Concomitant determination of hematological indices supported the application of the albumin-bilirubin score in non-malignant liver diseases.

The albumin-bilirubin (ALBI) score is a useful prognostic marker that predicts mortality in patients suffering from terminal diseases. Recently, it has been reported that ALBI score is a predictor of non-malignant liver diseases. The cutoff point of the ALBI score that distinguishes hepatocellular carcinoma from non-malignant liver disease is still not identified. Therefore, the ALBI score is a sensitive rather than a specific predictor of the poor outcomes of liver diseases. There are many hematological indices and ratios that are utilized as prognostic biomarkers. Among these biomarkers are the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR), and platelet-hemoglobin ratio (PHR), which are useful discriminating prognostic biomarkers for liver diseases, e.g., hepatocellular carcinoma, hepatitis, liver fibrosis, etc. There is evidence that PLR and PHR are prognostic biomarkers that predict the poor outcomes of diseases. Therefore, concomitant measurements of ALBI score and PHR or ALBI score and PLR will improve the predictive value that can differentiate hepatocellular carcinoma from non-malignant diseases.

The Use of the Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio in Predicting Transcatheter Aortic Valve Implantation Mortality.

AIM: Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are simple biomarkers that reflect systemic inflammation and are associated with adverse cardiovascular disease outcomes. The utility of NLR and PLR for risk prediction following transcatheter aortic valve implantation (TAVI) is not clear. METHOD: We retrospectively analysed a prospectively maintained database of patients who underwent TAVI at a tertiary hospital from 2009 to 2022. Baseline demographics, NLR, PLR and Society of Thoracic Surgeons Predicted Risk of Mortality (STS-PROM) scores were obtained. The 30-day and 1-year survival rates were analysed using a logistic regression model while overall survival was analysed using the Kaplan-Meier method. Predictors of survival were calculated using a Cox-hazards regression model and presented as odds ratio (OR) with 95% confidence interval (CI). RESULTS: Overall, 367 patients were included in this study (mean age 84 years, 51% male). Median follow-up was 19 months (interquartile range 8.8-40 months) with a median survival of 7.2 years (interquartile range 3.5-10.3 years). NLR was associated with 30-day mortality (OR 1.75; 95% CI 1.25-2.68; p<0.01). PLRs marginally predicted 1-year mortality (OR 1.01; 95% CI 1.00-1.02). However, only the STS-PROM score significantly predicted overall survival (hazard ratio 1.07; 95% CI 1.02-1.12; p=0.03) after adjustment for NLR and PLR. CONCLUSIONS: NLR is associated with 30-day mortality following TAVI. PLR was not a clinically significant predictor of mortality after TAVI. Only the STS-PROM score remained a significant predictor of overall survival.

Platelet and Lymphocyte-Related Parameters as Potential Markers of Osteoarthritis Severity: A Cross-Sectional Study.

BACKGROUND: Platelets and lymphocytes levels are important in assessing systemic disorders, reflecting inflammatory and immune responses. This study investigated the relationship between blood parameters (platelet count (PLT), mean platelet volume (MPV), lymphocyte count (LINF), and platelet-to-lymphocyte ratio (PLR)) and osteoarthritis (OA) severity, considering age, sex, and body mass index (BMI). METHODS: Patients aged ≥40 years were included in this cross-sectional study and divided into groups based on knee OA severity using the Kellgren-Lawrence (KL) grading system. A logistic regression model, adjusted for confounders, evaluated the ability of PLT, MPV, LINF, and PLR to categorize OA severity. Model performance in terms of accuracy, sensitivity, and specificity was assessed using ROC curves. RESULTS: The study involved 245 OA patients (51.4% female, 48.6% male) aged 40-90 years, 35.9% with early OA (KL < 3) and 64.1% moderate/severe OA (KL ≥ 3). Most patients (60.8%) were aged ≥60 years, and BMI was <25 kg/m2 in 33.9%. The model showed that a 25-unit increase in PLR elevates the odds of higher OA levels by 1.30 times (1-unit OR = 1.011, 95% CI [1.004, 1.017], p < 0.005), while being ≥40 years old elevates the odds by 4.42 times (OR 4.42, 95% CI [2.46, 7.95], p < 0.0005). The model's accuracy was 73.1%, with 84% sensitivity, 52% specificity, and an AUC of 0.74 (95% CI [0.675, 0.805]). CONCLUSIONS: Higher PLR increases the likelihood of moderate/severe OA, suggesting that monitoring these biomarkers could aid in early detection and management of OA severity. Further research is warranted to cross-validate these results in larger populations.

