Bakan SB, Sirin A, Akyuz U. Can quantitative surface antigen levels and systemic immune-inflammation index be predictive as a new indicator for the initiation of treatment in chronic hepatitis b? Eur J Gastroenterol Hepatol 2024; 36:489-497. [PMID: 38407853 DOI: 10.1097/meg.0000000000002737] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
OBJECTIVES The natural history of chronic HBV infection (CHB) is generally divided into four phases: HBeAg-positive chronic HBV infection (EPCI) and -hepatitis (EPCH), HBeAg-negative chronic HBV infection (ENCI) and -hepatitis (ENCH). This study aimed to investigate changes in serum quantitative surface antigen (qHBsAg), systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI) in a large number of CHB patients. METHOD Three hundred seventy-two CHB patients who underwent liver biopsy between January 2015 and February 2020 were evaluated. RESULTS The SII-values were strongly significant between EPCI-EPCH ( P = 0.002), however, there was significant difference between ENCI-ENCH ( P = 0.025). Considering the SIRI results, there was a significant difference between both EPCI-EPCH ( P = 0.009) and ENCI-ENCH ( P = 0.118). In HBeAg-positive patients HBV-DNA, qHBsAg, and SII were found to be predictive ( P = 0.029, P = 0.039, P = 0.027, respectively) while in HBeAg-negative patients, age, AST, HBV-DNA, qHBsAg, SII, and SIRI were found to be predictive ( P = 0.047, P = 0.084, P = <0.001, P = 0.001, P = 0.012, P = 0.002, respectively). In EPCH phase, whereby accuracy rate results of HBV-DNA, qHBsAg, and SII were 75.3%, 73.4%, and 60.4%, respectively, while in the ENCH phase the accuracy rates of age, AST, HBV-DNA, qHBsAg, SII, and SIRI values were 57.8%, 65.6%, 68.3%, 63.8%, 57.3% and 53.2%, respectively. CONCLUSION HBV-DNA, qHBsAg, and SII are predictive in EPCH patients. Age, AST, HBV-DNA, qHBsAg, SII and SIRI are all predictive in ENCH patients. In patients with CHB, we recommend using SII to distinguish between EPCI-EPCH and ENCI-ENCH. Based on its sensitivity and features, we believe that qHBsAg and SII are suitable measuring instruments in discrimination both of EPCI-EPCH and ENCI-ENCH.
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Affiliation(s)
- Mehmet Koroglu
- University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Department of Gastroenterology, Istanbul, Turkey
| | - Muhammed Ali Ayvaz
- Klinikum Fuessen, Department of Gastroenterology, Teaching hospital of the Ludwig-Maximilian University, Munich, Germany
| | - Suat Baran Bakan
- University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Department of Internal Medicine, Istanbul
| | - Abdullatif Sirin
- Duzce University Hospital, Department of Gastroenterology, Duzce
| | - Umit Akyuz
- University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Department of Gastroenterology, Istanbul, Turkey
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Hartanto MM, Prajoko YW, Putra A, Amalina ND. The Combination of Mesenchymal Stem Cells and Bovine Colostrum in Reducing α-SMA Expression and NLR Levels in Wistar Rats After 50% Fibrotic Liver Resection. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10557] [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: 12/27/2022] Open
Abstract
Background: Liver fibrogenesis will produce α-smooth muscle actin (α-SMA) expression and a continuous inflammatory process, seen through the neutrophil lymphocyte ratio (NLR). The combination of mesenchymal stem cells and bovine colostrum is a novel strategy for repairing hepatic fibrosis tissue. To assess the combination of mesenchymal stem cells and bovine colostrum to reduce α-SMA expression and NLR levels in Wistar rats after 50% fibrotic liver resection.
Methods: Thirty-six Wistar male rats were randomly divided into 6 groups (sham, control, colostrum, MSCs, and colostrum and MSCs combination). Rats were injected with CCl4 for 8 weeks to induce liver fibrosis then underwent liver resection. NLR levels was determined using Hematology Analyzer, α-SMA expression of myofibroblast was analyzed by immunofluorescence staining.
Results: A significant reduction in NLR levels on day 3 in the treatment group I (1.10), treatment II (0.83), treatment III (0.93) compared to the control group. A significant reduction in NLR levels on day 10 in the treatment group I (0.76), treatment II (0.64), treatment III (0.54) compared to the control group. A significant decrease in α-SMA in treatment group I (0.134), treatment II (0.68), treatment III (0.42) compared to the control group.
