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Journal of Diabetes Research 2023Glycated hemoglobin (HbA1c) is a commonly used clinical marker to monitor the control of type 2 diabetes mellitus patients (T2DM). However, it is unable to identify the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Glycated hemoglobin (HbA1c) is a commonly used clinical marker to monitor the control of type 2 diabetes mellitus patients (T2DM). However, it is unable to identify the ongoing inflammatory changes in the body. These factors could be easily identified and monitored by the neutrophil-to-lymphocyte ratio (NLR). Therefore, this study is aimed at investigating the relationship between NLR and glycemic control in T2DM.
METHOD
A comprehensive search of eligible studies was performed in various databases published until July 2021. A random effect model was used to estimate the standardized mean difference (SMD). A metaregression, subgroup, and sensitivity analysis were conducted to search for potential sources of heterogeneity.
RESULT
A total of 13 studies were included in this study. Accordingly, the SMD of the NLR values between the poor and good glycemic control groups was 0.79 (95% CI, 0.46-1.12). Our study also showed that high NLR was significantly associated with poor glycemic control in T2DM patients (OR = 1.50, 95% CI: 1.30-1.93).
CONCLUSION
The results of this study suggest an association between high NLR values and an elevated HbA1C in T2DM patients. Therefore, NLR should be considered a marker of glycemic control in addition to HbA1c in T2DM patients.
Topics: Humans; Diabetes Mellitus, Type 2; Glycated Hemoglobin; Glycemic Control; Neutrophils; Lymphocytes
PubMed: 37305430
DOI: 10.1155/2023/3117396 -
BMC Cardiovascular Disorders Jun 2023This study systematically reviewed the evidence regarding differences in the neutrophil to lymphocyte ratio (NLR) level between hypertensive and normotensive individuals... (Meta-Analysis)
Meta-Analysis
This study systematically reviewed the evidence regarding differences in the neutrophil to lymphocyte ratio (NLR) level between hypertensive and normotensive individuals as well as between patients with dipper and non-dipper hypertension (HTN). PubMed, Scopus, and Web of Science databases were systematically searched up to 20 December 2021. This was done without any limitation with regard to date, publication, or language. Pooled weighted mean differences (WMD) with 95% confidence intervals (95% CI) were reported. We assessed the quality of studies based on the Newcastle-Ottawa Scale (NOS). In total, 21 studies were included in our study. There was a significant increase in NLR levels for the hypertensive group in comparison to the control group (WMD = 0.40, 95%CI = 0.22-0.57, P < 0.0001). In addition, the NLR levels were higher in the non-dipper than in the dipper group (WMD = 0.58, 95%CI = 0.19-0.97, P = 0.003). Our findings showed that hypertensive patients had higher level of NLR than normotensive individuals.
Topics: Humans; Neutrophils; Lymphocytes; Hypertension; Blood Pressure; Blood Pressure Monitoring, Ambulatory
PubMed: 37270484
DOI: 10.1186/s12872-023-03304-w -
Surgical Infections May 2023The aim of this study was to analyze the diagnostic performance of total platelet count (PC), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR)... (Meta-Analysis)
Meta-Analysis
Diagnostic Performance of Total Platelet Count, Platelet-to-Lymphocyte Ratio, and Lymphocyte-to-Monocyte Ratio for Overall and Complicated Pediatric Acute Appendicitis: A Systematic Review and Meta-Analysis.
The aim of this study was to analyze the diagnostic performance of total platelet count (PC), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) in pediatric acute appendicitis (PAA). We conducted a systematic review of the literature in the main databases of medical bibliography. Two independent reviewers selected the articles and extracted relevant data. Methodological quality was assessed using the QUADAS2 index. A synthesis of the results, a standardization of the metrics, and four random effect meta-analyses were performed. Thirteen studies including data from 4,373 participants (2,767 patients with confirmed diagnosis of PAA and 1,606 controls) were included. Five studies compared PC, and the meta-analysis including three of them showed a non-significant mean difference of -34.47 platelets/1 × 10/L (95% confidence interval [CI], -88.10 to 19.16). Seven publications compared PLR and the meta-analysis of those studies showed significant mean differences between patients with PAA and controls (dif: 49.84; 95% CI, 25.82-73.85) as well as between patients with complicated and uncomplicated PAA (dif: 49.42; 95% CI, 25.47-73.37). Four studies compared LMR and the meta-analysis including 3 of them showed a non-significant mean difference of -1.88 (95% CI, -3.86 to 0.10). Although existing evidence is heterogeneous and limited, PLR appears to be a promising biomarker for the diagnosis of PAA and for the discrimination between complicated and uncomplicated PAA. Our results do not support the use of PC or LMR as biomarkers in PAA.
