Novel predictor of the occurrence of DKA in T1DM patients without infection: A combination of neutrophil/lymphocyte ratio and white blood cells

Abstract The role of inflammation has been identified in the pathogenesis of diabetic ketoacidosis (DKA). The neutrophil/lymphocyte ratio (NLR) and white blood cells (WBC) can be used to predict a systemic inflammatory response. Changes in NLR and WBC levels have never been explored in type 1 diabetes mellitus (T1DM) patients with DKA and an uninfected state. This retrospective study included a total of 644 participants. NLR and WBC were measured in the control group (n = 316) and in T1DM patients with mild-DKA (n = 92), severe-DKA (n = 52), and non-DKA (n = 184) in an uninfected state. Then, we assessed the independent predictors of DKA occurrence in T1DM patients in an uninfected state. The diagnostic performance of variables was determined by receiver operating characteristic curve analysis. Serum NLR of T1DM patients is significantly higher than that of normal controls, and if DKA occurs, NLR increases further and increases with the severity of DKA. In addition to diastolic blood pressure, blood urea nitrogen, glycated hemoglobin (HbA1c), and WBC, NLR was also independently associated with DKA in T1DM patients with an uninfected state (OR = 1.386, 95% CI: 1.127–1.705, p = 0.002). Furthermore, the diagnosis analysis showed that except for NLR and WBC, the area under the curve (AUC) of indicators with a statistical difference in patients with and without DKA were 0.747 for DKA diagnosis, and after the addition of NLR and WBC, the AUC was 0.806. The increased NLR level represents a low-cost and highly accessible predictor for DKA in T1DM patients with an uninfected state. The addition of inflammation indicators can play a statistically significant role in the prediction model of the DKA occurrence.

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Evaluation of neutrophil–lymphocyte ratio in predicting bloodstream infection

Biomarkers in Medicine ◽

10.2217/bmm-2018-0253 ◽

2019 ◽

Vol 13 (15) ◽

pp. 1255-1261 ◽

Cited By ~ 3

Author(s):

Jian Qu ◽

Hai-Yan Yuan ◽

Ying Huang ◽

Qiang Qu ◽

Zhan-Bo Ou-Yang ◽

...

Keyword(s):

Bloodstream Infection ◽

Operating Characteristic ◽

Area Under The Curve ◽

Study Group ◽

Healthy Controls ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Gram Positive Bacteria ◽

Diagnostic Indicator

Aim: The prognostic role of neutrophil-to-lymphocyte ratio (NLR) in bloodstream infection (BSI) deserves further investigation. Patients & methods: The NLR values were measured and compared in BSI patients and healthy controls. The receiver operating characteristic of NLR and cut-off values were measured in BSI patients and subgroups. Results: We have measured the NLR of study group with 2160 BSI patients and normal group with 2523 healthy controls, which was significantly high in study group (11.36 ± 21.38 vs 2.53 ± 0.86; p < 0.001) and the area under the curve was 0.834 (95% CI: 0.825–0.842; p < 0.001). The critical value of NLR for diagnosis of BSI was 3.09, with a sensitivity of 75.3%, and a specificity of 93.6%. Conclusion: NLR is an effective diagnostic indicator of including BSIs of Gram-negative bacteria, Gram-positive bacteria and fungus.

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Predictive value of the neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-neutrophil ratio, and neutrophil-to-monocyte ratio in lupus nephritis

Lupus ◽

10.1177/0961203320929753 ◽

2020 ◽

Vol 29 (9) ◽

pp. 1031-1039

Author(s):

Peng Liu ◽

Peiyuan Li ◽

Zhong Peng ◽

Yazhou Xiang ◽

Chenqi Xia ◽

...

Keyword(s):

