scholarly journals Neutrophil-Lymphocyte Ratio and Mortality in the Long Life Family Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 143-144
Author(s):  
Sithara Vivek ◽  
Bharat Thygarajan ◽  
Joanne M Murabito ◽  
Nicole Schupf ◽  
Joseph Zmuda ◽  
...  

Abstract Neutrophil to Lymphocyte Ratio (NLR) reflects the balance between the innate (neutrophils) and adaptive (lymphocytes) immunity. Though NLR is a strong predictor of mortality in the general population, the distribution of NLR and its association with mortality has not been evaluated in families with exceptional longevity. Hence, we evaluated this question in the Long Life Family Study, a family based study of exceptional longevity. We used data from offspring of long lived (n=2065) family members and spousal controls (n=673). We used multivariate linear regression models adjusted for age, family relatedness, sex, field center, BMI and comorbidities (diabetes, CVD, cancer) to evaluate differences in NLR between long lived family members and spousal controls. Cox proportional hazard models were used to examine the association between NLR and mortality. 157 (7.6%) offspring in long lived families and 68 (10.1%) spousal controls were deceased during 12 years of follow up. NLR was similar among offspring in long lived families and spousal controls (1.96±1.06 vs.1.98±1.28; p=0.64). There was a significant positive association between NLR and overall mortality [HR: 1.3, 95% CI (1.01, 1.67)), p:0.04]. There was no statistically significant difference in this association among offspring in long lived families and spousal controls (p for interaction =0.16). The association between NLR and overall mortality was no longer significant [HR: 1.24; p:0.36] after adjustment for IL-6 and hsCRP. These results suggest that NLR may be a predictor of mortality in families with exceptional longevity though this association may not be independent of other inflammatory biomarkers.

Author(s):  
Philip J. Johnson ◽  
Sofi Dhanaraj ◽  
Sarah Berhane ◽  
Laura Bonnett ◽  
Yuk Ting Ma

Abstract Background The neutrophil–lymphocyte ratio (NLR), a presumed measure of the balance between neutrophil-associated pro-tumour inflammation and lymphocyte-dependent antitumour immune function, has been suggested as a prognostic factor for several cancers, including hepatocellular carcinoma (HCC). Methods In this study, a prospectively accrued cohort of 781 patients (493 HCC and 288 chronic liver disease (CLD) without HCC) were followed-up for more than 6 years. NLR levels between HCC and CLD patients were compared, and the effect of baseline NLR on overall survival amongst HCC patients was assessed via multivariable Cox regression analysis. Results On entry into the study (‘baseline’), there was no clinically significant difference in the NLR values between CLD and HCC patients. Amongst HCC patients, NLR levels closest to last visit/death were significantly higher compared to baseline. Multivariable Cox regression analysis showed that NLR was an independent prognostic factor, even after adjustment for the HCC stage. Conclusion NLR is a significant independent factor influencing survival in HCC patients, hence offering an additional dimension in prognostic models.


2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Esin Merve Erol Koç ◽  
Rahime Bedir Fındık ◽  
Hatice Akkaya ◽  
Işılay Karadağ ◽  
Eda Özden Tokalıoğlu ◽  
...  

AbstractObjectivesTo evaluate the relationship between Coronavirus Disease 2019 (COVID-19) in pregnancy and adverse perinatal outcomes. The secondary aim is to analyze the diagnostic value of hematologic parameters in COVID-19 complicated pregnancies.MethodsThe current study is conducted in a high volume tertiary obstetrics center burdened by COVID-19 pandemics, in Turkey. In this cohort study, perinatal outcomes and complete blood count indices performed at the time of admission of 39 pregnancies (Study group) complicated by COVID-19 were compared with 69 uncomplicated pregnancies (Control group).ResultsThere was no significant difference between the obstetric and neonatal outcomes of pregnancies with COVID-19 compared to data of healthy pregnancies, except the increased C-section rate (p=0.026). Monocyte count, red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR), and monocyte/lymphocyte ratio (MLR) were significantly increased (p<0.0001, p=0.009, p=0.043, p<0.0001, respectively) whereas the MPV and plateletcrit were significantly decreased (p=0.001, p=0.008) in pregnants with COVID-19. ROC analysis revealed that the optimal cut-off value for MLR was 0.354 which indicated 96.7% specificity and 59.5% sensitivity in diagnosis of pregnant women with COVID-19. A strong positive correlation was found between the MLR and the presence of cough symptom (r=41.4, p=<0.0001).ConclusionsThe study revealed that, pregnancies complicated by COVID-19 is not related with adverse perinatal outcomes. MLR may serve as a supportive diagnostic parameter together with the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) in assessment of COVID-19 in pregnant cohort.


