Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in patients with systemic lupus erythematosus and their correlation with activity: A meta-analysis

Zeng, Aiping; Chen, Binxuan; Chen, Ying; Zhou, Renwu

doi:10.1016/j.intimp.2019.105949

Cited by 53 publications

(51 citation statements)

References 19 publications

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“…Recently, higher NLR and PLR are both positively correlated with SLEDAI-2K score and disease activity [23,27,44]. On the other hand, NLR is associated with infection and has been used as an indicator of bacteremia [23,24,28]. Our result showed NLR were associated with both disease are and infection.…”

Section: Discussionsupporting

confidence: 52%

“…Multivariate GEE analysis showed that SDI score, SLEDAI 2K score, NLR, Hb levels, platelet levels, RPR, and C3 levels were independent parameters for predicting SLE activity are (Table 3a). Here we con rmed that NLR, PLR, and RPR is a useful marker for the assessment of disease activity in pediatric SLE patients [23,29].…”

Section: Patient and Clinical Characteristicssupporting

confidence: 59%

“…Previous studies showed that NLR is associated with rheumatoid arthritis and psoriasis. Recently, higher NLR and PLR are both positively correlated with SLEDAI-2K score and disease activity [23,27,44]. On the other hand, NLR is associated with infection and has been used as an indicator of bacteremia [23,24,28].…”

Section: Discussionmentioning

confidence: 99%

“…Based on previous reports [23,[26][27][28][29], data encompassing both clinical and laboratory parameters were collected at each episode according to a standardized clinical protocol (detailed in supplement Table 1). [30,31].…”

Section: Patientsmentioning

confidence: 99%

“…However, most physicians agreed that no single biomarker had su cient predictive value for both events [8,19]. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were signi cantly higher in SLE patients compared with healthy controls and were positively correlated with SLEDAI score [23]. However, the NLR could be a good additive marker for diagnosing infection in patients with SLE [24].…”

Section: Introductionmentioning

confidence: 99%

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Differential Parameters between Activity Flare and Acute Infection in Pediatric Patients with Systemic Lupus Erythematosus

Luo

Yang

Lin

et al. 2020

Preprint

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Background: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease. SLE patients are vulnerable to infections. Infections might mimic and even trigger SLE flares. To distinguish acute infection from activity flare always remains a clinical challenge.We aim to explore the approach to differentiate active infection from disease activity in pediatric SLE patients.Methods: Fifty pediatric SLE patients presenting with 185 clinical episodes were collected.The associations betweenrelevant data encompassing both clinical and laboratory parameters and the outcome groups were analyzed using generalized estimating equations (GEEs)facilitatingthe analysis of data collected in longitudinal and repeated-measures designs.We also used a multinomial logistic regression model for simultaneous prediction of different outcome groups. Finally, we ran the GLIMMIX procedure to track trends of changes in parameters over time.Results: These 185 episodes were divided into 4 outcome groups: infected-active (n=102), infected-inactive (n=11), noninfected-active (n=59), and noninfected-inactive (n=13) episodes. Multivariate GEE analysis showed that SDI, SLEDAI-2K, neutrophil‐to‐lymphocyte ratio (NLR), hemoglobin, platelet, RDW-to-platelet ratio (RPR), and C3 are predictive of flare (combined calculated AUC of 0.8964 and with sensitivity of 82.2 % and specificity of 90.9%). Multivariate GEE analysis showed that SDI, fever temperature, CRP, procalcitonin, lymphocyte percentage, NLR, hemoglobin, and renal score in SLEDAI-2k are predictive of infection (combinedcalculated AUC of 0.7886 and with sensitivity of 63.5% and specificity of 89.2%). We developed regression equations for simultaneous prediction of 4 different outcome groups.We could differentiate noninfected-active from infected-active episodes by different change patterns of ESR, NLR, lymphocyte, C3, and C4 over time.Conclusions: The proposed approach could differentiateflares from infections in pediatric SLE patients. Combination of parameters from four different domains simultaneously, including inflammation (CRP, ESR, PCT), hematology (Lymphocyte percentage, NLR, PLR), complement (C3, C4), and clinical status (SLEDAI, SDI), is effective to make appropriate judgement and treatment decisions.