Lupus Nephritis ◽

Healthy Subjects ◽

Area Under The Curve ◽

Neutrophil To Lymphocyte Ratio ◽

Control Group ◽

Receiver Operating Characteristic Curves ◽

Lymphocyte Ratio ◽

And Control ◽

First Time

Objective To evaluate the role of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-neutrophil ratio (PNR), platelet-to-monocyte ratio (PMR), and neutrophil-to-monocyte ratio (NMR) as predictors for lupus nephritis (LN) patients without infection or as biomarkers for distinguishing between infection or flare with LN patients. Methods LN patients were divided into three groups: LN without infection, LN with infection, and LN with flare. A total of 57 healthy subjects were enrolled as controls. The differentiation was analyzed between LN without infection and control group, and LN with infection and LN with flare. Correlations among variables were assessed in the LN group without infection. Receiver operating characteristic curves were constructed in two comparable groups. Results NLR, PLR, and MLR were increased significantly in the LN group without infection as compared with those in healthy controls. NLR (area under the curve (AUC): 0.75) and MLR (AUC: 0.79) were useful for distinguishing between LN patients without infection and healthy subjects. In differentiating LN patients without infection from the controls, optimal cutoffs of NLR and MLR were 3.43 (sensitivity: 45.6%, specificity: 96.5%, and overall accuracy: 68.8%) and 0.24 (sensitivity: 75.0%, specificity: 73.7%, and overall accuracy: 73.6%), respectively. In addition, NLR ( r = 0.322, p = 0.011) and PLR ( r = 0.283, p = 0.026) were positively correlated with CRP. Importantly, NLR and NMR were increased while PNR was decreased in the LN group with infection in comparison with those in the LN group with flare. NLR (AUC: 0.80), NMR (AUC: 0.78), and PNR (AUC: 0.74) were useful in differentiating LN patients with infection and flare, and their optimal cutoffs were 4.02 (sensitivity: 82.6%, specificity: 69.6%, and overall accuracy: 75.5%), 12.19 (sensitivity: 80.4%, specificity: 73.9%, and overall accuracy: 77.5%), and 28.26 (sensitivity: 65.2%, specificity: 76.8%, and overall accuracy: 71.6%), respectively. Conclusions We demonstrated, for the first time, that MLR or NMR had the best accuracy in differentiating LN patients without infection from healthy subjects, or differentiating infection from flare in LN patients, respectively. Our results implied that NLR, MLR, PNR, and NMR may be useful biomarkers in predicting LN.

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The Role of Hematological Indices in Patients with Acute Coronary Syndrome

Disease Markers ◽

10.1155/2017/3041565 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 25

Author(s):

Jan Budzianowski ◽

Konrad Pieszko ◽

Paweł Burchardt ◽

Janusz Rzeźniczak ◽

Jarosław Hiczkiewicz

Keyword(s):

Acute Coronary Syndrome ◽

Risk Stratification ◽

Low Cost ◽

White Blood Cells ◽

Distribution Width ◽

Hematological Indices ◽

Lymphocyte Ratio ◽

Coronary Syndrome ◽

Improve Risk Stratification

An increased systemic and local inflammation plays a key role in the pathophysiology of acute coronary syndrome (ACS). This review will discuss the role of hematological indices: white blood cells (WBC), neutrophil to lymphocyte ratio (NLR), red cell distribution width (RDW), and platelet indices, that is, platelet to lymphocyte ratio (PLR), mean platelet volume (MPV), and platelet distribution width (PDW) in the case of ACS. In recent years, a strong interest has been drawn to these indices, given that they may provide independent information on pathophysiology, risk stratification, and optimal management. Their low-cost and consequent wide and easy availability in daily clinical practice have made them very popular in the laboratory testing. Furthermore, many studies have pointed at their effective prognostic value in all-cause mortality, major cardiovascular events, stent thrombosis, arrhythmias, and myocardial perfusion disorders in terms of acute myocardial infarction and unstable angina. The most recent research also emphasizes their significant value in the combined analysis with other markers, such as troponin, or with GRACE, SYNTAX, and TIMI scores, which improve risk stratification and diagnosis in ACS patients.

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Abstract WP92: Neutrophil-lymphocyte Ratio in Cerebral Aneurysm

Stroke ◽

10.1161/str.47.suppl_1.wp92 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Kee Ook Lee ◽

Kyung-Yul Lee ◽

Jae-Youn Kim ◽

Cheol-Young Lee ◽

Sang-Jun Na ◽

...

Keyword(s):

Cerebral Aneurysm ◽

Control Group ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Patients With Cancer ◽