Topics: Humans; Child; Platelet Count; Monocytes; Appendicitis; Blood Platelets; Lymphocytes; Biomarkers; Neutrophils; Retrospective Studies
PubMed: 37022749
DOI: 10.1089/sur.2023.013 -
Cardiology in the Young Aug 2023Kawasaki disease is a vasculitis that can lead to cardiac complications, including coronary artery disease and cardiogenic shock. Various scoring systems have been... (Review)
Review
BACKGROUND
Kawasaki disease is a vasculitis that can lead to cardiac complications, including coronary artery disease and cardiogenic shock. Various scoring systems have been developed to determine those that will be refractory to routine intravenous immunoglobulin therapy or develop coronary artery disease. The objective of this study was to determine if the neutrophil-lymphocyte ratio could predict refractory disease and coronary artery lesions in patients with Kawasaki disease.
METHODS
A systematic review of the literature was performed to identify manuscripts describing comparisons of neutrophil-lymphocyte ratio between those who had refractory disease and those who did not, and between those who developed coronary artery lesions and those who did not. Mean difference was compared between groups. Areas under the curve were utilised to determine the pooled area under the curve.
RESULTS
12 studies with 5593 patients were included in the final analyses of neutrophil-lymphocyte ratio for the prediction of refractory disease. Neutrophil-lymphocyte ratio before therapy was higher in refractory disease with a mean difference of 2.55 (p < 0.01) and pooled area under the curve of 0.724. Neutrophil-lymphocyte ratio after therapy was higher in refractory disease with a mean difference of 1.42 (p < 0.01) and pooled area under the curve for of 0.803. Five studies with 1690 patients were included in the final analyses of neutrophil-lymphocyte ratio for the prediction of coronary artery lesions. Neutrophil-lymphocyte ratio before therapy was higher in coronary artery lesions with a mean difference of 0.65 (p < 0.01).
CONCLUSION
The use of neutrophil-lymphocyte ratio may help physicians in the identification of patients at risk of refractory disease and coronary artery lesions in patients with Kawasaki disease.
Topics: Humans; Infant; Coronary Artery Disease; Immunoglobulins, Intravenous; Lymphocytes; Mucocutaneous Lymph Node Syndrome; Neutrophils; Retrospective Studies
PubMed: 37012661
DOI: 10.1017/S1047951123000653 -
Clinical and Experimental Dental... Jun 2023Macrophages are among the first cells to interact with the dental implant surface and are critical regulators for controlling the immune response toward biomaterials.... (Review)
Review
A systematic review comparing the macrophage inflammatory response to hydrophobic and hydrophilic sandblasted large grit, acid-etched titanium or titanium-zirconium surfaces during in vitro studies.
OBJECTIVES
Macrophages are among the first cells to interact with the dental implant surface and are critical regulators for controlling the immune response toward biomaterials. Macrophages can polarize between two main phenotypes: proinflammatory M1 macrophages and anti-inflammatory M2 macrophages. This systematic review aims to determine if a differing macrophage inflammatory response exists on hydrophilic sandblasted large grit, acid-etched (SLActive) surfaces compared to sandblasted large grit, acid-etched (SLA) titanium or titanium-zirconium surfaces during in vitro studies. MATERIAL AND METHODS: A systematic search of three electronic databases, Medline, DOSS (Dentistry and Oral Sciences Source), and WoS (Web of Science), was performed. Only in vitro studies were included in this systematic review. The electronic search was supplemented with a search of the references. Genetic expression and production of proinflammatory and anti-inflammatory proteins were assessed. The synthesis of quantitative data was completed by narrative synthesis.
RESULTS
A total of 906 studies were found with the systematic search. Eight studies remained after the application of inclusion and exclusion criteria. Six studies used murine macrophages, while two used human macrophages. Discs were used in six studies, while dental implants were used in the remaining two studies. Genetic expression and cytokine production of proinflammatory cytokines on SLActive surfaces were reduced compared to SLA. Anti-inflammatory genetic expression and cytokine production was increased on SLActive surfaces. The overall quality of the included studies was low to moderate.
