Parkinson’s disease(PD)is a common neurodegenerative disorder with increasing incidence and disability rates globally,placing a heavy burden on patients and their families.In the prodromal phase of PD,nonmotor sympto...Parkinson’s disease(PD)is a common neurodegenerative disorder with increasing incidence and disability rates globally,placing a heavy burden on patients and their families.In the prodromal phase of PD,nonmotor symptoms,particularly depression and sleep disorders,are frequent,with profound effects on disease progression and patient quality of life.Emerging research highlights the critical role of inflammatory markers-including interleukins and tumor necrosis factor-in the pathogenesis of prodromal PD.These inflammatory mediators participate in neurodegenerative processes and may induce or exacerbate depressive symptoms and sleep disorders by disrupting the function of the hypothala-micpituitary-adrenal axis and affecting neurotransmitter,including serotonin,metabolism.Understanding their correlations with nonmotor symptoms in prodromal PD remains incomplete,limiting our ability to develop targeted interventions.This comprehensive review aims to investigate the specific correlations between inflammatory markers and nonmotor symptoms-particularly depression and sleep disorders-in prodromal PD.The findings could have important practical applications,potentially leading to the development of new diagnostic tools and therapeutic strategies for managing PD.By identifying and understanding these correlations,healthcare providers may better predict disease progression and implement more effective treatments for nonmotor symptoms in PD.展开更多
Background:Diabetes mellitus(DM)is a prevalent chronic metabolic condition characterized by high blood sugar levels,resulting from insufficient insulin production or ineffective insulin use,posing substantial global h...Background:Diabetes mellitus(DM)is a prevalent chronic metabolic condition characterized by high blood sugar levels,resulting from insufficient insulin production or ineffective insulin use,posing substantial global health issues.Research on the relationship between glycemic status and the ratio of neutrophils to lymphocytes(NLR)and monocytes to lymphocytes(MLR)is limited.This study aimed to fill these knowledge gaps by examining the connection between DM and inflammatory markers within the Asir region.Methods:Data from 3545 participants were retrospectively analyzed.The dataset,gathered between 2021 and 2023,comprises 38 laboratory tests obtained from the Future Lab Pioneer database.The study's inclusion criteria focused on diabetes profile tests(glycated hemoglobin[HbA1c]and fasting blood glucose[FBG])and manually computed inflammatory markers(NLR and MLR),which were stratified by age and sex.Results:This study demonstrated significant differences in NLR levels compared with FBG levels across all adult age groups and adult female participants(p<0.0001),as well as among all elderly age groups(p=0.0006)and elderly women(p=0.01).MLR levels were significant in all adult age groups(p=0.04)and in adult women(p=0.02).When NLR and MLR were compared to HbA1c levels,a significant difference in the mean NLR was found in adult women(p=0.005).Additionally,the mean MLR levels were significant in all adult age groups(p=0.04)and adult women(p=0.02).Conclusion:Although a larger sample size is necessary for this research,the results indicate that NLR and MLR could serve as valuable indicators for evaluating inflammation in people with disrupted glucose metabolism,particularly in adult and female populations.展开更多
BACKGROUND Gastric cancer is a major global health concern,often diagnosed at advanced stages,leading to poor prognosis.Proximal and distal gastric cancers exhibit distinct clinicopathological features.AIM To investig...BACKGROUND Gastric cancer is a major global health concern,often diagnosed at advanced stages,leading to poor prognosis.Proximal and distal gastric cancers exhibit distinct clinicopathological features.AIM To investigate the diagnostic value of hematological and inflammatory markers in differentiating proximal and distal gastric cancers and to evaluate their association with clinical outcomes.METHODS A retrospective cohort study was conducted on 150 patients diagnosed with gastric adenocarcinoma through histopathological analysis.Patients were categorized into proximal gastric cancer and distal gastric cancer groups.Laboratory parameters were analyzed.RESULTS Of the 150 patients,84 had proximal gastric cancer and 66 had distal gastric cancer.Dysphagia was significantly more common in the proximal gastric cancer group,while anemia and higher platelet-to-lymphocyte ratio values were observed in the distal gastric cancer group(P=0.031).Tumor stage and neutrophil-to-lymphocyte ratio emerged as independent predictors of all-cause mortality.No significant differences were found in other laboratory or biochemical parameters between the groups.CONCLUSION Proximal and distal gastric cancers demonstrate distinct clinical and laboratory profiles.The platelet-to-lymphocyte ratio may serve as a valuable marker in differentiating cancer localization,while the neutrophil-to-lymphocyte ratio is a prognostic indicator for mortality.These findings highlight the potential of hematological markers in optimizing diagnosis and treatment strategies for gastric cancer.展开更多