Conclusion: In this study, it was found that α-SMA expression, NLR levels on the 3rd and 10th day of administration were reduced in group receiving combination of mesenchymal stem cells and bovine colostrum in the liver of post-resection Wistar rats by 50%.
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Maccali C, Augustinho FCD, Zocche TL, Silva TE, Narciso-Schiavon JL, Schiavon LDL. NEUTROPHIL-LYMPHOCYTE RATIO PREDICTS SHORT-TERM MORTALITY IN PATIENTS HOSPITALIZED FOR ACUTE DECOMPENSATION OF CIRRHOSIS. Arq Gastroenterol 2021; 58:131-138. [PMID: 34287528 DOI: 10.1590/s0004-2803.202100000-23] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 11/16/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Individuals with cirrhosis have a chronic systemic inflammation associated with an immune dysfunction, affecting the progression of the liver disease. The neutrophil-lymphocyte ratio (NLR) was proposed as a marker of systemic inflammatory response and survival in patients with cirrhosis. OBJECTIVE Evaluate the prognostic role of NLR in cirrhotic patients and its relation with inflammatory cytokines(IL-6, IL-10 and IL-17). METHODS In this prospective study two groups were evaluated: 1) Stable cirrhotic in outpatient follow-up (n=193); 2) Hospitalized cirrhotic for acute decompensation for at least 48 hours (n=334) with admission and 48 hours tests evaluation. Circulating inflammatory cytokines were available for 130 hospitalized patients. RESULTS In outpatients with stable cirrhosis, NLR correlated with MELD score and other variables associated with severity of disease. However, after a median of 32 months of follow up NLR was not associated with mortality (HR 1.058, 95%CI 0.900-1.243; P=0.495). In hospitalized patients, NLR at 48-hour after admission was independently associated with 90-day survival (HR 1.061, 95%CI 1.020-1.103; P=0.003) in multivariate Cox-regression analysis. The 90-day Kaplan-Meier survival probability was 87% for patients with a 48-hour NLR <3.6 and 62% for NLR ≥3.6 (P<0.001). Elevation of NLR in the first 48 hours was also independently associated with mortality (HR 2.038, 95%CI 1295-3207; P=0.002). The 90-day Kaplan-Meier survival probability was 83% when NLR did not increase and 62% when NLR increased (P<0.001). IL-6, IL-10 and IL-17 at admission were positively correlated with both admission and 48-hour NLR. Lower levels of baseline IL-10 were associated with NLR increase during first 48-hour. CONCLUSION NLR evaluated at 48 hours of hospitalization and its early increase after admission were independently associated with short-term mortality in patients hospitalized for acute decompensation of cirrhosis.
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Affiliation(s)
- Claudia Maccali
- Universidade Federal de Santa Catarina, Departamento de Medicina Interna, Divisão de Gastroenterologia, Florianópolis, SC, Brasil
| | - Fernanda Cristina de Augustinho
- Universidade Federal de Santa Catarina, Departamento de Medicina Interna, Divisão de Gastroenterologia, Florianópolis, SC, Brasil
| | - Tamara Liana Zocche
- Universidade Federal de Santa Catarina, Departamento de Medicina Interna, Divisão de Gastroenterologia, Florianópolis, SC, Brasil
| | - Telma Erotides Silva
- Universidade Federal de Santa Catarina, Departamento de Medicina Interna, Divisão de Gastroenterologia, Florianópolis, SC, Brasil
| | - Janaína Luz Narciso-Schiavon
- Universidade Federal de Santa Catarina, Departamento de Medicina Interna, Divisão de Gastroenterologia, Florianópolis, SC, Brasil
| | - Leonardo de Lucca Schiavon
- Universidade Federal de Santa Catarina, Departamento de Medicina Interna, Divisão de Gastroenterologia, Florianópolis, SC, Brasil
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Bannaga A, Arasaradnam RP. Neutrophil to lymphocyte ratio and albumin bilirubin grade in hepatocellular carcinoma: A systematic review. World J Gastroenterol 2020; 26:5022-5049. [PMID: 32952347 PMCID: PMC7476180 DOI: 10.3748/wjg.v26.i33.5022] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/10/2020] [Accepted: 08/25/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is a frequent cause of cancer related death globally. Neutrophil to lymphocyte ratio (NLR) and albumin bilirubin (ALBI) grade are emerging prognostic indicators in HCC.
