Elevated neutrophil‐to‐lymphocyte ratio but not platelet‐to‐lymphocyte ratio is associated with generalized aggressive periodontitis in a Chinese population

Abstract

Background Host inflammatory mediators are associated with tissue destruction in patients suffering from generalized aggressive periodontitis (GAgP). However, the correlations between neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) with GAgP remain unknown. Methods Periodontal clinical parameters, including probing depth (PD), bleeding index (BI) and attachment loss (AL) were collected from patients with GAgP and healthy controls. Complete blood cells analyses were obtained; further, NLR and PLR were calculated using neutrophil, platelet, and lymphocyte counts. Smooth curve fitting and segmented regression models were used to analyze the roles and predictive value of NLR with GAgP. Results In total, 505 participants from a Chinese population were recruited, including 133 healthy controls and 372 patients with GAgP. Periodontal clinical parameters, NLR, and neutrophil counts were significantly higher in patients with GAgP than the control group. Moreover, NLR was positively correlated with the risk and clinical parameters of GAgP. When NLR < 3, the risk of GAgP increased by 20.6% for each 0.1 increase in NLR, reaching saturation when NLR > 3. An increase in NLR equivalent to 1 was associated with an increase in PD, BI, and AL by 0.41 mm, 0.26, and 0.57 mm, respectively. Notably, PLR did not show obvious correlations with GAgP. Conclusions NLR but not PLR may be a potential marker to identify GAgP in healthy individuals, particularly in a Chinese population.

The clinical association between Periodontitis and COVID-19

“…Serum levels of ferritin, NT-proBNP, neutrophil lymphocyte ratio and troponin have been found to be significantly associated with periodontal disease [36,38,39,41,42]. This association points towards a commonality between periodontal disease and COVID-19-related adverse outcomes.…”

Blood Cell Count Inflammatory Markers as Prognostic Indicators of Periodontitis: A Systematic Review and Meta-Analysis

“…Regarding the selection section of the NOS scale, all the studies used pre-defined, transparent criteria to identify the presence of the disease (chronic periodontitis or aggressive periodontitis) and controls; thus, the case and control definitions were adequate. Nevertheless, the authors of the studies used different criteria to identify the disease according to official classifications (Periodontal Disease Classification, American Association of Periodontology 1999-three studies [ 23 , 25 , 28 ]; Classification of Periodontal and Peri-Implant Diseases and Conditions 2017-four studies [ 1 , 2 , 26 , 27 ]; Center of Disease Control and Prevention, American Academy of Periodontology Periodontal Disease Classification CDC/AAP-one study [ 29 ]), or no specified classification [ 7 , 24 ]. Only two studies (20%) out of ten had clear representativeness of the cases [ 23 , 28 ].…”

“…For the other six, it might be difficult to assess if the selection of controls was correct. Half of the studies enrolled subjects from the department of periodontology [ 1 , 2 , 7 , 23 , 26 ]; the other studies enrolled subjects from the internal medicine [ 28 ] or cardiology departments [ 24 ], or from an electrical company [ 29 ], and in two studies, the population was not stated [ 25 , 27 ].…”

Pretreatment Systemic Immune-Inflammation Index Predict Needs for Teeth Extractions for Locally Advanced Head and Neck Cancer Patients Undergoing Concurrent Chemoradiotherapy

“… 44 In a more recent Chinese study, Lu et al reported that the NLR values, but not PLR, were positively correlated with the risk and clinical parameters of aggressive periodontitis, with the risk of aggressive periodontitis increasing by 20.6% for each 0.1 increase in NLR below NLR<3 values in their healthy control group, reaching saturation when NLR > 3. 45 Torrungruang et al 46 and Acharya et al, 33 on the other hand, reported that both high NLR and PLR indices were robustly linked to severity of chronic periodontitis. Although these studies are fundamentally different from the one presented here, they all indicate a strong link between severe tooth problems and the systemic immune/inflammation response, regardless of the disease type and therapy used.…”