BACKGROUND Obesity in children and adolescents is a serious problem,and the efficacy of exercise therapy for these patients is controversial.AIM To assess the efficacy of exercise training on overweight and obese chil...BACKGROUND Obesity in children and adolescents is a serious problem,and the efficacy of exercise therapy for these patients is controversial.AIM To assess the efficacy of exercise training on overweight and obese children based on glucose metabolism indicators and inflammatory markers.METHODS The PubMed,Web of Science,and Embase databases were searched for randomized controlled trials related to exercise training and obese children until October 2023.The meta-analysis was conducted using RevMan 5.3 software to evaluate the efficacy of exercise therapy on glucose metabolism indicators and inflammatory markers in obese children.RESULTS In total,1010 patients from 28 studies were included.Exercise therapy reduced the levels of fasting blood glucose(FBG)[standardized mean difference(SMD):-0.78;95%confidence interval(CI):-1.24 to-0.32,P=0.0008],fasting insulin(FINS)(SMD:-1.55;95%CI:-2.12 to-0.98,P<0.00001),homeostatic model assessment for insulin resistance(HOMA-IR)(SMD:-1.58;95%CI:-2.20 to-0.97,P<0.00001),interleukin-6(IL-6)(SMD:-1.31;95%CI:-2.07 to-0.55,P=0.0007),C-reactive protein(CRP)(SMD:-0.64;95%CI:-1.21 to-0.08,P=0.03),and leptin(SMD:-3.43;95%CI:-5.82 to-1.05,P=0.005)in overweight and obese children.Exercise training increased adiponectin levels(SMD:1.24;95%CI:0.30 to 2.18,P=0.01)but did not improve tumor necrosis factor-alpha(TNF-α)levels(SMD:-0.80;95%CI:-1.77 to 0.18,P=0.11).CONCLUSION In summary,exercise therapy improves glucose metabolism by reducing levels of FBG,FINS,HOMA-IR,as well as improves inflammatory status by reducing levels of IL-6,CRP,leptin,and increasing levels of adiponectin in overweight and obese children.There was no statistically significant effect between exercise training and levels of TNF-α.Additional long-term trials should be conducted to explore this therapeutic perspective and confirm these results.展开更多
Heart failure is common in adult population,accounting for substantial morbidity and mortality worldwide.The main risk factors for heart failure are coronary artery disease,hypertension,obesity,diabetes mellitus,chron...Heart failure is common in adult population,accounting for substantial morbidity and mortality worldwide.The main risk factors for heart failure are coronary artery disease,hypertension,obesity,diabetes mellitus,chronic pulmonary diseases,family history of cardiovascular diseases,cardiotoxic therapy.The main factor associated with poor outcome of these patients is constant progression of heart failure.In the current review we present evidence on the role of established and candidate neurohumoral biomarkers for heart failure progression management and diagnostics.A growing number of biomarkers have been proposed as potentially useful in heart failure patients,but not one of them still resembles the characteristics of the"ideal biomarker."A single marker will hardly perform well for screening,diagnostic,prognostic,and therapeutic management purposes.Moreover,the pathophysiological and clinical significance of biomarkers may depend on the presentation,stage,and severity of the disease.The authors cover main classification of heart failure phenotypes,based on the measurement of left ventricular ejection fraction,including heart failure with preserved ejection fraction,heart failure with reduced ejection fraction,and the recently proposed category heart failure with mid-range ejection fraction.One could envisage specific sets of biomarker with different performances in heart failure progression with different left ventricular ejection fraction especially as concerns prediction of the future course of the disease and of left ventricular adverse/reverse remodeling.This article is intended to provide an overview of basic and additional mechanisms of heart failure progression will contribute to a more comprehensive knowledge of the disease pathogenesis.展开更多