Relationship Between Hematologic Inflammatory Markers and Glycemic Control in Type 2 Diabetes Mellitus Patients in a Tertiary Hospital in Nigeria.

INTRODUCTION: Hematologic inflammatory biomarkers derived from a full blood count (FBC) are elevated in Type 2 diabetes mellitus (DM). In low- and middle-income countries like Nigeria, a FBC is an affordable and easily available test, even in rural areas. Glycated hemoglobin (HbA1c), a measure of glycemic control, has been found to correlate with hematologic inflammatory markers. In Nigeria, where health care is expensive and patients essentially pay out of pocket, a more affordable and accessible alternative to HbA1c in determining glycemic control is needed. Therefore, this study aimed to determine the relationship between Hb A1c and hematologic inflammatory biomarkers, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and mean platelet volume (MPV), in predicting glycemic control. METHODS: This was a six-month study of 109 patients with Type 2 DM in a tertiary hospital in Lagos. The patients' HbA1c and FBC were measured. NLR, PLR, and MPV were derived from the FBC values. We categorized the patients based on glycemic control. Spearman correlation analysis was used to determine the relationship between HbA1c and the inflammatory biomarkers. RESULTS: There was no significant difference in NLR, PLR, and MPV between optimal and suboptimal controlled diabetic patients. Spearman's correlation analysis showed no significant association between NLR, PLR, MPV, and HbA1c in the patients (NLR: r=0.027, P=0.680; PLR: r=-0.091, P=0.356; MPV: r=-0.032, P=0.744). CONCLUSION: The inflammatory markers studied had no significant relationship with HbA1c and might not help monitor glycemic control in Type 2 DM patients.

Predictive value of near-term prediction models for severe immune-related adverse events in malignant tumor PD-1 inhibitor therapy.

Immune-related adverse events (irAEs) impact outcomes, with most research focusing on early prediction (baseline data), rather than near-term prediction (one cycle before the occurrence of irAEs and the current cycle). We aimed to explore the near-term predictive value of neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), absolute eosinophil count (AEC) for severe irAEs induced by PD-1 inhibitors. Data were collected from tumor patients treated with PD-1 inhibitors. NLR, PLR, and AEC data were obtained from both the previous and the current cycles of irAEs occurrence. A predictive model was developed using elastic net logistic regression Cutoff values were determined using Youden's Index. The predicted results were compared with actual data using Bayesian survival analysis. A total of 138 patients were included, of whom 47 experienced grade 1-2 irAEs and 18 experienced grade 3-5 irAEs. The predictive model identified optimal α and λ through 10-fold cross-validation. The Shapiro-Wilk test, Kruskal-Wallis test and logistic regression showed that only current cycle data were meaningful. The NLR was statistically significant in predicting irAEs in the previous cycle. Both NLR and AEC were significant predictors of irAEs in the current cycle. The model achieved an area under the ROC curve (AUC) of 0.783, with a sensitivity of 77.8% and a specificity of 80.8%. A probability ≥ 0.1345 predicted severe irAEs. The model comprising NLR, AEC, and sex may predict the irAEs classification in the current cycle, offering a near-term predictive advantage over baseline models and potentially extending the duration of immunotherapy for patients.

Inflammatory markers related to survival in breast cancer patients: Peru.