AIM To study published literature of NLR and ALBI over the last five years, and to validate NLR and ALBI locally in our centre as indicators of HCC survival.
METHODS A systematic review of the published literature on PubMed of NLR and ALBI in HCC over the last five years. The search followed the guidelines of the preferred reporting items for systematic reviews and meta-analyses. Additionally, we also investigated HCC cases between December 2013 and December 2018 in our centre.
RESULTS There were 54 studies describing the relation between HCC and NLR and 95 studies describing the relation between HCC and ALBI grade over the last five years. Our local cohort of patients showed NLR to have a significant negative relationship to survival (P = 0.011). There was also significant inverse relationship between the size of the largest HCC nodule and survival (P = 0.009). Median survival with alpha fetoprotein (AFP) < 10 KU/L was 20 mo and with AFP > 10 KU/L was 5 mo. We found that AFP was inversely related to survival, this relationship was not statically significant (P = 0.132). Mean survival for ALBI grade 1 was 37.7 mo, ALBI grade 2 was 13.4 months and ALBI grade 3 was 4.5 mo. ALBI grades performed better than Child Turcotte Pugh score in detecting death from HCC.
CONCLUSION NLR and ALBI grade in HCC predict survival better than the conventional alpha fetoprotein. ALBI grade performs better than Child Turcotte Pugh score. These markers are done as part of routine clinical care and in cases of normal alpha fetoprotein, these markers could give a better understanding of the patient disease progression. NLR and ALBI grade could have a role in modified easier to learn staging and prognostic systems for HCC.
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Affiliation(s)
- Ayman Bannaga
- Department of Gastroenterology and Hepatology, University Hospital Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, West Midlands, United Kingdom
- Warwick Medical School, University of Warwick, Coventry CV4 7HL, West Midlands, United Kingdom
| | - Ramesh P Arasaradnam
- Department of Gastroenterology and Hepatology, University Hospital Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, West Midlands, United Kingdom
- Warwick Medical School, University of Warwick, Coventry CV4 7HL, West Midlands, United Kingdom
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Ruta VM, Man AM, Alexescu TG, Motoc NS, Tarmure S, Ungur RA, Todea DA, Coste SC, Valean D, Pop MC. Neutrophil-To-Lymphocyte Ratio and Systemic Immune-Inflammation Index-Biomarkers in Interstitial Lung Disease. Medicina (Kaunas) 2020; 56:E381. [PMID: 32751302 PMCID: PMC7466218 DOI: 10.3390/medicina56080381] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 01/19/2023]
Abstract
Background and objectives: The aims of the study were to evaluate the utility of neutrophil-to-lymphocyte ratio (NLR) and the systemic immune-inflammation index (SII) as inflammation markers and prognostic factors in patients with known interstitial lung disease secondary to connective tissue diseases (CTD-ILD) compared with idiopathic pulmonary fibrosis (IPF). Materials and Methods: Forty-two patients with known interstitial lung disease (21 with IPF and 21 with CTD-ILD) and 42 control matched healthy patients were included. The NLR was calculated as the absolute neutrophil count divided by the absolute lymphocyte count, and the SII was calculated as follows: SII = platelets × neutrophils/lymphocytes, with the data being obtained from the patients data charts at admission, before any treatment. Results: our hypothesis was that in patients with interstitial lung disease NLR and SII would have higher values compared with patients with CTD-ILD or control healthy patients. The mean NLR value was 3.01 (±1.35) among patients with idiopathic pulmonary fibrosis, and 2.38 (±1.08) among patients with CTD-ILD without significant statistical difference (p = 0.92). There was however a clinically significant statistical difference when compared with the control group, where NLR was 2.00 (±1.05) (p = 0.003). SII values were 619.37 (±329.51) in patients with IPF, 671.55 (±365.73) in CTD-ILD group and 569.73 (±326.67) in healthy subjects (p = 0.13) Conclusions: A mean NLR value of 2.8 and a SII value over 500 in patients with connective diseases can become a marker of pulmonary interstitial involvement. In the context of non-exacerbated interstitial lung disease, NLR and SII have reduced numerical values, without being statistically correlated with prognosis when we compared with patients with connective tissue diseases without exacerbation or with healthy people, the cut off being of 2.4. However subsequent studies in larger patient samples might provide changes in these cut-off values.