The Mean ◽

Artery Disease ◽

Wbc Count ◽

And Control

Introduction: Blood neutrophil/lymphocyte ratio (NLR) is a simple marker of subclinical inflammation that can be easily obtained. The NLR has recently emerged as a prognostic marker in patients with cancer and coronary artery disease. However, little is known about the role of NLR in patients with intracranial aneurysm (IA). Hypothesis: The purpose of this study was to determine the clinical significance of NLR in patients with IA. Methods: The study group consisted of patients with IA who had been admitted to the neurology department from January 2008 to December 2014. A total of 362 patients including 176 patients with unruptured IA, 186 patient with ruptured IA were enrolled in this study. The control group consisted of 178 age, sex-matched healthy adults who had not harbor IA by CTA, MRA, DSA. The baseline NLR was calculated as the ratio of neutrophil count to lymphocyte count. WBC count>12.000 cells per μL or <4.000 cells per μL and high body temperature>38 ° are excluded from the study. Results: The Mean NLR was significantly higher among persons with cerebral aneurysm compared with controls (P < 0.001). The level of NLR in ruptured IA group were found higher compared to unruptured IA and control group (7.0 ± 6.6 vs 2.5 ± 1.5 vs 1.6 ± 0.5, P < 0.001). Other comorbid conditions were balanced between these three groups. Conclusions: Higher NLR is associated with cerebral aneurysm. Unlike many other inflammatory markers and bioassays, NLR are inexpensive and readily available biomarkers that may be useful for risk stratification in patients with cerebral aneurysm.

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Fibrinogen-to-Albumin Ratio in Familial Mediterranean Fever: Association with Subclinical Inflammation

Klinische Pädiatrie ◽

10.1055/a-1610-9745 ◽

2021 ◽

Author(s):

Esra Nagehan Akyol Onder ◽

Pelin Ertan

Keyword(s):

Familial Mediterranean Fever ◽

Periodic Fever ◽

Characteristic Curve ◽

Area Under The Curve ◽

Colchicine Treatment ◽

Control Group ◽

Subclinical Inflammation ◽

Albumin Ratio ◽

Mediterranean Fever

Abstract Background Familial Mediterranean fever (FMF) is the most seen monogenic periodic fever syndrome characterised by bouts of fever and serositis. It is known that subclinical inflammation (SI) can persist in the symptom-free period and lead to amyloidosis even under colchicine treatment. This study aimed to evaluate the role of the fibrinogen-to-albumin ratio (FAR) in FMF and its correlation with SI. Material and Methods A total of 112 patients with FMF and 78 controls were enrolled in this retrospective study. Demographic, laboratory and genetic data were obtained from the hospital records. Results The FAR values of the FMF cases were significantly higher than the control group (p<0.001). In the FMF group, the patients with SI had higher FAR values than those without SI (p<0.001). FAR was positively correlated with SI (r=0.413, p<0.001). The receiver operating characteristic curve analysis showed that FAR had a higher area under the curve value than albumin and fibrinogen. Conclusion Detecting SI in patients with FMF is crucial in preventing amyloidosis, the most devastating complication of FMF. FAR is a simple, inexpensive, easily obtained indicator which can be used for reflecting SI in FMF.

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Reduction of Inflammatory C3 and C4 Complement Proteins in Severe COVID-19 Patients

10.21203/rs.3.rs-127493/v1 ◽

2020 ◽

Author(s):

Ali Ghazavi ◽

Ghasem Mosayebi ◽

Nafiesh Keshavarzian ◽

Somayeh Rabiemajd ◽

Ali Ganji

Keyword(s):

Blood Cells ◽

Viral Infections ◽

White Blood Cells ◽

Control Group ◽

Serum Samples ◽

Complement Proteins ◽

And Control ◽

The Complement System ◽

Shed Light

Abstract Background: The complement system, consisting of more than 20 soluble proteins, has a key role in innate immunity and inflammation that eliminates pathogens and viral infections. Therefore, we investigated the titer of C3, C4, and total IgG in the serum of the non-severe and severe COVID-19 patients. Methods: For this purpose, peripheral blood samples were collected from 30 non-sever, 30 severe COVID-19 patients, and 30 healthy individuals with similar age and sex as the control group. The amount of total IgG, C3, and C4 were analyzed in the serum samples. Also, white blood cells, platelets (PLTs), and lymphocytes were counted by the auto-analyzer. Results: White blood cells had no difference between patients and control groups. The results showed a significant decrease in lymphocyte and PLTs in COVID-19 patients compare to control. Complement proteins including C3 and C4 were increased in non-severe COVID-19 patients than the other groups. Total IgG showed a notable decrease in severe patients. In conclusion, the level of C3 and C4 complement proteins were increased in non-severe-COVID-19 patients; however, in the severe COVID-19 patients their concentrations were decreased. Conclusion: However, inflammatory C3 and C4 complement factors increase in non-severe COVID-19, it decreased in the severe patients that may be because of more consumption by the formation of the immune complex. These results can shed light on the inflammatory role of C3 and C4 proteins in various phases of the disease and could provide a basis for further exploration of the pathophysiological significance and can suggest them for specific interventions.