INTRODUCTION: Breast cancer is a disease with high global prevalence. Clinical inflammatory biomarkers have been proposed as prognostic indicators in oncology. This research aims to determine the relationship between inflammatory markers and overall survival in breast cancer patients from four representative hospitals in Lima, Peru. METHODS: This is a multicentric, analytical, longitudinal retrospective cohort study with survival analysis in female patients with breast cancer, from 2015 to 2020, who had received at least one complete treatment regimen. The dependent variable was overall survival, and the independent variables were inflammatory markers neutrophil lymphocyte ratio, platelet lymphocyte ratio (PLR), albumin, and red cell distribution width; intervening variables included age, clinical stage, molecular subtype, and other known prognostic factors. The Kaplan-Meier method was applied to generate survival curves with the Log-Rank test, and finally, Cox regression, to find crude and adjusted hazard ratios (HR). RESULTS: Of 705 evaluated patients, 618 were analyzed. The mean age was 56.6 ± 12.3 years, 18.0% of patients were pure HER2 positive, 39.3% luminal A, 29.9% luminal B, 11.0% triple-negative, and 81.4% showed overweight and obesity. The average overall survival was 51.1 months. In the multivariate analysis, factors significantly related to lower overall survival were PLR > 150 (adjusted HR: 2.33; 95% confidence interval (CI): 1.22, 4.44) and stage III (adjusted HR: 4.15; 95% CI: 1.35, 12.83). CONCLUSIONS: The Elevated Platelet-Lymphocyte Index and advanced clinical stage were associated with lower overall survival in breast cancer patients. Furthermore, PLR >150 proved to be an independent prognostic factor for mortality.

Prognostic roles of neutrophil-lymphocyte, monocyte-lymphocyte and platelet-lymphocyte ratios for long-term all-cause mortality in heart failure.

Background: Heart failure (HF) and inflammation have a bidirectional relation leading to activation and adaptation of multiple cellular lines, including leucocyte subtypes and platelets. We aimed to assess and compare the predictive value of the neutrophil-lymphocyte (NLR), monocyte-lymphocyte (MLR) and platelet-lymphocyte (PLR) ratios for all-cause long-term mortality in HF. Methods: This is an observational retrospective cohort study that included patients from the HI-HF cohort that survived the initial hospitalization. Vital status and survival time were assessed in June 2020. Results: We analyzed 1018 HF patients with a mean age of 72.32 ± 10.29 years and 53.54 % women. All-cause long-term mortality was 38.21 % after a median follow-up time of 68 [38 - 82] months. NLR (AUC 0.667, 95 %CI 0.637 - 0.697), MLR (AUC 0.670, 95 %CI 0.640 - 0.700) and PLR (AUC 0.606, 95 %CI 0.574 - 0.636) were predictors of all-cause mortality. In multivariable Cox proportional hazards analysis, NLR≥3.56 was the only hematological index independent predictor of fatality (HR 1.36, 95 %CI 1.05 - 1.76). Conclusions: Of the three hematological indices, NLR was the only independent predictor of all-cause long-term mortality of HF patients. We suggest NLR≥3.56 as an auxiliary prognostic biomarker for the evaluation of HF patients.

Anti-inflammatory Effect of Batroxobin Combined With Anticoagulation in Patients With Cerebral Venous Thrombosis.

Inflammation is pivotal in the pathogenesis and development of cerebral venous thrombosis (CVT). Herein, we aimed to assess the anti-inflammatory effects of batroxobin combined with anticoagulation in CVT. Participants were categorized into the batroxobin group (batroxobin combined with anticoagulation) and the control group (anticoagulation only). Regression analysis was employed to explore the association between the number of episodes of batroxobin administration and the fluctuation of inflammatory indicators, as well as the proportion of patients with inflammatory indicators that were reduced after batroxobin use. Twenty-three cases (age: 39.9 ± 13.8 years, female: 39.1%) in the batroxobin group and 36 cases (40.3 ± 9.6 years, 52.8%) in the control group were analyzed. Compared to the control group, batroxobin combined with anticoagulation significantly decreased fibrinogen (P < .001), platelet-lymphocyte ratio (PLR) (P = .016) and systemic immune-inflammation index (SII) (P = .008), and increased the proportion of the patients with lower fibrinogen (P < .001), neutrophil-lymphocyte ratio (NLR) (P = .005), PLR (P = .026), and SII (P = .006). Linear analysis showed that as the number of episodes of batroxobin administration increased, the fibrinogen (P < .001), the PLR (P = .001), and the SII (P = .020) significantly decreased. Logistic regression analysis showed as the number of episodes of batroxobin administration increased, the ratio of the patients with decreased NLR (P = .008) and PLR (P = .015), as well as SII (P = .013), significantly increased. Batroxobin could decrease NLR, PLR, and SII in CVT. The effect was related to the number of episodes of batroxobin administration. Besides reducing fibrinogen and indirect thrombolysis effects, this may be another critical benefit of batroxobin for CVT.