BACKGROUND Locally advanced rectal cancer is treated using neoadjuvant chemoradiation(nCRT),followed by total mesorectal excision(TME).Tumor regression and pathological post-treatment stage are prognostic for oncologi...BACKGROUND Locally advanced rectal cancer is treated using neoadjuvant chemoradiation(nCRT),followed by total mesorectal excision(TME).Tumor regression and pathological post-treatment stage are prognostic for oncological outcomes.There is a significant correlation between markers representing cancer-related inflammation,including high neutrophil-to-lymphocyte ratio(NLR),monocyteto-lymphocyte ratio(MLR),and platelet-to-lymphocyte(MLR)and unfavorable oncological outcomes.However,the predictive role of these markers on the effect of chemoradiation is unknown.AIM To evaluate the predictive roles of NLR,MLR,and PLR in patients with locally advanced rectal cancer receiving neoadjuvant chemoradiation.METHODS Patients(n=111)with locally advanced rectal cancer who underwent nCRT followed by TME at the Minimally Invasive Surgery Unit,Siriraj Hospital between 2012 and 2018 were retrospectively analyzed.The associations between post-treatment pathological stages,neoadjuvant rectal(NAR)score and the pretreatment ratios of markers of inflammation(NLR,MLR,and PLR)were analyzed.RESULTS Clinical stages determined using computed tomography,magnetic resonance imaging,or both were T4(n=16),T3(n=94),and T2(n=1).The NAR scores were categorized as high(score>16)in 23.4%,intermediate(score 8-16)in 41.4%,and low(score<8)in 35.2%.The mean values of the NLR,PLR,and MLR correlated with pathological tumor staging(ypT)and the NAR score.The values of NLR,PLR and MLR were higher in patients with advanced pathological stage and high NAR scores,but not statistically significant.CONCLUSION In patients with locally advanced rectal cancer,pretreatment NLR,MLR and PLR are higher in those with advanced pathological stage but the differences are not significantly different.展开更多
BACKGROUND The distinction between foot and ankle wound healing complications as opposed to infection is crucial for the appropriate and efficacious allocation of antibiotic therapy.Multiple reports have focused on th...BACKGROUND The distinction between foot and ankle wound healing complications as opposed to infection is crucial for the appropriate and efficacious allocation of antibiotic therapy.Multiple reports have focused on the diagnostic accuracy of different inflammatory markers,however,mainly in the diabetic population.AIM To evaluate the diagnostic accuracy of white cell count(WCC)and C-reactive protein(CRP)as diagnostic tools for this distinction in the non-diabetic cohort.METHODS Data was reviewed from a prospectively maintained Infectious Diseases Unit database of 216 patients admitted at Leicester University Hospitals–United Kingdom with musculoskeletal infections over the period between July 2014 and February 2020(68 mo).All patients with confirmed diagnosis of diabetes were excluded while only those with confirmed microbiological or clinical diagnosis of foot or ankle infection were included in our study.For the included patients,we retrospectively retrieved the inflammatory markers(WCCs and CRP)at the time of presentation.Values of CRP 0-10 mg/L and WCC 4.0-11.0×109/L were considered normal.RESULTS After exclusion of patients with confirmed diabetes,25 patients with confirmed foot or ankle infections were included.All infections were confirmed microbiolo-gically with positive intra-operative culture results.7(28%)patients with osteomyelitis(OM)of the foot,11(44%)with OM of the ankle,5(20%)with ankle septic arthritis and 2(8%)patients with post-surgical wound infection were identified.Previous bony surgery was identified in 13(52%)patients,either a corrective osteotomy or an open reduction and internal fixation for a foot or ankle fracture with the infection developing on top of the existing metalwork.21(84%)patients did have raised inflammatory markers while 4(16%)patients failed to mount an inflammatory response even with subsequent debridement and removal of metal work.CRP sensitivity was 84%,while WCC sensitivity was only 28%.CONCLUSION CRP has a relatively good sensitivity in the diagnosis of foot and ankle infections in non-diabetic patients,whereas WCC is a poor inflammatory marker in the detection of such cases.In presence of clinically high level of suspicion of foot or ankle infection,a normal CRP should not rule out the diagnosis of OM.展开更多