CONCLUSIONS
SLActive surfaces modulate macrophages to reduce proinflammatory and increase anti-inflammatory gene expression and cytokine production compared to SLA surfaces. The in vitro nature of the included studies does not replicate the in vivo healing cascade. Further in vivo studies are required to assess the macrophage response toward SLActive implant surfaces compared to SLA surfaces.
Topics: Mice; Humans; Animals; Dental Implants; Titanium; Zirconium; Surface Properties; Macrophages; Cytokines; Anti-Inflammatory Agents
PubMed: 36991526
DOI: 10.1002/cre2.730 -
Monocyte distribution width as a screening tool for COVID-19: A systematic review and meta-analysis.International Journal of Laboratory... Oct 2023
Meta-Analysis
Topics: Humans; COVID-19; Monocytes; SARS-CoV-2; Research Design
PubMed: 36990687
DOI: 10.1111/ijlh.14070 -
Expert Review of Anticancer Therapy Apr 2023Neutrophil-to-lymphocyte ratio is suggested as a prognostic and predictive factor for patients with rectal cancer. The purpose of the current meta-analysis is to... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Neutrophil-to-lymphocyte ratio is suggested as a prognostic and predictive factor for patients with rectal cancer. The purpose of the current meta-analysis is to evaluate the relationship between neutrophil-lymphocyte ratio (NLR) and the outcome of patients, with rectal cancer receiving chemoradiation and surgery.
METHODS
A systematic review on two databases and a selection of studies were done. Thereafter, two meta-analyses were performed, evaluating the relationship of baseline NLR with overall survival (OS) and disease-free survival (DFS).
RESULTS
Thirty-one retrospective studies were selected. Twenty-six studies have documented a significant relationship of NLR to OS (HR 2.05, CI 1.66-2.53), whereas 23 studies have reported a weaker but significant relationship of NLR to DFS (HR 1.78, CI 1.49-2.12). Among the moderator variables, a possible effect for age and sex on the relationship of NLR with DFS is suggested.
CONCLUSIONS
Baseline NLR >3 is a simple and reproducible prognostic factor, with a more consistent effect in the elderly. It could be a reliable variable to support clinicians in defining personalized treatment strategies, even though a standardization of the cutoff and a better characterization among microsatellite unstable rectal tumors are necessary.
Topics: Humans; Aged; Neutrophils; Neoadjuvant Therapy; Retrospective Studies; Lymphocytes; Rectal Neoplasms; Prognosis; Chemoradiotherapy, Adjuvant
PubMed: 36970998
DOI: 10.1080/14737140.2023.2194635 -
Critical Care Medicine May 2023We performed a systemic review and meta-analysis to evaluate the diagnostic accuracy of monocyte distribution width (MDW) and to compare with procalcitonin and... (Comparative Study)
Comparative Study Meta-Analysis
OBJECTIVES
We performed a systemic review and meta-analysis to evaluate the diagnostic accuracy of monocyte distribution width (MDW) and to compare with procalcitonin and C-reactive protein (CRP), in adult patients with sepsis.
DATA SOURCES
A systematic literature search was performed in PubMed, Embase, and the Cochrane Library to identify all relevant diagnostic accuracy studies published before October 1, 2022.
STUDY SELECTION
Original articles reporting the diagnostic accuracy of MDW for sepsis detection with the Sepsis-2 or Sepsis-3 criteria were included.
DATA EXTRACTION
Study data were abstracted by two independent reviewers using a standardized data extraction form.
DATA SYNTHESIS
Eighteen studies were included in the meta-analysis. The pooled sensitivity and specificity of MDW were 84% (95% CI [79-88%]) and 68% (95% CI [60-75%]). The estimated diagnostic odds ratio and the area under the summary receiver operating characteristic curve (SROC) were 11.11 (95% CI [7.36-16.77]) and 0.85 (95% CI [0.81-0.89]). Significant heterogeneity was observed among the included studies. Eight studies compared the diagnostic accuracies of MDW and procalcitonin, and five studies compared the diagnostic accuracies of MDW and CRP. For MDW versus procalcitonin, the area under the SROC was similar (0.88, CI = 0.84-0.93 vs 0.82, CI = 0.76-0.88). For MDW versus CRP, the area under the SROC was similar (0.88, CI = 0.83-0.93 vs 0.86, CI = 0.78-0.95).
CONCLUSIONS
The results of the meta-analysis indicate that MDW is a reliable diagnostic biomarker for sepsis as procalcitonin and CRP. Further studies investigating the combination of MDW and other biomarkers are advisable to increase the accuracy in sepsis detection.