Association of the systemic immune-inflammation index (SII) and severity of diabetic ketoacidosis in patients with type 1 diabetes mellitus: a retrospective cohort study.

Background: Diabetic ketoacidosis (DKA) is the most serious metabolic complication of type 1 diabetes mellitus (T1DM). Insulin deficiency and inflammation play a role in the pathogenesis of DKA. The authors aimed to assess the systemic immune-inflammation index (SII) as a marker of severity among T1DM patients with DKA and without infection. Methods: The authors included T1DM patients older than or equal to 12 years hospitalized because of DKA. The authors excluded patients with infection or any condition that can change SII parameters or cause metabolic acidosis. The authors compared SII, neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) between severe and non-severe DKA groups. The authors also assessed the need for an ICU, length of stay, and 90-day readmission rate between the groups. Results: The study included 241 patients with a median age of 17 (14, 24) years, and 44.8% were males. More patients with severe DKA (45%) required ICU admission (P<0.001). Median SII increased with DKA severity, and the difference was significant (P=0.033). No significant difference was observed as regards median NLR or PLR (P=0.380 and 0.852, respectively). SII, but not NLR or PLR, had a significant negative correlation with PH (r=-0.197, P=0.002) and HCO3 level (r=-0.144, P=0.026). Also, being in the highest SII quartile was an independent risk factor for DKA severity (OR, 2.522; 95% CI, 1.063-6.08; P=0.037). The authors estimated an SII cut-off value of 2524.24 to predict DKA severity with high specificity. Conclusion: Elevated SII is a risk factor for DKA severity in T1DM. It is better than NLR and PLR in prognosticating DKA patients. These findings highlight the role of inflammation in DKA. SII can help as a valuable and simple tool to assess DKA severity.

NLR, MLR, and PLR are adverse prognostic variables for sleeve lobectomy within non-small cell lung cancer.

BACKGROUND: The goal of the research was to examine the value of peripheral blood indicators in forecasting survival and recurrence among people suffering central-type non-small cell lung cancer (NSCLC) undergoing sleeve lobectomy (SL). METHODS: Clinical information was gathered from 146 individuals suffering from NSCLC who had SL at our facility between January 2014 and May 2023. Peripheral blood neutrophil lymphocyte ratio (NLR), monocyte lymphocyte ratio (MLR), and platelet lymphocyte ratio (PLR) levels were determined by receiver operating characteristic (ROC) curve to establish the threshold points. Kaplan-Meier survival analysis was employed to evaluate the prognostic value of different groupings, and both univariate and multivariate Cox proportional hazards model (referred to as COX) were performed. RESULTS: The disease-free survival (DFS) and overall survival (OS) cutoff values were carried out via ROC analysis. Kaplan-Meier survival analysis revealed notable differences in OS for NLR (≥2.196 vs. <2.196, p = 0.0009), MLR (≥0.2763 vs. <0.2763, p = 0.0018), and PLR (≥126.11 vs. <126.11, p = 0.0354). Similarly, significant differences in DFS were observed for NLR (≥3.010 vs. <3.010, p = 0.0005), MLR (≥0.2708 vs. <0.2708, p = 0.0046), and PLR (≥126.11 vs. <126.11, p = 0.0028). Univariate Cox analysis showed that NLR (hazard ratio [HR]: 2.469; 95% confidence interval [CI]: 1.416-4.306, p < 0.001), MLR (HR: 2.192, 95% CI: 1.319-3.643, p = 0.002) and PLR (HR: 1.696, 95% CI: 1.029-2.795, p = 0.038) were correlated alongside OS. Multivariate Cox analysis showed that NLR (HR: 2.036, 95% CI: 1.072-3.864, p = 0.030) was a separate OS risk variable. Additionally, the pN stage (HR: 3.163, 95% CI: 1.660-6.027, p < 0.001), NLR (HR: 2.530, 95% CI: 1.468-4.360, p < 0.001), MLR (HR: 2.229, 95% CI: 1.260-3.944, p = 0.006) and PLR (HR: 2.249, 95% CI: 1.300-3.889, p = 0.004) were connected to DFS. Multivariate Cox analysis showed that pN stage (HR: 3.098, 95% CI: 1.619-5.928, p < 0.001) was a separate DFS risk variable. CONCLUSION: The study demonstrates that NLR, MLR, and PLR play a convenient and cost-effective role in predicting survival and recurrence among individuals alongside central-type NSCLC having SL.