2020 ◽  
Vol 66 (10) ◽  
pp. 1371-1375
Author(s):  
Mehmet Cosgun ◽  
Yilmaz Gunes ◽  
Isa Sincer ◽  
Asli Kurtar Mansiroglu

SUMMARY OBJECTIVE: Inflammation has been suggested as a potential mechanism in the pathogenesis of arrhythmia. Hemogram parameters such as monocyte count to high-density lipoprotein cholesterol ratio (MHR), neutrophil/lymphocyte ratio (NLR), and monocyte/lymphocyte ratio (MLR) have been considered to be markers of inflammation and new cardiovascular risk predictors. This retrospective study aimed to investigate the relationship between MHR, NLR, and MLR in patients with paroxysmal supraventricular tachycardia (PSVT). METHODS: A retrospective study conducted at a university hospital in Bolu, Turkey, between 2017 and 2019. Our study included 196 patients who underwent electrophysiological study (EPS) due to palpitation or documented PSVT on electrocardiography (ECG). Patients having documented atrioventricular nodal re-entrant tachycardia (AVNRT) on ECG or inducible AVNRT on EPS were included in the PSVT group (n=130), and patients with palpitation but without inducible arrhythmia on EPS (n=66) were included in the control group. Routine biochemical and hemogram tests were performed before the EPS procedure. RESULTS: When hemogram parameters were compared, there was no statistically significant difference in MHR values [0.010 (0.001-0.030) vs 0.010 (0.001-0.020) p =0.67]. Additionally, both NLR [2.21(0.74-11.36) vs 1.98(0.72-24.87) p=0.13] and MLR [0.25 (0.03-1.05) vs 0.24(0.07-1.39) p=0.41] were not statistically significant between the two groups. CONCLUSION: There is no significant difference in PSVT patients regarding hemogram parameters including white blood cell subtypes, MLR, NLR, and MHR. Therefore the evaluation of hemogram parameters may not be clinically relevant for PSVT patients.


Author(s):  
Angira Saha ◽  
Sakar Saxena ◽  
Romi Srivastava ◽  
Sanjeev Narang

Aim: To evaluate the role of biomarkers from blood samples of COVID-19 patients admitted in Index Medical College Hospital & R.C. Material & Methods: Hematological parameters such as Neutrophil lymphocyte ratio (NLR), Platelet lymphocyte ratio (PLR) & Systemic Inflammatory Index (SII) were studied in RT-PCR positive patients to evaluate the utility of these parameters for early diagnosis of COVID-19. Results: The study showed that there was statistically significant difference in test groups in reference to Neutrophil lymphocyte ratio (NLR) & SII values (p<0.05). But no statistically significant difference was observed between test groups in reference to Platelet lymphocyte ratio (PLR) values (p>0.05). Conclusion: Leukocyte, Neutrophil, NLR & SII values can be used in the early diagnosis of COVID-19. Keywords: NLR, SII, Leukocyte, Neutrophil


2021 ◽  
Vol 12 (8) ◽  
pp. 16-22
Author(s):  
Shilpa Tumkur Andane Gowda ◽  
Shahari Hegde Kusumakar ◽  
Raveendra Kodur Ramamurthy ◽  
Rohith Maraludevanapura Govindaiah

