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Xu Y, Geng R, Meng X, Feng Z, Wang X, Zhang G, Bai L. The impact of inflammatory biomarkers on amputation rates in patients with diabetic foot ulcers. Int Wound J 2024; 21:e14827. [PMID: 38522433 PMCID: PMC10961172 DOI: 10.1111/iwj.14827] [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: 02/02/2024] [Revised: 02/18/2024] [Accepted: 02/23/2024] [Indexed: 03/26/2024] Open
Abstract
Diabetic Foot Ulcers (DFUs) are a major complication of diabetes, often leading to amputation. Understanding the relationship between haematological inflammatory markers and the incidence of amputation in DFU patients with infectious complications is crucial for improving management and outcomes. This retrospective study, conducted from May 2020 to October 2022, involved 109 patients with DFUs, categorised into amputation (AM) and non-amputation (NAM) groups. Patients were evaluated for various factors, including demographic data, DFU duration, and blood parameters such as haemoglobin A1c (HbA1c), haemoglobin (Hb), albumin (ALB), white blood cell count (WBC), erythrocyte sedimentation rate (ESR), procalcitonin (PCT), C-reactive protein (CRP), platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-monocyte ratio (LMR). Statistical analyses were performed using independent sample t-tests, Mann-Whitney U test and logistic regression. The univariate analysis showed no significant difference in BMI, DM duration or DFU duration between groups. However, significant differences were noted in PCT, Hb, ESR, ALB, HbA1c and WBC levels, and in inflammatory ratios (NLR, PLR and LMR). Multivariate logistic regression identified CRP, NLR and PLR as independent risk factors for amputation. The study highlights CRP, PLR and NLR as key independent risk factors for amputation in patients with DFUs. These easily obtainable markers from routine blood tests can effectively aid in predicting the risk of osteomyelitis and amputation, enhancing clinical decision making and patient care strategies.
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Affiliation(s)
- Yun Xu
- Ward 1, The Department of EndocrinologyThe First Affiliated Hospital of Xinxiang Medical UniversityWeihuiChina
| | - Ruina Geng
- Ward 1, The Department of EndocrinologyThe First Affiliated Hospital of Xinxiang Medical UniversityWeihuiChina
| | - Xiangyu Meng
- Ward 1, The Department of EndocrinologyThe First Affiliated Hospital of Xinxiang Medical UniversityWeihuiChina
| | - Zhipeng Feng
- The Department of General MedicineThe First Affiliated Hospital of Xinxiang Medical UniversityWeihuiChina
| | - Xu Wang
- Ward 1, The Department of EndocrinologyThe First Affiliated Hospital of Xinxiang Medical UniversityWeihuiChina
| | - Guanying Zhang
- Ward 2, The Department of UrologyThe First Affiliated Hospital of Xinxiang Medical UniversityWeihuiChina
| | - Liwei Bai
- Ward 1, The Department of EndocrinologyThe First Affiliated Hospital of Xinxiang Medical UniversityWeihuiChina
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Tsalta-Mladenov ME, Andonova SP. Peripheral blood cell count ratios as a predictor of poor functional outcome in patients with acute ischemic stroke. Neurol Res 2024; 46:213-219. [PMID: 37846878 DOI: 10.1080/01616412.2023.2270336] [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: 06/22/2023] [Accepted: 10/08/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND AND AIMS Acute ischemic stroke (AIS) is a leading cause of death and long-term disability worldwide. Thromboinflammation plays an important role in the pathophysiology of stroke. The peripheral blood cell count ratios (PBCCR): neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR), are global inflammatory indicators with prognostic value for the clinical outcome after stroke. We aimed to determine the relationship between NLR, PLR, or LMR and the functional outcome three months post-stroke. METHODS A prospective, hospital-based study, including 141 participants with AIS, was conducted at a referral stroke center in North-Eastern Bulgaria. The PBCCRs were obtained during the first 24 hours after stroke onset. Stroke severity was measured using the NIHSS scale, and functional outcome was assessed with the modified Rankin Scale (mRS) at discharge and 3 months post-stroke. RESULTS We found significantly lower total lymphocyte counts, and higher NLR, PLR, and C-reactive protein in the poor-outcome group (mRS>3) three months post-stroke. A positive correlation was found between the NIHSS score and mRS score on discharge, NLR, and PLR with the worse outcome on the third month. The receiver operating characteristic (ROC) curves showed the predictability of NLR (AUC, 0.626, 95%CI: 0.524-0.724, p = 0.018), and for PLR- (AUC, 0.613, 95%CI: 0.510-0.716, p = 0.031). The optimal cutoff value for NLR was 2.68 (sensitivity 77.8% and specificity 60.4%), and for PLR - 122.6 (sensitivity 77.8% and specificity 61.5%). CONCLUSION Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are simple, widely available, and cost-effective biomarkers with high prognostic value for the clinical outcome three months post-stroke.