Evaluating Cardiovascular Risks: The Platelet Lymphocyte Ratio and the Neutrophil Lymphocyte Ratio As High-Risk Heart Score Predictors in Non-ST Elevation Myocardial Infarction (NSTEMI) and Unstable Angina Patients.

Introduction Acute coronary syndromes (ACS), encompassing non-ST elevation myocardial infarction (NSTEMI) and unstable angina (UA), present significant challenges in risk assessment and management, particularly in resource-constrained environments like India. The burden of cardiovascular diseases in such regions necessitates cost-effective and readily accessible tools for risk stratification. Previous research has emphasized the role of inflammatory markers in coronary artery disease (CAD), prompting investigations into simple and affordable biomarkers for risk assessment. Platelet lymphocyte ratio (PLR) and neutrophil lymphocyte ratio (NLR) have emerged as potential biomarkers for thrombotic activity in cardiac illnesses, offering simplicity, accessibility, and cost-effectiveness in risk assessment making them particularly valuable in resource-poor settings like India, where advanced diagnostic tools may be limited. Objective This study aims to evaluate the effectiveness of PLR and NLR as predictors of high-risk HEART (history, ECG, age, risk factors, and troponin) scores in patients with NSTEMI and UA. Methods A prospective cross-sectional study was conducted at the Saveetha Medical College and Hospitals in Chennai, India, from March 2021 to September 2022. The study included 288 adults diagnosed with NSTEMI or UA, aged 18 years and above. The inclusion criteria comprised patients with confirmed diagnoses of NSTEMI or UA based on clinical symptoms, electrocardiographic findings, and cardiac biomarker elevation. The exclusion criteria encompassed patients with active infections, acute traumatic injuries, end-stage renal disease, malignant neoplasms, and ST-elevation myocardial infarction (STEMI). In addition to the HEART score, PLR, and NLR were computed to assess the prognosis of patients admitted to the Saveetha Medical College and Hospitals. Results The statistical analysis revealed significant correlations between PLR, NLR, and HEART score risk categories. The Pearson's correlation coefficient indicated strong associations between PLR/NLR values and HEART score risk groups, suggesting their potential as predictive markers for adverse clinical outcomes. Additionally, analysis of variance (ANOVA) demonstrated significant differences in PLR/NLR values across different HEART score risk categories, further highlighting their relevance in risk stratification. The effect sizes for these correlations were moderate to large, indicating clinically meaningful associations between PLR/NLR and cardiovascular risk. Conclusion In cases of NSTEMI and UA, PLR and NLR show potential as simple and inexpensive indicators of high-risk patients. By leveraging these inexpensive biomarkers, healthcare providers can enhance risk assessment and prognostication in patients presenting with ACS, facilitating timely interventions and tailored management strategies.

Platelet-to-lymphocyte ratio as a prognostic predictive marker on adults with traumatic brain injury: Systematic review.

Background: The platelet-to-lymphocyte ratio (PLR) has emerged as a prognostic predictive marker in various diseases, but its role in traumatic brain injury (TBI) has not been fully elucidated. This study aims to evaluate the role of PLR as a prognostic predictive marker in adults with TBI. Methods: This systematic review was conducted according to the Preferred Reporting Items in the Systematic Review and Meta-analysis Guidelines 2020. A comprehensive search was performed using PubMed, Google Scholar, Scopus, Crossref, OpenAlex, Semantic Scholar, Library of Congress, and Jisc Library Hub Discover database to identify relevant studies published up to February 2023. Both prospective and retrospective observational studies written in English or Indonesian were included in the study. No restrictions were placed on the year and country of publication and duration of follow-up. Study quality was evaluated using the Newcastle-Ottawa Scale (NOS), and the risk of bias was estimated using the Cochrane Risk of Bias Assessment Tool for Nonrandomized Research (Ro-BANS) tool. A narrative synthesis was also conducted to summarize the findings. Results: We retrieved 1644 references using the search strategy, and 1623 references were excluded based on screening the title and abstract. The full text was retrieved for 20 articles and subjected to the eligibility criteria, of which 16 were excluded from the study. Four papers with a total of 1.467 sample sizes were included in the review. The median of NOS for study quality was 8-9, with the risk of selection bias using the Ro-BANS tool being low in all studies except for the blinding outcome assessments, which are all unclear. The study finding suggests that the PLR has the potential as an independent prognostic predictive marker in adult patients with TBI. In three studies, a high level of admission PLR may independently predict an increasing mortality risk in 30 days and adverse outcomes measured by the Glasgow outcome scale in 6 months following TBI. However, one study shows that PLR may have limited value as a predictor of mortality or favorable neurological outcomes compared to other hematological parameters. Further studies were needed to establish the clinical utility of PLR and fill the present gaps. Conclusion: This systematic review provides evidence supporting the utilization of PLR as a prognostic predictive marker in adult patients with TBI. The PLR can mainly be utilized, especially in rural practice, as PLR is a simple, low-cost, and routinely performed hematological examination.

