C-reactive protein to lymphocyte count ratio is a promising novel marker in hepatitis C infection: the clear hep-c study

Abstract

OBJECTIVE: Chronic hepatitis C (CHC) is one of the most important health problems affecting the significant rate of world population and it may lead to cirrhosis and hepatocellular carcinoma. C-reactive protein to lymphocyte count ratio (CLR) is used in estimating inflammatory burden. Therefore, this study aimed to compare CLR values between CHC patients and healthy controls and between CHC patients with and without fibrosis. METHODS: Patients with CHC infection who visited outpatient and inpatient internal medicine clinics of our institution between January 2021 and December 2021 were enrolled to this retrospective study. CLR of the patients with CHC and healthy controls were compared. We further compared CLR of CHC patients with and without fibrosis. RESULTS: Median CLR of CHC and control subjects was 2.61 (5.13%) and 0.31 (0.37%), respectively. CLR of the CHC group was significantly increased compared to the CLR of the controls (p<0.001). There was a significant positive correlation between CLR and APRI score (r=0.15, p=0.04). The sensitivity and specificity of CLR in determining CHC above 0.58% level were 84% and 82%, respectively (AUC: 0.884, p<0.001, 95%CI 0.84-0.93). In subgroup analysis, CLR was 3.97 (6.6%) for CHC patients with fibrosis and 1.7 (4.4%) for CHC subjects without fibrosis (p=0.001). CONCLUSIONS: Increased CLR in patients with CHC may be an alarming finding of liver fibrosis, as CLR is associated with both CHC and hepatic fibrosis.

Associations Between Inflammatory Mediators and Bone Outcomes in Postmenopausal Women: A Cross-Sectional Analysis of Baseline Data from the Prune Study

“…A major strength of our cross-sectional investigation is the assessment of the associations between inflammatory mediators and bone health across various estimates of bone strength and geometry in several sites within the hip and appendicular skeleton, in addition to bone density and bone turnover markers. Biomarkers of inflammation, including acute-phase proteins such as hs-CRP, activated monocytes and lymphocytes, cytokines, chemokines, and their derived immune–inflammatory indices are not only linked to acute 95 and chronic infection 96 but are also involved in the etiology of chronic disease, including cardiovascular disease, cancer, type 2 diabetes 97 and related complications such as diabetic nephropathy 98 and thyroiditis. 99 Inflammation also contributes to chronic bone diseases, such as rheumatoid arthritis and osteoporosis.…”

“Lymphocyte * Neutrophil” count decreased in SARS‐CoV‐2 Omicron patients in Shanghai with no significant change in CRP and SAA

“…It is often markedly elevated for 6 ~ 8 h in response to tissue injury or inflammation 23 . It has been widely used in clinic, for example, the increase in CLR (C‐reactive protein to lmyphosphate count ratio) is specific for the diagnosis of thyroiditis and hepatitis 7,8 . CAR (C‐reactive protein to serum albumin ratio) has high sensitivity and specificity in the diagnosis of diabetes nephropathy 6 .…”

“… 23 It has been widely used in clinic, for example, the increase in CLR (C‐reactive protein to lmyphosphate count ratio) is specific for the diagnosis of thyroiditis and hepatitis. 7 , 8 CAR (C‐reactive protein to serum albumin ratio) has high sensitivity and specificity in the diagnosis of diabetes nephropathy. 6 CRP has been suggested to be associated with respiratory function (PaO 2 /FiO 2 ), is a predictor of respiratory failure 24 , and it's elevation is widely used as an inflammatory factor in SARS‐CoV‐2 infection.…”

“…Neutrophil and lymphocyte‐based indexes have been proposed as novel inflammatory markers in various clinical diseases including irritable bowel disease, 2 COVID‐19 infection, 3 cardiac conditions, 4 and thyroiditis. 5 In addition, CRP‐based markers are recognized as predictor of inflammation in diabetic nephropathy, 6 in hepatitis, 7 thyroiditis, 8 and in autoimmune liver conditions. 9 Thus, it can be hypothesized that LYM * NEU and CRP can be associated with SARS‐CoV‐2 infection with Omicron variant.…”

CRP as a potential predictor of outcome in acute ischemic stroke

“…Plasma C-reactive protein (CRP) is predominantly synthesized by the liver after tissue damage and is a sensitive marker of inflammation (8). According to previous research, CRP-based inflammatory markers were associated with various inflammatory conditions, such as diabetic nephropathy (9), subacute thyroiditis (10) and hepatitis (11). As stroke is also associated with inflammation, it is worthwhile studying CRP in subjects who have suffered a stroke.…”