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Section: Discussionsupporting

confidence: 52%

Section: Patient and Clinical Characteristicssupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Patientsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Differential Parameters between Activity Flare and Acute Infection in Pediatric Patients with Systemic Lupus Erythematosus

Luo

Yang

Lin

et al. 2020

Preprint

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The study of METTL14, ALKBH5, and YTHDF2 in peripheral blood mononuclear cells from systemic lupus erythematosus

Luo

Rao

Zhang

et al. 2020

Molec Gen & Gen Med

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Background This study was aimed to explore the mRNA expression of m6A “writers” (METTL3, MTEEL14, and WTAP), “erasers” (FTO and ALKBH5), and “readers” (YTHDF2) in peripheral blood mononuclear cells (PBMCs) from systemic lupus erythematosus (SLE) patients and investigate the relation between their expressions with clinical features. Methods In all, 54 SLE patients and 42 healthy controls (HC) were included in the current study. Quantitative reverse transcription‐polymerase chain reaction (qRT‐PCR) was used to investigate the mRNA expression of m6A “writers,” “erasers,” and “readers” in PBMCs from SLE patients and HC. Results Decreased mRNA expression of MTEEL14, ALKBH5, and YTHDF2 was observed in SLE patients compared with those in HC (p < .001). The decreased mRNA expression of METTL14 was associated with white blood cell count (WBC) and monocyte count (M), this decreased mRNA expression of ALKBH5 was associated with C‐reactive protein (CRP), neutrophil percentage (N%), lymphocyte percentage (L%), neutrophil–lymphocyte ratio (NLR), complement 3 (C3), and fever, and the decreased mRNA expression of YTHDF2 was associated with L%, NLR, C3, and fever. In addition, there was a positive correlation between mRNA expression of METTL14, ALKBH5, and YTHDF2 in PBMCs from SLE patients. Importantly, logistic regression analysis revealed that decreased mRNA expression of YTHDF2 was a risk factor for SLE. Conclusion Taken all together, our findings suggested decreased YTHDF2 that was associated with disease activity may play an important role in the pathogenesis of SLE, METTL14 and ALKBH5 may be concomitantly decreased.

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Differential approach to peripheral blood cell ratios in patients with systemic lupus erythematosus and various manifestations

2020

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New markers of systemic lupus erythematosus (SLE) activity are under investigation. In recent years, the researchers have been focusing increased attention on the role of haematological indicators in assessing the disease activity. Specifically, neutrophil-, basophil-, eosinophil-, monocyte-and platelet-to-lymphocyte ratios (NLR, BLR, ELR, MLR and PLR) have been considered. The specific objective of this study was to determine the suitability of the haematological markers for the assessment of SLE activity and SLE-related organ damage. This study is a retrospective analysis of 136 patients with SLE (124 women and 12 men) who received chloroquine/hydroxychloroquine (HQ/HCQ) monotherapy or HQ/HCQ therapy combined with low/medium doses of glucocorticoid. All patients were assessed for disease activity using the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) scale. In addition, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) inflammatory parameters were determined in each patient. NLR, BLR, ELR, MLR and PLR were evaluated and correlated with the SLE activity parameters and inflammatory markers. The mean values of the haematological indicators were compared in particular manifestations of SLE-induced organ damage. For numerical variables, descriptive statistics were calculated: median, standard deviation, minimum and maximum values. The Mann-Whitney U test was used for the comparison of continuous variables in the two groups. The Spearman rank correlation test was used to search for any relationships between variables. A p value < 0.05 was considered to be statistically significant. We have found a positive correlation between ELR, MLR and the SLEDAI scale (r = 0.22 and r = 0.27, respectively). NLR, MLR and PLR ratios were significantly correlated with ESR and CRP. Considerably higher NLR values were found in patients with cutaneous and/or mucosal symptoms and with kidney involvement compared to patients without such involvement (4.26 ± 4.2 vs 3.27 ± 2.7; p = 0.05 and 5.45 ± 5.6 vs 3.05 ± 2.0; p < 0.001 respectively). BLR and MLR were significantly higher in patients manifesting symptoms of vasculitis (0.09 ± 0.1 vs 0.02 ± 0.01; p < 0.001 and 3.1 ± 4.2 vs 0.3 ± 0.1; p < 0.001 respectively), arthritis and/or myositis (0.04 ± 0.09 vs 0.02 ± 0.01; p = 0.01 and 1.02 ± 2.6 vs 0.35 ± 0.4; p = 0.01 respectively), whereas elevated ELR ratios were observed in patients with vasculitis (0.4 ± 0.5 vs 0.08 ± 0.06; p < 0.001) compared to patients without such organ involvement. The PLR marker was substantially higher in patients exhibiting haematological disorders in the course of SLE (276.6 ± 226.4 vs 192.6 ± 133.5; p = 0.01). The results indicate that ELR and MLR are effective markers of SLE activity. The haematological indicators may predict SLE-dependent organ damage, particularly cutaneous, mucosal, arthritic, myositic, haematological and kidney involvement.

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Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in patients with systemic lupus erythematosus and their correlation with activity: A meta-analysis

Cited by 53 publications

References 19 publications

Differential Parameters between Activity Flare and Acute Infection in Pediatric Patients with Systemic Lupus Erythematosus

Differential Parameters between Activity Flare and Acute Infection in Pediatric Patients with Systemic Lupus Erythematosus

The study of METTL14, ALKBH5, and YTHDF2 in peripheral blood mononuclear cells from systemic lupus erythematosus

Differential approach to peripheral blood cell ratios in patients with systemic lupus erythematosus and various manifestations

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