Effect of aerobic exercise on neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and lymphocyte-monocyte ratio in burn patients: A randomized controlled trial.

BACKGROUND: This study aimed to investigate the effects of aerobic exercises in addition to standard treatment on parameters such as neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR) in patients with burns. METHODS: A total of 31 hospitalized patients included in the study were divided into two groups using covariate adaptive randomization method according to burn percentage and burn type (1st:standard treatment, 2nd: standard treatment + aerobic training). NLR, PLR, and LMR were evaluated for 5 weeks in all groups. Independent samples t-test and Mann-Whitney U test were used to examine differences between the two groups. For comparing more than two groups, Friedman's test was used for non-normally distributed variables and Bonferroni test was used as the post hoc pairwise comparison method. RESULTS: Intragroup comparison of individuals in group 1 showed that the NLR values on days 7 and 14 were significantly higher than those on days 28 and 35 (p < 0.05). Intragroup comparison of individuals in group 2 showed that the NLR values on days 1, 7, and 14 were significantly higher than those on days 21 and 35. Additionally, the NLR values on day 14 were higher than those on day 28. Individuals in group 1 showed a significant increase in PLR values each week (p < 0.05). CONCLUSIONS: The addition of aerobic training to standard treatment in patients with burns may be more effective in improving inflammation markers such as NLR, PLR, and LMR.

Associations of ω-3, ω-6 polyunsaturated fatty acids intake and ω-6: ω-3 ratio with systemic immune and inflammatory biomarkers: NHANES 1999-2020.

Background: In recent years, diseases caused by abnormal immune-inflammatory responses have become increasingly severe. Dietary intervention involving omega-3 polyunsaturated fatty acids (ω-3 PUFAs) has emerged as a potential treatment. However, research investigating the relationship between ω-3, ω-6 PUFAs, and ω-6 to ω-3 ratio with inflammatory biomarkers remains controversial. Methods: To investigate the correlation between the intake of ω-3 and ω-6 PUFAs and the ratio of ω-6: ω-3 with biomarkers of inflammation, the National Health and Nutrition Examination Survey (NHANES) data (1999 to 2020) was utilized. The systemic immune-inflammation index (SII), platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), and white blood cell (WBC) were selected as study subjects. Dietary data for ω-3 and ω-6 PUFAs were collected via two 24-h dietary recall interviews. SII index and other indicators were obtained from the blood routine data. The multiple linear regression and restricted cubic spline models were utilized to evaluate the association of ω-3, ω-6 PUFAs intake, and ω-6: ω-3 ratio to SII and secondary measures. Results: This study involved a total of 43,155 American adults. ω-3 and ω-6 PUFAs exhibited negative correlations with SII, PLR, NLR, and WBC. The correlation between ω-6: ω-3 ratio and SII, PLR, NLR, and WBC was not significant. Furthermore, the dose-response relationship showed that the relationship between the intake of ω-3 and ω-6 PUFAs and SII was an "L" pattern. Conclusion: Intake of dietary ω-3 and ω-6 PUFAs reduces the levels of several inflammatory biomarkers in the body and exerts immunomodulatory effects.

Is It Possible to Use Inflammatory Markers as Potential Biomarkers for Chronic Urticaria?