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Affiliation(s)
- Victoria Maria Ruta
- Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj Napoca, Romania;
| | - Adina Milena Man
- Department of Pneumology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj Napoca, Romania; (A.M.M.); (N.S.M.); (D.A.T.); (M.C.P.)
| | - Teodora Gabriela Alexescu
- Department of Internal Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj Napoca, Romania; (S.T.); (S.C.C.)
| | - Nicoleta Stefania Motoc
- Department of Pneumology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj Napoca, Romania; (A.M.M.); (N.S.M.); (D.A.T.); (M.C.P.)
| | - Simina Tarmure
- Department of Internal Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj Napoca, Romania; (S.T.); (S.C.C.)
| | - Rodica Ana Ungur
- Department of Medical Rehabilitation, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj Napoca, Romania;
| | - Doina Adina Todea
- Department of Pneumology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj Napoca, Romania; (A.M.M.); (N.S.M.); (D.A.T.); (M.C.P.)
| | - Sorina Cezara Coste
- Department of Internal Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj Napoca, Romania; (S.T.); (S.C.C.)
| | - Dan Valean
- Department of General Surgery, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj Napoca, Romania;
| | - Monica Carmen Pop
- Department of Pneumology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj Napoca, Romania; (A.M.M.); (N.S.M.); (D.A.T.); (M.C.P.)
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Duzenli T, Koseoglu H. Predictive role of neutrophil to lymphocyte ratio in patients with intrahepatic cholangiocarcinoma submitted to treatment of 90Y-microspheres. Nucl Med Commun 2020; 41:714. [PMID: 32520895 DOI: 10.1097/MNM.0000000000001178] [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] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tanoğlu A, Düzenli T. Neutrophil-to-lymphocyte ratio alone may not be a true indicator of the severity of acute pancreatitis. Turk J Gastroenterol 2019; 30:937. [PMID: 31625940 DOI: 10.5152/tjg.2019.18856] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Alpaslan Tanoğlu
- Department of Gastroenterology, Sultan Abdulhamid Han Training and Research Hospital, İstanbul, Turkey
| | - Tolga Düzenli
- Department of Gastroenterology, Sultan Abdulhamid Han Training and Research Hospital, İstanbul, Turkey
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Mao W, Wu J. Haematologic indices in hepatitis B virus-related liver disease. Clin Chim Acta 2019; 500:135-142. [PMID: 31654630 DOI: 10.1016/j.cca.2019.10.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 08/29/2019] [Revised: 10/05/2019] [Accepted: 10/07/2019] [Indexed: 02/07/2023]
Abstract
Several markers and prognostic scores have been identified for predicting the development and progression of liver disease; among them, haematological parameters (the neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), platelet to lymphocyte ratio (PLR), red cell distribution width (RDW), RDW to platelet ratio (RPR), mean platelet volume (MPV), and mean corpuscular volume (MCV)) have recently gained significant interest. Compared with traditional prognostic factors, haematological indices are easy to obtain and relatively inexpensive. There is growing evidence that these haematological indices play a key role in HBV-related liver diseases and has been proposed as a predictive marker of adverse outcomes in these patients. This article focuses on discussing the diagnostic and prognostic value of the haematological indices in patients with HBV-related liver diseases.
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Affiliation(s)
- WeiLin Mao
- Department of Clinical Laboratory, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, PR China
| | - JianPing Wu
- Department of Clinical Laboratory, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, PR China.