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Affiliation(s)
- Mihael Emilov Tsalta-Mladenov
- Department of Neurology and Neuroscience, Faculty of Medicine, Medical University "Prof. Paraskev Stoyanov", Varna, Bulgaria
- Second Clinic of Neurology with ICU and Stroke unit, University Hospital "Sveta Marina", Varna, Bulgaria
| | - Silva Peteva Andonova
- Department of Neurology and Neuroscience, Faculty of Medicine, Medical University "Prof. Paraskev Stoyanov", Varna, Bulgaria
- Second Clinic of Neurology with ICU and Stroke unit, University Hospital "Sveta Marina", Varna, Bulgaria
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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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Oka T, Sato F, Ono T, Kawaguchi T, Murotani K, Sueyoshi S, Kuroiwa T, Kurita T, Fukahori M, Mitsuhashi T, Sato K, Chitose S, Umeno H. Prognostic values of systemic inflammation and nutrition-based prognostic indices in oropharyngeal carcinoma. Laryngoscope Investig Otolaryngol 2023; 8:675-685. [PMID: 37342125 PMCID: PMC10278114 DOI: 10.1002/lio2.1070] [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: 01/09/2023] [Revised: 04/11/2023] [Accepted: 04/17/2023] [Indexed: 06/22/2023] Open
Abstract
Objective Pretreatment systemic inflammation and nutrition-based prognostic indices (SINBPI) have demonstrated significance. This study investigated the prognostic value of pretreatment SINBPI for patients with oropharyngeal cancer and identified unfavorable prognostic markers. Methods We retrospectively reviewed the data of 124 patients with oropharyngeal squamous cell carcinoma (OPSCC) who received definitive treatment between January 2010 and December 2018. The prognostic utility of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), prognostic nutritional index, and high-sensitivity modified Glasgow prognostic score (HS-mGPS) was assessed for disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS) using univariate and multivariate analyses. Results Multivariate analyses revealed that human papillomavirus (HPV) status and HS-mGPS were significantly associated with DFS, DSS, and OS. Patients with a HS-mGPS of 2 had a significantly higher rate of treatment-related deaths than those with a HS-mGPS of 0 or 1. The combination of the HS-mGPS and PLR had more accurate predictive ability in DFS and OS compared with the HS-mGPS alone, and the combination of the HS-mGPS and LMR had more accurate predictive ability in DSS and OS. Conclusion Our results indicated that the HS-mGPS was a useful prognostic marker for patients with OPSCC, and combined markers consisting of the HS-mGPS and PLR or LMR may provide more accurate prognostic predictions.Level of Evidence: 3.
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Affiliation(s)
- Tsunehiro Oka
- Department of Otolaryngology‐Head and Neck SurgeryKurume University School of MedicineKurumeJapan
| | - Fumihiko Sato
- Department of Otolaryngology‐Head and Neck SurgeryKurume University School of MedicineKurumeJapan
| | - Takeharu Ono
- Department of Otolaryngology‐Head and Neck SurgeryKurume University School of MedicineKurumeJapan
| | - Toshihiko Kawaguchi
- Department of Otolaryngology‐Head and Neck SurgeryKurume University School of MedicineKurumeJapan
| | | | - Shintaro Sueyoshi
- Department of Otolaryngology‐Head and Neck SurgeryKurume University School of MedicineKurumeJapan
| | - Taikai Kuroiwa
- Department of Otolaryngology‐Head and Neck SurgeryKurume University School of MedicineKurumeJapan
| | - Takashi Kurita
- Department of Otolaryngology‐Head and Neck SurgeryKurume University School of MedicineKurumeJapan
| | - Mioko Fukahori
- Department of Otolaryngology‐Head and Neck SurgeryKurume University School of MedicineKurumeJapan
| | - Toshiyuki Mitsuhashi
- Department of Otolaryngology‐Head and Neck SurgeryKurume University School of MedicineKurumeJapan
| | - Kiminobu Sato
- Department of Otolaryngology‐Head and Neck SurgeryKurume University School of MedicineKurumeJapan
| | - Shun‐Ichi Chitose
- Department of Otolaryngology‐Head and Neck SurgeryKurume University School of MedicineKurumeJapan
| | - Hirohito Umeno
- Department of Otolaryngology‐Head and Neck SurgeryKurume University School of MedicineKurumeJapan
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Karadeniz FÖ, Karadeniz Y, Altuntaş E. Systemic immune-inflammation index, and neutrophilto-lymphocyte and platelet-to-lymphocyte ratios can predict clinical outcomes in patients with acute coronary syndrome. Cardiovasc J Afr 2023; 34:1-7. [PMID: 37145864 DOI: 10.5830/cvja-2023-011] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 02/27/2023] [Indexed: 05/06/2023] Open
Abstract
OBJECTIVE Inflammatory mechanisms play an important role in the pathogenesis of atherosclerosis and myocardial infarction. The clinical and prognostic importance of inflammatory parameters, such as neutrophil-lymphocyte (NLR) and platelet-lymphocyte ratios (PLR) in complete blood counts in acute myocardial infarction and other cardiovascular diseases has been demonstrated. However, systemic immune-inflammation index (SII) calculated from neutrophils, lymphocytes and platelets in the complete blood cell count has not been studied sufficiently and is thought to provide a better prediction. This study investigated whether haematological parameters such as SII, NLR and PLR were associated with clinical outcomes in acute coronary syndrome (ACS) patients. METHODS We included 1 103 patients who underwent coronary angiography for ACS between January 2017 and December 2021. The association between major adverse cardiac events (MACE) that developed in hospital and at 50 months of follow up and SII, NLR and PLR was compared. Long-term MACE were defined as mortality, re-infarction and target-vessel revascularisation. SII was calculated using the formula: NLR × total platelet count in the peripheral blood (per mm3). RESULTS Of the 1 103 patients, 403 were diagnosed with ST-elevation myocardial infarction and 700 with non-STelevation myocardial infarction. The patients were divided into a MACE and a non-MACE group. In hospital and during the 50-month follow up, 195 MACE were observed. SII, PLR and NLR were found to be statistically significantly higher in the MACE group (p < 0.001). SII, C-reactive protein level, age and white blood cell count were independent predictors of MACE in ACS patients. CONCLUSIONS SII was found to be a strong independent predictor of poor outcomes in ACS patients. This predictive power was greater than that of PLR and NLR.