Background: This study aimed to determine whether the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) at admission affect the transition of pediatric patients diagnosed with acute spontaneous urticaria to chronic urticaria. Methods: This study included 390 patients who presented to the Department of Pediatrics at Akdeniz University Hospital with acute spontaneous urticaria between January 2020 and December 2022. A statistical comparison was made between the hematological parameters of patients who developed chronic urticaria and those who did not. Neutrophil, lymphocyte, and platelet counts, as well as NLR, PLR, and SII ratios, were used for the comparison. Results: It was observed that acute urticaria progressed to chronic urticaria in 5.8% (n = 23) of the patients. No significant differences in lymphocyte, hemoglobin, and platelet counts were observed between the group progressing to chronic urticaria and the control group (P > 0.05). However, the chronic urticaria group had higher leukocyte and absolute neutrophil counts (P = 0.009 and P < 0.001, respectively). In addition, the NLR was significantly higher in the chronic urticaria group (P = 0.029), whereas no statistically significant difference was observed in the PLR (P = 0.180). The chronic urticaria group had a significantly higher SII than the control group (P = 0.011). Conclusion: Hematological parameters, particularly NLR and SII, may be useful indicators of the transition from acute to chronic urticaria in pediatric patients. The early identification of these markers could help monitor patients and guide treatment decisions. Further comprehensive studies are required to validate these findings.

Association of dietary inflammatory index with immune-inflammatory biomarkers in rheumatoid arthritis patients: results from NHANES 1999-2018.

Background: Synovial inflammation is the main reason for joint damage in patients with rheumatoid arthritis (RA). Diet is recognized as one of the therapeutic strategies to control the inflammatory activity in RA. However, few studies have investigated the association between diet and immune-inflammatory biomarkers in RA patients. Our study aims to examine the correlation between dietary inflammatory potential and systemic immune-inflammation Index (SII), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR) in the RA population. Materials and methods: The National Health and Nutrition Examination Survey (NHANES) was the data source utilized in this study, spanning from 1999 to 2018. The study encompassed 2,500 RA participants in total. The dietary inflammatory potential was calculated by the dietary inflammation index (DII) score based on dietary recall interviews. The generalized multiple linear regression analyses were used to evaluate the relationship between DII and immune-inflammatory markers. Furthermore, subgroup analyses and restricted cubic spline models were performed. Results: After full adjustments, there were significant positive correlations between DII levels and SII/NLR in RA patients (SII, ß: 14.82, 95% CI: 5.14-24.50, p = 0.003; NLR, ß: 0.04, 95% CI: 0.01-0.08, p = 0.005). It was noteworthy that inconsistent results were observed in the association between DII and SII as well as NLR in subgroups of red blood cell levels (Interaction p-value <0.001). Conclusion: Pro-inflammatory dietary status in the RA population is significantly positively correlated with SII and NLR, influenced by variations in red blood cell levels.

Fournier's gangrene originating from the perianal region or the urogenital area: does it make a difference?

OBJECTIVE: Fournier's gangrene (FG) is a rare and serious disorder which is associated with high mortality. In the literature, there is no study evaluating clinician-, patient- and disease-related factors affecting disease outcomes according to aetiological variation in FG. In our study, laboratory results and Uludag Fournier's Gangrene Severity Index (UFGSI) score, clinical characteristics and mortality rates were compared between FG originating from perianal or from urogenital regions. METHOD: Platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) and UFGSI risk scores were calculated in patients with FG at presentation to the emergency department. The patients were assigned to two groups according to FG aetiology. RESULTS: It was observed that the number of debridement interventions and the need for colostomy were significantly greater in the perianal FG group, while the need for flap or reconstruction was significantly (p=0.002) higher in the genitourinary FG group. No significant difference was detected in mortality between groups and the difference in aetiology had no significant effect on the results of the neutrophil-to-lymphocyte ratio, LRINEC or UFGSI scores. CONCLUSION: Laboratory results and UFGSI score were helpful in assessing disease severity independently from aetiology. The higher number of debridement interventions to protect anal function in the perianal group and the greater need for reconstructive surgery in the urogenital group were identified as factors that prolonged length of hospital stay.

Association of neutrophil/lymphocyte and platelet/lymphocyte ratios with inflammation and survival in Mexican patients on chronic hemodialysis.