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Clinical usefulness of high levels of C-reactive protein for diagnosing epithelial ovarian cancer

Scientific Reports ◽

10.1038/s41598-020-77167-y ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Desheng Yang ◽

Haini Li ◽

Xiaoyan Sun ◽

Shengmei Yang ◽

Kewei Wang ◽

...

Keyword(s):

Ovarian Cancer ◽

Characteristic Curve ◽

Area Under The Curve ◽

Control Group ◽

Diagnostic Efficacy ◽

Reactive Protein ◽

Cancer Group ◽

Diagnostic Capability ◽

Diagnostic Role

AbstractThe purpose of the present study was to evaluate the diagnostic role of CRP in ovarian cancer and to assess whether CRP can be combined with tumor markers to enhance the diagnostic efficacy toward ovarian cancer. Area under the curve, sensitivity, and specificity were calculated to access the diagnostic ability of each singly and combined as markers for ovarian cancer. The CRP cut-off value was then calculated to evaluate the diagnostic efficacy of CRP for ovarian cancer. Our results showed that values for all markers were significantly higher in the cancer group than in the control group. Receiver operating characteristic curve results showed that CA125 had the highest diagnostic efficacy for ovarian cancer, while the sensitivity for CRP was higher than for CA125, and the specificity for CRP was equal to that of CA125. The combination of CRP, CA125, and HE4, however, provided the strongest diagnostic capability. Furthermore, the diagnostic cut-off value for CRP with regard to ovarian cancer was 9.8 mg/L, and high levels of CRP were correlated with stage and tumor size of ovarian cancer. Our study indicated that CRP is valuable in the diagnosis of ovarian cancer, and that combining CRP with CA125 and HE4 improved the diagnostic efficacy with respect to ovarian cancer.

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Abstract WP133: The Clinical Impact of Neutrophil/Lymphocyte Ratio in Patient With Cerebral Aneurysm

Stroke ◽

10.1161/str.51.suppl_1.wp133 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Kee Ook Lee ◽

Cheol-Young Lee ◽

Kyung-Yul Lee ◽

Seung-Hun Oh ◽

Ji Hoe Heo ◽

...

Keyword(s):

Cerebral Aneurysm ◽

Independent Predictor ◽

Control Group ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

The Mean ◽

Wbc Count ◽

And Control

Introduction: Increased neutrophils, and stress-induced low lymphocyte levels both indicate changes in the immune system. Blood neutrophil/lymphocyte ratio (NLR) is shown to be a simple, reliable and inexpensive inflammatory indicator that can provide important information on many conditions. Recently, NLR has been proposed as a useful biomarker to predict cardiovascular risk. However, little is known about the role of NLR in patients with intracranial aneurysm (IA). Hypothesis: The purpose of present study was to investigate whether NLR values differ in patients with IA. Methods: The study group consisted of patients with IA who had been admitted to the neurology department from January 2008 to December 2016. A total of 406 patients including 198 patients with unruptured IA, 208 patient with ruptured IA were enrolled in this study. The control group consisted of 420 age, sex-matched healthy adults who had not harbor IA by CTA, MRA, DSA. The baseline NLR was calculated as the ratio of neutrophil count to lymphocyte count. WBC count>12.000 cells per μL or <4.000 cells per μL and high body temperature>38 ° are excluded from the study. Results: The Mean NLR was significantly higher among persons with cerebral aneurysm compared with controls (P < 0.001). The level of NLR in ruptured IA group were found higher compared to unruptured IA and control group (6.1 ± 4.3 vs 2.7 ± 1.5 vs 1.8 ± 1.1, P < 0.001). Other comorbid conditions were balanced between these three groups. Conclusions: We demonstrated that the NLR is an independent predictor of IA patients. In addition, higher NLR is associated with ruptured IA. Unlike many other inflammatory markers and bioassays, NLR are inexpensive and readily available biomarkers that may be useful for risk stratification in patients with cerebral aneurysm. The clinical implications of NLR on IA remain to be established by future investigations. A long term prospective study is needed to clarify this matter.