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Liu L, Cao J, Zhong Z, Guo Z, Jiang Y, Bai Y, Xu J. Noninvasive indicators predict advanced liver fibrosis in autoimmune hepatitis patients. J Clin Lab Anal 2019; 33:e22922. [PMID: 31115929 PMCID: PMC6757115 DOI: 10.1002/jcla.22922] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/04/2019] [Accepted: 05/06/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Liver biopsy is the criterion standard for diagnosing liver fibrosis, but it is not widely used to monitor liver fibrosis because of the invasiveness, risk of complications, and sample errors. Therefore, it is necessary to involve other techniques to monitor liver fibrosis or cirrhosis during clinical practice. The objective was to explore noninvasive indicators to predict advanced liver fibrosis in autoimmune hepatitis (AIH) patients. METHODS A total of 45 AIH patients and 47 healthy controls were recruited to this retrospective study. Complete blood count and liver function tests were performed for all subjects. AIH patients were divided into "no/minimal fibrosis" group and "advanced fibrosis" group based on liver biopsy. RESULTS AIH patients demonstrated significantly higher monocytes, MCV, RDW-CV, RDW-SD, NLR, RDW-CV/PLT, RDW-SD/PLT, TBIL, DBIL, GLB, ALT, AST, GGT, ALP, and GPR and lower WBC, neutrophils, lymphocytes, RBC, HGB, HCT, LMR, TP, ALB, and AAR compared with healthy controls. Patients with advanced fibrosis showed remarkably higher RDW-CV, RDW-SD, RDW-CV/PLT, RDW-SD/PLT, AAR, and FIB-4 and lower RBC, PLT, PCT, and ALB compared with the no/minimal fibrosis group. Logistic regression analysis showed that RDW-SD/PLT was an independent risk factor for advanced fibrosis with an OR (95% CI) of 2.647 (1.383-5.170). Receiver operating characteristic (ROC) analysis revealed that RDW-SD, RDW-CV/PLT, RDW-SD/PLT, FIB-4, and AAR had an area under the ROC curve (AUC) above 0.700 and RDW-SD/PLT had the largest AUC of 0.785 with a cutoff value of 0.239. CONCLUSION RDW-SD, RDW-CV/PLT, RDW-SD/PLT, FIB-4, and AAR were excellent noninvasive biomarkers and RDW-SD/PLT was an independent risk factor for predicting advanced fibrosis in AIH patients.
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Affiliation(s)
- Lingyan Liu
- Department of Clinical Laboratory, Shanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Junying Cao
- Department of Infectious Disease, Shanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Zhengrong Zhong
- Department of Clinical Laboratory, Shanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Zhuying Guo
- Department of Clinical Laboratory, Shanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yunfei Jiang
- Department of Clinical Laboratory, Shanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yupan Bai
- Department of Infectious Disease, Shanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Jie Xu
- Department of Infectious Disease, Shanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
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Abstract
We investigated associations between inflammatory marker levels and hepatitis C virus (HCV)-related compensated liver cirrhosis risk in patients with chronic hepatitis C (CHC) infection in China. We used a case-control design and data from the records of 110 Chinese patients with CHC and cirrhosis for the study; 458 CHC patients who did not have a diagnosis of cirrhosis were matched to the case group by age and sex characteristics. We also investigated fatty liver disease risk factors. The group of patients with CHC infection and cirrhosis had lower platelet-to-lymphocyte ratio (PLR) values (60.63 [44.09, 89.31]) compared with the control group patients (80.24 [57.85, 111.08]). The results indicated that the group of patients with cirrhosis had higher 4-factor fibrosis index and aspartate aminotransferase (AST)-to-platelet ratio index (APRI) values compared with the group of patients with CHC-only (1.66 [0.98, 2.60] vs 0.71 [0.45, 1.17], respectively; P < .001 and 2.12 [0.97, 4.25] vs 0.99 [0.51, 2.01], respectively; P < .001). Compared with the control group, the AST/alanine aminotransferase ratio (AAR) values in the group of patients with cirrhosis were significantly higher (P < .001). Logistic regression analysis that included model adjustment for demographic characteristics and other factors that could affect cirrhosis risk revealed that greater 1/PLR values were associated with an increased odds of having cirrhosis (adjusted odds ratio [AOR], 95% confidence interval [CI] 0.991 [0.985-0.996]); APRI and AAR values were also independent predictors of the presence of compensated cirrhosis. We found that compared with the patients with CHC-only, the triglyceride, cholesterol, and low-density lipoprotein cholesterol levels in the patients with both CHC and fatty liver disease were significantly higher. The multivariate analysis of the risk of fatty liver development in patients with CHC infection found that cholesterol level was a statistically significant risk factor (AOR [95% CI] 1.380 [1.089-1.750], P = .008). Increased 1/PLR, APRI, and AAR values were associated with increased risks for development of cirrhosis in this population of Chinese patients with CHC infection. Higher cholesterol levels increased the risk of development of fatty liver disease in patients with CHC.