Background: Diabetes is a pro-thrombotic state associated with increased risk of atherosclerosis and inflammation. Neutrophil lymphocyte ratio (NLR) provides information about early and subclinical inflammation and thus may act as a prognostic marker for vascular complications in type 2 diabetes. Aims and Objective: To analyze the correlation between Neutrophil- Lymphocyte ratio in diabetics with and without vascular complications. Materials and Methods: A total of 111 patients admitted in Victoria hospital and Bowring & Lady Curzon hospital attached to Bangalore Medical College and Research Institute from NOV 2018 to MAY 2020 were studied. The data was collected according to the proforma in terms of history, clinical examination and the necessary investigations. NLR was observed in type 2 diabetic patients and was compared in those with complications and without complications. Results: The NLR was higher in diabetics with vascular complications compared to those without complications, 2.8 ± 0.7 fl versus 6.8 ± 3.1 fl (P< 0.001), respectively. In this study, Mean N (%), In No Vascular Complications was 61.7 ± 10.6 and with vascular complications was 79.9 ± 9.5. Mean L (%) in No Vascular Complications was 23.7 ± 5.8. Mean N (%), In No Vascular Complications was 61.7 ± 10.6 and with vascular complications was 79.9 ± 9.5. There was a significant difference in mean N (%) mean L (%) and NLR in comparison with respect to Complications. Conclusion: This study showed significantly higher NLR in diabetic patients with vascular complications. Hence, NLR can be used as a simple parameter to assess the vascular complications in diabetes.


Author(s):  
Heba Ibrahim Ashraf ◽  
Abd El-Rahman Mohamed El-Mashad ◽  
Mai Rabie El-Sheikh

Background: Preterm infants with Intra-Ventricular Hemorrhage (IVH) are at risk for developing significant complications, including post hemorrhagic hydrocephalus and seizures. Neonatal seizures are the most common overt manifestation of neurological dysfunction in the newborn, and is associated with short- and long-term adverse effects. Objective: The aim of the study is to evaluate the value of Peripheral Neutrophil- lymphocyte ratio (NLR) as a predictor of seizure in preterm infants with intra-ventricular hemorrhage. Methods: This prospective cohort study that comprised 60 Preterm infants with IVH admitted at NICU pediatric department Tanta university hospital from November 2019 to May 2020, Preterm infants were divided into two groups according to incidence of seizure. Preterm infants in this study subjected to Careful history taking, clinical examination and investigations (laboratory and Trans-cranial ultrasound) as well as analysis of result and follow up clinical status for development of seizure. Results: There was a statistically highly significant difference regarding NLR and development of seizure with p value <0.001 (NLR ≥ 2.3 with sensitivity 96%, specificity 93%, Area under the curve 0.849 and accuracy 84.9%). Conclusion: NLR is a predictor of seizure in preterm infants with intra-ventricular hemorrhage.


Author(s):  
Demet Aydogan kırmızı ◽  
Emre Baser ◽  
Taylan Onat ◽  
Melike Demir Caltekin ◽  
Mustafa Kara ◽  
...  

Abstract Purpose To compare the rates obtained from hematological parameters in cases of late-onset idiopathic fetal growth restriction (FGR) with healthy pregnancies and to evaluate the effect on neonatal outcomes. Methods The study group consisted of 63 pregnant women with late-onset idiopathic FGR and the control group consisted of 91 healthy pregnant women. The determined rates were calculated from the control hemograms of patients at 28 weeks. Both groups were compared for neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and other parameters. Results NLR, leukocyte and neutrophil levels were significantly higher in the FGR group (p<0.05). There was no significant difference in PLR, platelet and lymphocyte levels between the groups (p>0.05). To predict FGR, the best cut-off value of NLR was determined to be 4.11 with 56% sensitivity and 88% specificity values. Conclusion Neutrophil, lymphocyte and platelet interactions have an important role in FGR development. Inflammation can be involved in the etiopathogenesis in late-onset FGR.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Bin Waleed ◽  
Y L Xia ◽  
L J Gao ◽  
Y Xiaomeng ◽  
G Tse ◽  
...  