BACKGROUND Coronary artery disease(CAD)is a major cause of death worldwide,and India contributes to about one-fifth of total CAD deaths.The development of CAD has been linked to the accumulation of Nε-carboxymethyl-l...BACKGROUND Coronary artery disease(CAD)is a major cause of death worldwide,and India contributes to about one-fifth of total CAD deaths.The development of CAD has been linked to the accumulation of Nε-carboxymethyl-lysine(CML)in heart muscle,which correlates with fibrosis.AIM To assess the impact of CML and inflammatory markers on the biochemical and cardiovascular characteristics of CAD patients with and without diabetes.METHODS We enrolled 200 consecutive CAD patients who were undergoing coronary angiography and categorized them into two groups based on their serum glycosylated hemoglobin(HbA1c)levels(group I:HbA1c≥6.5;group II:HbA1c<6.5).We analyzed the levels of lipoproteins,plasma HbA1c levels,CML,interleukin-6(IL-6),tumor necrosis factor alpha(TNF-α),and nitric oxide.RESULTS Group I (81 males and 19 females) patients had a mean age of 54.2 ± 10.2 years, with a mean diabetes duration of4.9 ± 2.2 years. Group II (89 males and 11 females) patients had a mean age of 53.2 ± 10.3 years. Group I had moresevere CAD, with a higher percentage of patients with single vessel disease and greater stenosis severity in the leftanterior descending coronary artery compared to group II. Group I also exhibited a larger left atrium diameter.Group I patients exhibited significantly higher levels of CML, TNF-α, and IL-6 and lower levels of nitric oxide ascompared with group II patients. Additionally, CML showed a significant positive correlation with IL-6 (r = 0.596,P = 0.001) and TNF-α (r = 0.337, P = 0.001) and a negative correlation with nitric oxide (r=-4.16, P = 0.001). Oddsratio analysis revealed that patients with CML in the third quartile (264.43-364.31 ng/mL) were significantlyassociated with diabetic CAD at unadjusted and adjusted levels with covariates.展开更多
BACKGROUND Studies have shown elevated C-reactive protein(CRP)to predict mechanical ventilation(MV)in patients with coronavirus disease 2019(COVID-19).Its utility is unknown in patients with chronic kidney disease(CKD...BACKGROUND Studies have shown elevated C-reactive protein(CRP)to predict mechanical ventilation(MV)in patients with coronavirus disease 2019(COVID-19).Its utility is unknown in patients with chronic kidney disease(CKD),who have elevated baseline CRP levels due to chronic inflammation and reduced renal clearance.AIM To assess whether an association exists between elevated inflammatory markers and MV rate in patients with stagesⅢb-ⅤCKD and COVID-19.METHODS We conducted a retrospective cohort study on patients with COVID-19 and stagesⅢb-ⅤCKD.The primary outcome was the rate of invasive MV,the rate of noninvasive MV,and the rate of no MV.Statistical analyses used unpaired t-test for continuous variables and chi-square analysis for categorical variables.Cutoffs for variables were CRP:100 mg/L,ferritin:530 ng/mL,D-dimer:0.5 mg/L,and lactate dehydrogenase(LDH):590 U/L.RESULTS 290 were screened,and 118 met the inclusion criteria.CRP,D-dimer,and ferritin were significantly different among the three groups.On univariate analysis for invasive MV(IMV),CRP had an odds ratio(OR)-5.44;ferritin,OR-2.8;LDH,OR-7.7;D-dimer,OR-3.9,(P<0.05).The admission CRP level had an area under curve-receiver operator characteristic(AUROC):0.747 for the IMV group(sensitivity-80.8%,specificity-50%)and 0.663 for the non-IMV(NIMV)group(area under the curve,sensitivity-69.2%,specificity-53%).CONCLUSION Our results demonstrate a positive correlation between CRP,ferritin,and D-dimer levels and MV and NIMV rates in CKD patients.The AUROC demonstrates a good sensitivity for CRP levels in detecting the need for MV in patients with stagesⅢb-ⅤCKD.This may be because of the greater magnitude of increased inflammation due to COVID-19 itself compared with increased inflammation and reduced clearance due to CKD alone.展开更多
BACKGROUND New onset hyperglycemia is common in patients with severe coronavirus disease 2019(COVID-19)infection.Cytokine storm due to COVID-19 infection is an essential etiology for new-onset hyperglycemia,but factor...BACKGROUND New onset hyperglycemia is common in patients with severe coronavirus disease 2019(COVID-19)infection.Cytokine storm due to COVID-19 infection is an essential etiology for new-onset hyperglycemia,but factors like direct severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)-induced pancreaticβ-cell failure have also been postulated to play a role.AIM We plan to investigate further the mechanisms underlying SARS-CoV-2 infection-induced hyperglycemia,particularly the rationale of the cytokine-induced hyperglycemia hypothesis,by evaluating the association between inflammatory markers and new onset hyperglycemia in non-diabetic patients with COVID-19 infection.METHODS We conducted a retrospective case-control study on adults without diabetes mellitus hospitalized for COVID-19 infection.The serum levels of glucose and inflammatory markers at presentation before initiation of corticosteroid were