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Affiliation(s)
- Xu Li
- Department of Hepatology
- Key Laboratory of Organ Regeneration & Transplantation of Ministry of Education
| | - Le Wang
- Department of Ultrasound, The First Hospital of Jilin University, Jilin University, Changchun, China
| | - Pujun Gao
- Department of Hepatology
- Key Laboratory of Organ Regeneration & Transplantation of Ministry of Education
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Özer Sarı S, Köseoğlu H, Akar M, Solakoğlu T, Ersoy O. Nötrofil / lenfosit oranı kronik hepatit B hastalarında karaciğer fibrozisini saptamada kullanılabilir mi? Ege Tıp Dergisi 2019. [DOI: 10.19161/etd.504466] [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] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Peng Y, Li Y, He Y, Wei Q, Xie Q, Zhang L, Xia Y, Zhou X, Zhang L, Feng X, Chen K, Chen S, Chen W, Long Q, Chai J. The role of neutrophil to lymphocyte ratio for the assessment of liver fibrosis and cirrhosis: a systematic review. Expert Rev Gastroenterol Hepatol 2018; 12:503-513. [PMID: 29629626 DOI: 10.1080/17474124.2018.1463158] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Neutrophil to lymphocyte ratio (NLR) is widely used to assess inflammatory diseases. We performed a systematic review to explore the prognostic role of NLR for the assessment of liver fibrosis and cirrhosis. Areas covered: We searched the PubMed and EMBASE databases for the eligible papers which explored the association between NLR and liver fibrosis/cirrhosis or investigated the prognostic value of NLR in cirrhotic patients. Expert commentary: In accordance with assessment of liver fibrosis stage, we classified papers into four subgroups by etiology. For the patients with nonalcoholic fatty liver disease (NAFLD) there was a significant association between NLR and fibrosis stage and nonalcoholic fatty liver disease activity score (NAS), while NLR had a negative correlation with fibrosis stage for the patients with chronic hepatitis B (CHB). As for the patients with and chronic hepatitis C (CHC), NLR might not be significantly associated with fibrosis stage. Moreover, NLR seemed to be significantly useful for predicting outcomes in cirrhotic patients. Hence, NLR might be associated with liver fibrosis stage, especially in patients with NAFLD. Furthermore, NLR might be a useful biomarker for evaluating the prognosis in cirrhotic patients.
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Affiliation(s)
- Ying Peng
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Yan Li
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Yonghong He
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Qinglin Wei
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Qiaoling Xie
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Liangjun Zhang
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Yiju Xia
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Xueqian Zhou
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Lu Zhang
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Xinchan Feng
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Kun Chen
- b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Sheng Chen
- c Department of Pediatrics, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Wensheng Chen
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Qinglin Long
- b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
| | - Jin Chai
- a Cholestatic Liver Diseases Center, Southwest Hospital , Third Military Medical University , Chongqing , China.,b Department of Gastroenterology, Southwest Hospital , Third Military Medical University , Chongqing , China
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Abdullah SM. Prevalence of Hepatitis B and C virus infection and their co-relation with hematological and hepatic parameters in subjects undergoing Premarital Screening in the Jazan Region, Kingdom of Saudi Arabia. Pak J Med Sci 2018; 34:316-321. [PMID: 29805400 PMCID: PMC5954371 DOI: 10.12669/pjms.342.14278] [Citation(s) in RCA: 10] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objective: Hepatitis is a serious health concern with a high rate of mortality and morbidity world over. Saudi Arabia also has its course of the disease incidence. The data on the prevalence of the disease is still limiting. This study aimed to estimate the prevalence of hepatitis B virus [HBV] and hepatitis C virus [HCV] infection in the Jazan region and study its effects on hematological and hepatic parameters. Methods: This cross-sectional study was conducted at premarital screening centre located in King Fahd Central Hospital, Jazan, Kingdom of Saudi Arabia. A total of 7,826, Saudi couples undertaking premarital screening from Jazan region, were enrolled in the study and screened between January 2014 and June 2015 for hepatitis B virus and hepatitis C virus. Complete blood counts and hepatic profile were carried out for individuals who were Hepatitis B and or C virus positive. Results: A higher prevalence of hepatitis virus infection in male participants [HBV 1.9%; HCV 0.4%] than in females [HBV 1.43%; HCV 0.2%] was seen. The neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte (PLR) ratios were significantly decreased among HBV- and HCV-infected patients. The concentration of hepatic enzymes showed a statistically significant increase in seropositive individuals. The levels of albumin were significantly decreased in individuals with hepatitis B and C when compared with the control group Conclusions: The study concludes that the prevalence of HBV infection among Saudi subjects in Jazan was higher than the prevalence of HCV infection, and both HBV and HCV were higher in men than in women.