Abstract Background There is increasing evidence that inflammatory biomarkers growth differentiation factor 15 (GDF-15) and neutrophil-lymphocyte ratio (NLR) appear to be associated with stroke and adverse cardiovascular events in patients with atrial fibrillation (AF). However, long-term impact of catheter ablation (CA) on GDF-15 and NLR is still unknown. Objective To evaluate the long-term change in GDF-15 and NLR after CA in paroxysmal AF patients. Methods A total of 58 paroxysmal AF patients were consecutively enrolled to perform CA. The inflammatory biomarkers GDF-15 and NLR were measured at baseline and 6-months postablation. Results All patients except one could complete 6-Months follow up. Fifty (87.7%) patients maintained sinus rhythm (SR group) and seven (12.3%) patients sustained AF recurrence (AFR group). No significant difference was noted in clinical and procedural characteristics between two groups (p>0.05), except mean fluoroscopy time (minutes 22±11.7 vs. 13±5.3, p=0.001) significantly longer in AFR than SR group. The GDF-15 (pg/ml 195±57 vs. 216±88, p=0.398), and NLR (% 1.8 (1.3–3) vs. 2.6 (1.4–3.4), p=0.395) were comparable at baseline in both SR and AFR groups respectively. At 6-months postablation, GDF-15 (pg/ml 133±41 vs. 195±57, p<0.001), and NLR (% 1.6 (1.1–2) vs. 1.8 (1.3–3), p=0.004) were significant deceased compared to baseline levels in SR group. However, GDF-15 (pg/ml 139±86 vs. 216±88, p=0.064), and NLR (% 1.6 (1.2–3) vs. 2.6 (1.4–3.4), p=0.398) biomarkers remained comparable to baseline level in AFR group (p>0.05) Conclusion Inflammatory biomarkers; GDF-15 and NLR significantly decreased at long-term on successful maintenance of sinus rhythm by CA in paroxysmal AF patients. Acknowledgement/Funding None


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Gehan M Elassal ◽  
Mohamed A Elsayed ◽  
Amal M Shehata

Abstract Background Community-acquired pneumonia (CAP) is a common, potentially fatal disease despite advances in both diagnosis and treatment. Community-acquired pneumonia is the most common type of pneumonia. It occurs outside of hospitals or other health care facilities. Community acquired pneumonia (CAP) is a frequent and severe infection associated with a high mortality. Objectives This work aims to evaluate the role of neutrophil/lymphocyte ratio in prognosis of elderly patients with community acquired pneumonia compared to CRP level. Patients and Methods This prospective study was conducted upon 30 elderly patients in chest department at Ain shams University hospitals with community acquired pneumonia. All patients were diagnosed as having CAP by presence of new infiltrates in chest radiography associated with clinical picture. Clinical examination, traditional tests such as Confusion, Urea, Respiratory rate, Blood pressure, aged 65 and older (CURB-65), CRP level and NLR were evaluated at admission and after two weeks of admission. The predictive value for 30-day mortality of traditional tests and NLR were compared. Results The present study found that mean age of the studied cases was 72.9 ± 5.14 years old, 20 (66.7%) of patients were males while 10 (33.3%) were females. All patients had co-morbidities with diabetes mellitus and renal impairment the most common by percentage of 36.7%. There was highly significant correlation between neutrophil/lymphocyte count ratio (NLCR), neutrophil count and lymphocytic count and the outcome of CAP patients (p = 0.000, 0.004, 0.000 respectively) compared to other inflammatory biomarkers like WBC count (p = 0.02) and CRP (p = 0.521) and CURB-65 score (p = 0.074). This study showed that no deaths occurred in patients with NLR below 10, mortality was 8.3% in patients with NLR between 10 and 20 and 91.7% in patients with a NLR above 20. NLCR remain high with no significant difference in follow up labs among patients who died. Conclusion NLR showed emerging prognostic value in predicting outcome and 30day mortality rate in community acquired pneumonia. Unlike many other inflammatory markers and bioassays, NLR is an inexpensive, easy to handle, cost effective and readily available marker that is obtained from basic blood count providing an additional advantage in predicting hospitalization period and mortality.


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