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Affiliation(s)
- Fatma Özpamuk Karadeniz
- Cardiology Department, Karamanoğlu Mehmetbey University, Karaman Research and Training Hospital, Karaman, Turkey.
| | - Yusuf Karadeniz
- Division of Endocrinology, Department of Internal Medicine, Karaman Research and Training Hospital, Karaman, Turkey
| | - Emine Altuntaş
- Department of Cardiology, Sancaktepe Professor Dr İlhan Varank Training and Research Hospital, Istanbul, Turkey
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Peng HX, Lin K, He BS, Pan YQ, Ying HQ, Hu XX, Xu T, Wang SK. Platelet-to-lymphocyte ratio could be a promising prognostic biomarker for survival of colorectal cancer: a systematic review and meta-analysis. FEBS Open Bio 2016; 6:742-50. [PMID: 27398314 PMCID: PMC4932454 DOI: 10.1002/2211-5463.12083] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [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: 03/03/2016] [Revised: 05/09/2016] [Accepted: 05/10/2016] [Indexed: 01/04/2023] Open
Abstract
Inflammation is one of the most important causes leading to colorectal carcinogenesis, and inflammatory biomarkers such as the platelet-to-lymphocyte ratio (PLR) might predict survival in colorectal cancer (CRC). However, the prognostic value of PLR in CRC patients remains controversial. The prognostic value of PLR was comprehensively analyzed in 12 articles including 3541 CRC patients (10 for overall survival (OS), seven for disease-free survival (DFS), three for recurrence-free survival (RFS), and three for cancer-specific survival (CSS)) in this study. The overall pooled hazard ratios (HRs) of PLR for OS, DFS, and CSS were significant at 1.29 (95% confidence interval, CI = 1.13-1.47, P H = 0.149), 1.43 (95% CI = 1.03-1.97, P H = 0.025), and 1.26 (95% CI = 1.04-1.52, P H = 0.223), respectively. However, there was no evidence of significance for RFS (HR = 1.29, 95% CI = 0.98-1.70, P H = 0.231) in our study. Stratified analyses indicated elevated PLR was a predictor of poor OS (metastatic patients) and DFS (Caucasian population) and was also significantly associated with OS in univariate analysis (HR = 1.35, 95% CI = 1.14-1.60, P H = 0.532) and those only treated surgically (HR = 1.37, 95% CI = 1.10-1.70, P H = 1.080). However, our findings indicated that elevated PLR is a promising prognostic biomarker for colorectal cancer, especially in metastatic Caucasian CRC patients.
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Affiliation(s)
- Hong-Xin Peng
- Medical School of Southeast University Nanjing Jiangsu China; Central Laboratory Nanjing First Hospital Nanjing Medical University Nanjing Jiangsu China
| | - Kang Lin
- Central Laboratory Nanjing First Hospital Nanjing Medical University Nanjing Jiangsu China
| | - Bang-Shun He
- Central Laboratory Nanjing First Hospital Nanjing Medical University Nanjing Jiangsu China
| | - Yu-Qin Pan
- Central Laboratory Nanjing First Hospital Nanjing Medical University Nanjing Jiangsu China
| | - Hou-Qun Ying
- Medical School of Southeast University Nanjing Jiangsu China; Central Laboratory Nanjing First Hospital Nanjing Medical University Nanjing Jiangsu China
| | - Xiu-Xiu Hu
- Medical School of Southeast University Nanjing Jiangsu China; Central Laboratory Nanjing First Hospital Nanjing Medical University Nanjing Jiangsu China
| | - Tao Xu
- Central Laboratory Nanjing First Hospital Nanjing Medical University Nanjing Jiangsu China
| | - Shu-Kui Wang
- Central Laboratory Nanjing First Hospital Nanjing Medical University Nanjing Jiangsu China
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