Background Inflammatory markers like interleukin-1, 6, and 8, transforming growth factor-β (TGF-β)1, and tumor necrosis factor-α have been found to be associated with diabetic nephropathy (DN), indicating that its pathogenesis may be inflammatory. These inflammatory markers are not routinely used, so, creating the need for easily and routinely done markers aim to enhance the prognostic process of diabetic microvascular complications. Lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) can be routinely assessed, in addition to being considered as predictors for the survival of patients in renal diseases and malignancies. Aim The aim was to evaluate the prognostic value of LMR in DN of type 2 diabetes mellitus, and to compare it with other ratios: NLR and PLR. Patients and methods A case–control study including 100 type 2 diabetes mellitus patients and 25 apparently healthy controls. It was carried out at the inpatient and outpatient clinics, Internal Medicine Department, Al-Azhar University Hospital, New Damietta. Three groups were formed according to urinary albumin-to-creatinine ratio; group I, type 2 diabetics with normoalbuminuria, group II, type 2 diabetics with increased albuminuria, with further division into group IIA: with microalbuminuria/group IIB: macroalbuminuria or overt DN, and group III: controls. Full history, clinical examination, and laboratory tests: urinary albumin-to-creatinine ratio and complete urine analysis, complete blood count with assessment of LMR, NLR, and PLR, beside, blood sugar, HbA1c, renal function with assessment of estimated glomerular filtration rate, liver function, abdominal ultrasonography, fundus examination, and ECG were done for all the participants. Results The LMR mean was 2.4/2.8/3.2/2.1 in group I/IIA/IIB/III, respectively, showing the increasing ratios in parallel with the progression of DN severity and albuminuria through the groups, with the highest ratios in group IIB of overt DN. The NLR mean was 1.8/2.9/3.7/1.2 and the PLR mean was 175, 8/249, 2/277, 3/108, 3 in the corresponding group. Receiver operating characteristic curve analysis for ratios between groups I and IIA demonstrated that with a best cutoff point of 2.66 for the LMR, the sensitivity was 44%, the specificity: 92% (the ability of the LMR to predict DN risk); 2.2 for the NLR, the sensitivity: 84%, the specificity: 98%; 207 for the PLR, the sensitivity: 72%, and the specificity: 80%. So, in predicting the DN risk, NLR came first as regards the specificity followed by LMR and then PLR, but followed by PLR and then LMR as regards the sensitivity. Conclusion LMR may be considered as a surrogate inflammatory marker for DN in early stages and in between stages, but it is not better than NLR as a screening tool for DN diagnosis.
Background Atherosclerosis is an inflammatory reaction of the vessel wall. Emphysema may induce systemic inflammation, part of which may be the development or progression of atherosclerosis. So, the relationship between emphysema and atherosclerosis, whether both are due to the same causative agent and pathogenesis or emphysema led to atherosclerosis, is still not clearly understood. So, the aim of this work is to study the relationship between carotid atherosclerosis versus pulmonary emphysema extent and airflow obstruction. Results Cigarette smoking index was higher in patients than controls. According to FEV1%, patients were classified into: GOLD 1 (mild): FEV1 ≥ 80% predicted, GOLD 2 (moderate): 50% ≤ FEV1 < 80% predicted, GOLD 3 (severe):30% ≤ FEV1 < 50% predicted, and GOLD 4 (very severe): FEV1 < 30% predicted. There was a significant difference between the studied groups as regard to ABG parameters. Emphysema score showed a positive correlation with thrombus size, plaque size, and stenosis percent. Approximately 2/3 of patients had atherosclerotic changes and the other 1/3 had increased IMT. GOLD staging, also, correlated with thrombus size and stenosis percent. So, there was a strong positive correlation between both emphysema score and GOLD staging and carotid atherosclerosis. Conclusion The relationship between emphysema and atherosclerosis is suggested to be the chronic inflammatory reaction (against the same risk factor) based on the positive correlation between carotid atherosclerosis versus emphysema score and GOLD staging. The inherence of emphysema and atherosclerosis may be considered a syndrome. If so, targeting the same pathogenic mechanism will be valuable for their control.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.