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Correlation of Neutrophil to Lymphocyte Ratio with Expression of Neutrophil Extracellular Traps Within Stroke Emboli

Interventional Neuroradiology ◽

10.1177/15910199211065530 ◽

2021 ◽

pp. 159101992110655

Author(s):

Jorge Arturo Larco ◽

Mehdi Abbasi ◽

Sarosh Irfan Madhani ◽

Madalina Oana Mereuta ◽

Yang Liu ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Blood Cells ◽

White Blood Cells ◽

Neutrophil Extracellular Traps ◽

Vessel Occlusion ◽

Average Percentage ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Extracellular Traps

Background & Purpose It has been hypothesized that circulating neutrophils have a direct correlation with the composition of emboli in acute ischemic stroke (AIS). The aim of this study is to evaluate the association between neutrophil-lymphocyte ratio (NLR) in peripheral blood and the expression of neutrophil extracellular traps (NETs) within stroke emboli. Methods Consecutive patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO) that underwent mechanical thrombectomy (MT) were included. Patients were divided into two groups based on NLR median value. Retrieved thrombi were histologically analyzed using Martius Scarlett Blue (MSB) for main thrombus components including red blood cells (RBCs), white blood cells (WBCs), fibrin and platelet. Immunohistochemistry staining for von Willebrand Factor (vWF) and anti-citrullinated H3 (H3Cit; NETs marker) was also performed. Results Samples from a total of 84 patients were included. The average percentage of RBCs, WBCs, fibrin, platelet, H3Cit, and vWF components in thrombi were 45.1%, 3.5%, 21.8%, 29.6%, 19.7% and 14.8% respectively. When stratifying by NLR group [low (≤3.94) versus high (>3.95)], high NLR group had significantly more WBCs (4.5%), fibrin (24.2%), H3Cit (22.7%) and vWF (17.1%) thrombus fractions compared to low NLR group. Additionally, RBC content (38.8%) was lower in the high NLR group. Conclusions NLR is correlated with the amounts of WBCs, fibrin, NETs and vWF within the thrombi retrieved from AIS patients due to LVO.

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AMELIORATIVE ROLE OF BEE HONEY AND ROYAL JELLY AGAINST CISPLATIN INDUCED ALTERATION IN HEMATOLOGICAL PARAMETERS IN MALE WISTER ALBINO RAT

International Journal of Pharmacy and Pharmaceutical Sciences ◽

10.22159/ijpps.2018v10i4.23153 ◽

2018 ◽

Vol 10 (4) ◽

pp. 110 ◽

Cited By ~ 1

Author(s):

Waykar Bhalchandra ◽

Yahya Ali Alqadhi ◽

A. S. Ninawe

Keyword(s):

Blood Cells ◽

Royal Jelly ◽

Hematological Parameters ◽

White Blood Cells ◽

Hemoglobin Concentration ◽

Control Group ◽

Corpuscular Volume ◽

Corpuscular Hemoglobin ◽

Mean Values

Objective: This study aims to investigate the ameliorative role of dietary bee honey and royal jelly against cisplatin-induced alterations in hematological parameters in male wistar albino rat.Methods: Male wistar albino rats of same age and weight were randomly divided into four groups; G, I: control group which was given 0.9% saline, G: II: cisplatin (7 mg/kg/d) was injected intraperitoneally for 15 d, G, III bee honey with royal jelly (500 mg/kg/d of honey and 100 mg/kg/d of royal jelly) fed orally daily for 15 d, G, IV: cisplatin (7 mg/kg/d) was injected intraperitoneally and honey (500 mg/kg/d) and royal Jelly (100 mg/kg/d) fed orally daily for 15 d. The hematological parameters like total number of white blood cells (WBCs), red blood cells (RBCs), platelets, % of hemoglobin (Hb), and mean values of packed cell volume (PCV), mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC) were measured by using automated hematology system.Results: Cisplatin treated rats revealed a significant decrease in total number of white blood cells (WBCs), red blood cells (R. B. Cs), platelets, percentage of hemoglobin (Hb), and mean values of packed cell volume (PCV), corpuscular volume (MCV) and corpuscular hemoglobin concentration (MCHC) as compared to control group. Royal jelly and honey treated group of rats revealed a significant increase in all blood parameters compared to control group. Dietary bee honey with royal jelly along with cisplatin-treated rats revealed significant increas as compared to animals treated with cisplatin (G, II) and the computed significant valus for the above parameters are 10.00, 2.30, 8,54, 12.00, 35.00, 47.40 and 32,30 respectively.Conclusion: Bee honey and royal jelly could be used as dietary preventive natural products against cisplatin-induced hematological alterations during the treatment of cancer.

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