collected.Hyperglycemia was defined as glucose levels≥140 mg/dL.C-Reactive protein(CRP)≥100 mg/L,ferritin≥530 ng/mL,lactate dehydrogenase(LDH)≥590 U/L,and D-dimer≥0.5 mg/L were considered elevated.We used theχ2 test for categorical variables and the Mann-Whitney U test for continuous variables and calculated the logistic regression for hyperglycemia.RESULTS Of the 520 patients screened,248 met the inclusion criteria.Baseline demographics were equally distributed between patients with hyperglycemia and those who were normoglycemic.Serum inflammatory markers in patients with or without new-onset hyperglycemia were elevated as follows:CRP(58.1%vs 65.6%,P=0.29),ferritin(48.4%vs 34.9%,P=0.14),D-dimer(37.1%vs 37.1%,P=0.76)and LDH(19.4%vs 11.8%,P=0.02).Logistic regression analysis showed LDH odds ratio(OR)=1.623(P=0.256).We observed significantly higher mortality(24.2%vs 9.1%,P=0.001;OR=2.528,P=0.024)and length of stay(8.89 vs 6.69,P=0.026)in patients with hyperglycemia.CONCLUSION Our study showed no association between CRP,ferritin,LDH,D-dimer levels,and new-onset hyperglycemia in non-diabetic patients with COVID-19 infection.It also shows an increased mortality risk and length of stay in patients with hyperglycemia.With new-onset hyperglycemia being closely associated with poor prognostic indices,it becomes pivotal to understand the underlying pathophysiological mechanisms behind the SARS-CoV-2 infection-induced hyperglycemia.We conclude that the stress hyperglycemia hypothesis is not the only mechanism of SARS-CoV-2 infection-induced hyperglycemia but rather a multicausal pathogenesis leading to hyperglycemia that requires further research and understanding.This would help us improve not only the clinical outcomes of COVID-19 disease and inpatient hyperglycemia management but also understand the long-term effects of SARS-CoV-2 infection and further management.展开更多
C-reactive protein (CRP) is associated with unfavorable outcome in patients with acute ischemic syndromes and in patients with chronic stable angina.Elevated CRP levels suggestive of heightened inflammatory state in v...C-reactive protein (CRP) is associated with unfavorable outcome in patients with acute ischemic syndromes and in patients with chronic stable angina.Elevated CRP levels suggestive of heightened inflammatory state in vascular conditions are often associated with elevated interleukin-6 (IL-6) levels.The aim of our study was to show the predictive importance of CRP and IL-6 levels in patients with ischemic stroke that has not been fully elucidated.Design We studied 647 consecutive elderly patients (>65 years) with stroke who were documented with ischemic stroke,presence of significant carotid atherosderosis and absence of atrial fibrillation.The study population included 150 patients (74 men,76 women,mean age 74±2).Patients underwent evaluation of high sensitive CRP and IL-6 levels at baseline,during hospitalization and at discharge.Results In-hospital mortality was 6%,1 year mertality was 15% and a second cerebrovascular event occurred in 12% of patients.Those with in- hospital events had significantly higher baseline CRP and IL-6 levels than patients without events (3.8+1.1 vs 1.9±0.9 mg/L,P<0.01 and 13.8±3.4 vs 6.3±2.1 pg/ml,P<0.01,respectively).Also CRP and IL-6 levels were significantly higher in those patients with an event within 3 months of discharge compared to patients without an event (3.6±1.3 vs 1.1±0.7 mg/L,P<0.01 and 14.2±3.7 vs 5.4±1.6 pg/ml,P<001, respectively).Both base line CRP levels and IL-6 were predictive of events both in-hospital and after 3 months while CRP and IL-6 levels at baseline were not associated with a poor 1 year prognosis.Elevated CRP levels were associated with an unfavorable outcome only when IL-6 levels were also elevated.In a stepwise multivariate analysis IL-6 level was a stronger predictor of outcome than CRP.Conclusions In conclusion,elevated CRP and IL-6 levels may identify elderly patients at increased medium term risk,but do not predict one year events in this subset of patients.CRP levels predict events only when they are coupled with IL-6 levels.(J Ceriatr Cardiol 2004;1:44- 48.)展开更多