Topics: Adult; Humans; Biomarkers; C-Reactive Protein; Monocytes; Procalcitonin; Sepsis
PubMed: 36877030
DOI: 10.1097/CCM.0000000000005820 -
Journal of Immunology Research 2023Spontaneous preterm birth is one of the most common pregnancy complications in obstetric clinical practice, and its etiology is complex. The problems of low survival and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Spontaneous preterm birth is one of the most common pregnancy complications in obstetric clinical practice, and its etiology is complex. The problems of low survival and high morbidity rates of premature infants need to be solved urgently. The platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR) are two novel biomarkers of inflammation, and several studies have linked PLR and LMR to spontaneous preterm birth. These systematic review and meta-analysis are aimed at analyzing the relationship between PLR and LMR in patients with spontaneous preterm birth to provide new ideas for the early prevention and treatment of spontaneous preterm births.
METHODS
Cochrane Library, EMBASE, PubMed, and China National Knowledge Infrastructure databases were inspected to gather PLR and LMR in patients with spontaneous preterm birth, all from the database to February 2022. Interstudy heterogeneity was evaluated using Cochran's test and statistic. Differences in PLR and LMR between patients with spontaneous preterm birth and full-term controls were evaluated by computing standardized mean differences and 95% confidence intervals. Publication bias and sensitivity analyses were also performed.
RESULTS
Nine studies were included in the meta-analysis based on the inclusion and exclusion criteria. The meta-analysis showed that serum PLR values were remarkably larger for patients with spontaneous preterm birth than for full-term controls (SMD = 0.49, 95% CI: 0.13 to 0.84, = 0.007), whereas the difference between serum LMR in patients with spontaneous preterm birth and full-term controls was not statistically significant (SMD: 0.35, 95% CI: -0.18, 0.88, = 0.199). The results of Begg's and Egger's tests revealed that the publication bias of the meta-analysis was not significant. The outcomes of the sensitivity analysis showed that the individual studies did not influence the meta-analysis results.
CONCLUSIONS
Current evidence shows that PLR is strongly associated with spontaneous preterm birth, whereas LMR is not. PLR has a certain clinical value in diagnosing and treating spontaneous preterm births, and our research will provide strong theoretical support for clinical work. In the future, it will be necessary to further explore the reasons for the increased PLR in the serum of patients with spontaneous preterm birth and other mechanisms inducing spontaneous preterm birth.
Topics: Infant, Newborn; Pregnancy; Female; Humans; Monocytes; Premature Birth; Lymphocytes; Blood Platelets; Biomarkers
PubMed: 36814523
DOI: 10.1155/2023/6841344 -
BMC Anesthesiology Feb 2023In this systematic review and meta-analysis, we aim to analyze the current literature to evaluate neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
In this systematic review and meta-analysis, we aim to analyze the current literature to evaluate neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) values among critically ill patients who develop delirium as compared to those who do not.
METHODS
PubMed, Web of Science, and Scopus were used to conduct a systematic search for relevant publications published before June 12, 2022. The Newcastle-Ottawa scale was used for quality assessment. Because a significant level of heterogeneity was found, we used the random-effects model to generate pooled effects.
RESULTS
Twenty-four studies including 11,579 critically ill patients, of whom 2439 were diagnosed with delirium, were included in our meta-analysis. Compared with the non-delirious group, the delirious group's NLR levels were significantly higher (WMD = 2.14; CI 95% = 1.48-2.80, p < 0.01). In the subgroup analysis according to the type of critical condition, the NLR levels in patients of delirious group were significantly more than those of non-delirious group in studies on POD, PSD and PCD (WMD = 1.14, CI 95% = 0.38-1.91, p < 0.01, WMD = 1.38, CI 95% = 1.04-1.72, p < 0.001, and WMD = 4.22, CI 95% = 3.47-4.98, p < 0.001, respectively). However, compared with the non-delirious group, the delirious group's PLR levels were not significantly different (WMD = 1.74; CI 95% = -12.39-15.86, p = 0.80).
CONCLUSION
Our findings support NLR to be a promising biomarker that can be readily integrated into clinical settings to aid in the prediction and prevention of delirium.
Topics: Humans; Prognosis; Neutrophils; Critical Illness; Lymphocytes; Delirium
PubMed: 36803215
DOI: 10.1186/s12871-023-01997-2