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Affiliation(s)
- Saleh Mohammed Abdullah
- Saleh Mohammed Abdullah, M.Sc., PhD, Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Saudi Arabia
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Alsebaey A, Elhelbawy M, Waked I. Platelets-to-lymphocyte ratio is a good predictor of liver fibrosis and insulin resistance in hepatitis C virus-related liver disease. Eur J Gastroenterol Hepatol 2018; 30:207-11. [PMID: 29240565 DOI: 10.1097/MEG.0000000000001013] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Hepatitis C virus (HCV) is a global health problem that is complicated by liver fibrosis and insulin resistance (IR). AIM The aim of this study was to validate neutrophils-to-lymphocytes ratio (NLR) and platelets-to-lymphocytes ratio (PLR) as indirect biomarkers of liver fibrosis and IR in HCV patients. PATIENTS AND METHODS One hundred and fifty patients were enrolled. Physical examination, BMI, liver function tests, serum creatinine, complete blood count, serum HCV RNA count by PCR, and abdominal ultrasonography were performed. Transient elastography measurement using FibroScan was performed. Patients were classified into those with mild fibrosis (F1-F3) and significant fibrosis (F4). IR was defined as homeostasis model assessment of IR more than 2. NLR and PLR were calculated. RESULTS The average age of the patients was 47.21±10.51 years, mainly men (n=119; 79.3%), and 87.3% (n=131) had IR and 44.7% (n=67) had significant fibrosis. PLR was lower in patients with IR (74.95±37.90 vs. 94.71±31.45; P=0.032) unlike the NLR, which was comparable (P>0.05). Patients with significant fibrosis had lower PLR (66.43±39.38 vs. 86.35±33.85; P=0.001) unlike NLR (P>0.05). PLR (cutoff≥77.47) had 78.9% sensitivity, 60.3% specificity, 22.4% positive predictive value, and 95.2% negative predictive value for non-IR (P=0.008). At a cutoff of at least 63.71, PLR had 73.5% sensitivity, 61.2% specificity, 70.1% positive predictive value, and 65.1% negative predictive value for nonsignificant fibrosis (P=0.001). Age and PLR (odds ratio=0.99; 95% confidence interval=0.976-0.999) were predictors of IR, whereas age, total bilirubin, serum albumin, liver stiffness, and PLR (odds ratio=0.98; 95% confidence interval=0.974-0.994) were predictors of significant fibrosis. CONCLUSION PLR is useful in distinguishing the patients with significant fibrosis or IR unlike NLR.
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Korkmaz P, Demirturk N, Batırel A, Cem Yardimci A, Cagir U, Atakan Nemli S, Korkmaz F, Zeynep Akcam F, Sener Barut H, Bayrak B, Karakecili F, Tarakci H, Yulugkural Z, Yuksel E, Aktug Demir N, Ural O, Sumer S, Harman R, Kadanali A, Ozturk S, Cetin Akhan S, Eren Tulek N, Keten D, Sener A, Aygen B, Kocagul Celikbas A, Yilmaz Karadag F, Aydin G, Arslan E, Sacligil C, Akengin Ocal G, Tanoglu A, Ulcay A, Karagoz E, Saltoglu N, Sırmatel F, Akdeniz H, Aynıoglu A, Arslan Ozel S, Dirgen Caylak S, Celik I, Alpay Y, Bestepe Dursun Z, Bekcibasi M, Tuncer Ertem G, Tigli A, Sargin Altunok E, Avsar K, Suer K, Sayan M. Noninvasive Models to Predict Liver Fibrosis in Patients with Chronic Hepatitis B: A Study from Turkey. Hepat Mon 2017; In Press. [DOI: 10.5812/hepatmon.60266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
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