Significance of Neutrophil to Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) in Diabetic Foot Ulcer and Potential New Therapeutic Targets

Şerban, Dragoş; Παπάνας, Νικόλαος; Dascălu, Ana Maria; Kempler, Péter; Rizvi, Ali A.; Rizzo, Manfredi; Tudor, Corneliu; Tudosie, M; Tănăsescu, Denisa; Stoian, Anca Pantea; Gouveri, Evanthia; Costea, Daniel Ovidiu

doi:10.1177/15347346211057742

Cited by 30 publications

(27 citation statements)

References 87 publications

(174 reference statements)

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“…The neutrophil to lymphocyte (NLR) and platelet to lymphocyte (PLR) ratios are useful, inexpensive and readily available predictive biomarkers for several inflammatory, autoimmune, infectious and cardiovascular diseases and various types of cancer (12)(13)(14)(15)(16)(17), all of which are potential complications associated with space missions (1,2,18,19). Interestingly, a recent study suggested NLR as a biomarker for future inflight immune health monitoring (20).…”

Section: Introductionmentioning

confidence: 99%

Long-duration head-down tilt bed rest confirms the relevance of the neutrophil to lymphocyte ratio and suggests coupling it with the platelet to lymphocyte ratio to monitor the immune health of astronauts

et al. 2022

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The identification of safe and easily-determined-inflight biomarkers to monitor the immune system of astronauts is mandatory to ensure their well-being and the success of the missions. In this report, we evaluated the relevance of two biomarkers whose determination could be easily implemented in a spacecraft in the near future by using bedridden volunteers as a ground-based model of the microgravity of spaceflight. Our data confirm the relevance of the neutrophil to lymphocyte ratio (NLR) and suggest platelet to lymphocyte ratio (PLR) monitoring to assess long-lasting immune diseases. We recommend coupling these ratios to other biomarkers, such as the quantification of cytokines and viral load measurements, to efficiently detect immune dysfunction, determine when countermeasures should be applied to promote immune recovery, prevent the development of disease, and track responses to treatment.

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Section: Introductionmentioning

confidence: 99%

Long-duration head-down tilt bed rest confirms the relevance of the neutrophil to lymphocyte ratio and suggests coupling it with the platelet to lymphocyte ratio to monitor the immune health of astronauts

et al. 2022

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“…Several studies have revealed that ESR is the most useful marker for bone infection, except that it shows an opposite trend [ 35 , 36 ]. Similarly, Serban et al [ 37 ] found that elevated NLR is correlated with OM in DFU infections. The negative correlation between ESR, NLR, and OM in our study, which is inconsistent with previous results, should thus be evaluated further.…”

Section: Discussionmentioning

confidence: 89%

Classification Model for Diabetic Foot, Necrotizing Fasciitis, and Osteomyelitis

Kim

Yoo

Lee

et al. 2022

Biology

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Diabetic foot ulcers (DFUs) and their life-threatening complications, such as necrotizing fasciitis (NF) and osteomyelitis (OM), increase the healthcare cost, morbidity and mortality in patients with diabetes mellitus. While the early recognition of these complications could improve the clinical outcome of diabetic patients, it is not straightforward to achieve in the usual clinical settings. In this study, we proposed a classification model for diabetic foot, NF and OM. To select features for the classification model, multidisciplinary teams were organized and data were collected based on a literature search and automatic platform. A dataset of 1581 patients (728 diabetic foot, 76 NF, and 777 OM) was divided into training and validation datasets at a ratio of 7:3 to be analyzed. The final prediction models based on training dataset exhibited areas under the receiver operating curve (AUC) of the 0.80 and 0.73 for NF model and OM model, respectively, in validation sets. In conclusion, our classification models for NF and OM showed remarkable discriminatory power and easy applicability in patients with DFU.

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“…Most patients admitted to our hospital had infected lesions (35.5%). The majority also had other complications of diabetes, such as nephropathy (17.1%), retinopathy (19.9%), and heart disease (63.3%); all of these complications represent risk factors for the appearance of diabetic foot lesions [ 41 , 42 ].…”

Section: Discussionmentioning

confidence: 99%

The Outcome of Surgical Treatment for the Neuropathic Diabetic Foot Lesions—A Single-Center Study

Bobircă

Smarandache

Bobircă

et al. 2022

Life

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The prevalence of diabetic foot complications is continuously increasing as diabetes has become one of the most important “epidemics” of our time. The main objective of this study was to describe the appropriate surgical intervention for the complicated neuropathic diabetic foot; the secondary goal was to find the risk factors associated with minor/major amputation and good or adverse surgical outcomes. This is an observational, retrospective study conducted between 1 January 2018 and 31 December 2019, which included 251 patients from the General Surgery Department at the Dr I. Cantacuzino Clinical Hospital in Bucharest with type II diabetes mellitus and neuropathic diabetic foot complications. The surgical conditions identified at admission were the following: osteitis (38.6%), infected foot ulcer (27.5%), gangrene (20.7%), infected Charcot foot (3.6%), non-healing wound (3.6%), necrosis (3.2%), and granulated wound (2.8%). We found that a minor surgical procedure (transmetatarsal amputation of the toe and debridement) was performed in 85.8% of cases, and only 14.2% needed major amputations. Osteitis was mainly associated with minor surgery (p = 0.001), while the gangrene and the infected Charcot foot were predictable for major amputation, with OR = 2.230, 95% CI (1.024–4.857) and OR = 5.316, 95% CI (1.354–20.877), respectively. Admission anemia and diabetic nephropathy were predictive of a major therapeutical approach, with p = 0.011, OR = 2.975, 95% CI (1.244–8.116) and p = 0.001, OR = 3.565, 95% CI (1.623–7.832), respectively. All the major amputations had a good outcome, while only several minor surgeries were interpreted as the adverse outcome (n = 24). Osteitis (45.8%) and admission anemia (79.2%) were more frequently associated with adverse outcomes, with p = 0.447 and p = 0.054, respectively. The complicated neuropathic diabetic foot requires a surgical procedure mainly associated with a good outcome.

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Significance of Neutrophil to Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) in Diabetic Foot Ulcer and Potential New Therapeutic Targets

Cited by 30 publications

References 87 publications

Long-duration head-down tilt bed rest confirms the relevance of the neutrophil to lymphocyte ratio and suggests coupling it with the platelet to lymphocyte ratio to monitor the immune health of astronauts

Long-duration head-down tilt bed rest confirms the relevance of the neutrophil to lymphocyte ratio and suggests coupling it with the platelet to lymphocyte ratio to monitor the immune health of astronauts

Classification Model for Diabetic Foot, Necrotizing Fasciitis, and Osteomyelitis

The Outcome of Surgical Treatment for the Neuropathic Diabetic Foot Lesions—A Single-Center Study

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