INTRODUCTION: Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are markers of systemic inflammatory status. The relationship between NLR, PLR, and mortality is controversial among hemodialysis (HD) patients. OBJECTIVE: Evaluate NLR and PLR in the prediction of mortality in chronic HD patients. MATERIALS AND METHODS: We analyzed 130 patients with a follow-up for 66 months. Four groups were established according to NLR-PLR values. Kaplan-Meier curves and Cox proportional hazards analysis were used. RESULTS: NLR-PLR correlated positively with C-reactive protein. Cox regression analysis for overall mortality among the four groups included age (HR 1.027, 95% CI 1.003-1.053) and albumin (HR 0.25, 95% CI 0.073-0.85). For cardiovascular (CV) mortality only pulse pressure differential (PPD) was included (HR 1.033; 95% CI 1.014-1.052). Low NLRs and high PLRs were associated with CV mortality (Log Rank test, p = 0.033). CONCLUSIONS: Low NLRs and high PLRs predict the risk of CV mortality among HD patients.

Evaluation of peripheral inflammatory parameters of cases with suicide attempts.

PURPOSE: The purpose of the present study was to examine the inflammation markers of patients who have attempted suicide by comparing them with those of healthy controls. The leukocyte cell levels, Neutrophil/Lymphocyte Ratios (NLR), Basophil/Lymphocyte Ratios (BLR), Platelet/Lymphocyte Ratios (PLR), Monocyte/Lymphocyte Ratios (MLR), Systemic Inflammation Index (SII), Neutrophil/Albumin Ratios (NAR) values were compared with those of healthy controls. METHOD: A total of 376 people were included in the study (276 patients who attempted suicide, and 100 healthy people (the control group)). The demographic data and laboratory parameters of the participants were analyzed from the hospital automation system. RESULTS: The participants' female/male ratio was 158/118 (42.8%/57.1%) in the group of patients who attempted suicide and 41/59 (41/59%) in the control group. When the distribution of laboratory parameters was evaluated, although the NLR, BLR, NAR, SII, and MLR values, which are indicators of peripheral inflammation, were high in patients who attempted suicide (p = 0.049 for MLR, p = 0.000 for other values), the PLR (p = 0.586) value did not differ significantly between the groups. Patients who had attempted more than one suicide had elevated BLR (p = 0.007), SII (p = 0.003), and NAR (p = 0.003) values. DISCUSSION: Based on the results obtained, it was considered that paying attention to inflammation parameters in patient follow-ups, and monitoring of SII, NLR, BLR, and NAR values of patients who had attempted suicide once would be beneficial in preventing future suicide attempts. These results strengthen the idea that inflammatory processes play roles in the pathophysiology of suicidal behavior. However, further studies are needed to elucidate the complex pathophysiological mechanisms of immune pathways underlying suicidal behavior.

Evaluation of leukocyte ratios as survival prognostic markers in feline retrovirus infections.

The utility of neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR) as prognostic markers in Feline Leukemia Virus (FeLV) and Feline Immunodeficiency Virus (FIV) infections has not yet been investigated. The aim of this study was to investigate these leukocyte ratios in retrovirus-positive cats and to evaluate their prognostic value for survival. This retrospective case-control study included 142 cats, 75 FIV-Antibodies (Ab)-positive, 52 FeLV-Antigen (Ag)-positive, and 15 FIV-Ab+FeLV-Ag-positive, and a control population of 142 retrovirus-negative age-, sex-, and lifestyle-matched cats. Signalment, complete blood count at the time of serological testing, and outcome were recorded. Leukocyte ratios were compared within the same case-control population, among the three retrovirus-seropositive populations, and were related to survival time. No significant difference was found in NLR, MLR, or PLR between FIV-Ab-positive and FIV-Ab+FeLV-Ag-positive cats and their cross-matched controls. In the FeLV-Ag-positive population, MLR was significantly lower than in the control population (0.05 and 0.14, respectively, P=0.0008). No ratio discriminated among the three infectious states. No ratio was significantly different between survivors and non-survivors in the population of FIV-Ab-positive cats. MLR at diagnosis was significantly higher in FeLV-Ag-positive cats that died 1-3 years after diagnosis than in FeLV-Ag-positive cats still alive at 3 years (P=0.0284). None of the three ratios could predict retroviruses-positive cats that would survive to the end of the study. Overall the results indicate that NLR, MLR, and PLR are not significantly different among retrovirus statuses evaluated and had a very limited prognostic value for the survival time in retrovirus-positive cats.