Pyrethroid esters are widely used as insecticides worldwide. In this study, we aimed to evaluate the harmful effect of deltamethrin on the male reproductive system through the assessment of reproductive hormones, infl...Pyrethroid esters are widely used as insecticides worldwide. In this study, we aimed to evaluate the harmful effect of deltamethrin on the male reproductive system through the assessment of reproductive hormones, inflammatorymarkers, and testicular function. To achieve our aim, eighty male 7-9-week-old, Wistar rats were taken, weighed, and divided into four experimental groups. The first group was kept as a control group, and the other three groups were given deltamethrin orally at different concentrations (0.87, 8.7, and 17.4 mg/kg body weight) for nine weeks. The resultsindicated that deltamethrin administration associated with a significant decrease in reproductive hormones, especially FSH, LH, and significant elevation in the interleukin 2 (IL2), interleukin 6 (IL6), histamine, and cortisol levels. Also, thesignificance of inhibition of sperm motility and viability, decreased testis weights, sperm count, and fructose in semen were noted. These findings clarify the harmful effect of deltamethrin on the male reproductive system by producing a significant alteration in reproductive hormones, inflammatory markers as well as testicular function.展开更多
BACKGROUND Familial Mediterranean fever(FMF)is an autosomal recessive autoinflammatory disorder marked by recurrent episodes of fever and serositis.Resistin,a proinflammatory cytokine,may play a role in FMF pathogenes...BACKGROUND Familial Mediterranean fever(FMF)is an autosomal recessive autoinflammatory disorder marked by recurrent episodes of fever and serositis.Resistin,a proinflammatory cytokine,may play a role in FMF pathogenesis by promoting the release of interleukin-1beta,tumour necrosis factor alpha,and interleukin-6.AIM To evaluate serum resistin levels in children with FMF during acute attacks and remission,and to assess its potential as a biomarker for disease activity and progression.METHODS A case-control study was conducted involving 40 pediatric patients with FMF and 40 age-and sex-matched healthy controls.Serum resistin and inflammatory markers—including total leukocyte count(TLC),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),serum amyloid A(SAA),and fibrinogen—were measured using enzyme-linked immunosorbent assay and standard assays.RESULTS No significant differences were found in age or sex between FMF patients and controls.Among FMF patients,fever was the most prevalent symptom(95%),followed by abdominal pain(75%).The most frequently detected genetic mutation was M694I,followed by M694V,E148Q,M680I,and V726A.Compound heterozygous mutations,including M694I/V726A and M694I/M694V,were equally represented.During acute attacks,FMF patients exhibited significantly elevated levels of TLC,ESR,CRP,SAA,and fibrinogen compared to attack-free periods and controls.Serum resistin levels were markedly higher during acute attacks and showed a strong positive correlation with other acute inflammatory markers.Receiver operating characteristic curve analysis demonstrated high sensitivity and specificity of resistin as a potential biomarker for FMF.CONCLUSION Resistin is significantly elevated in children with FMF during acute episodes and correlates with established inflammatory markers.These findings support its potential role as a non-invasive biomarker for disease activity and severity in pediatric FMF.展开更多
In this article,we critically appraise the study by Wu et al,which investigated the prognostic value of preoperative inflammatory and nutritional markers in colorectal cancer patients with peritoneal metastasis.This r...In this article,we critically appraise the study by Wu et al,which investigated the prognostic value of preoperative inflammatory and nutritional markers in colorectal cancer patients with peritoneal metastasis.This retrospective cohort study included 133 patients.The findings indicate that patients with high neutrophil-to-lymphocyte ratios(NLRs)or lower hemoglobin(Hb)levels have significantly shorter overall survival(OS)than those with lower NLRs or normal Hb levels,respectively.Furthermore,age,carbohydrate antigen 199 levels,the NLR,Hb,and the peritoneal cancer index were identified as independent prognostic factors for OS.A nomogram was subsequently developed,demon-strating its ability to accurately predict the OS of colorectal cancer patients with peritoneal metastasis.This study introduces a potentially valuable prognostic tool for these patients.However,further validation in multicenter cohorts is needed to confirm its clinical applicability,to assess its limitations,and to elucidate the underlying mechanism of these identified biomarkers.展开更多
Background Post-traumatic epilepsy(PTE)is characterised by recurrent epileptic seizures following traumatic brain injury(TBI).PTE has a high incidence and leads to significant disability rates,posing a substantial soc...Background Post-traumatic epilepsy(PTE)is characterised by recurrent epileptic seizures following traumatic brain injury(TBI).PTE has a high incidence and leads to significant disability rates,posing a substantial socioeconomic burden.This study aimed to evaluate the predictive value of peripheral blood inflammatory markers—including neutrophils,lymphocytes,platelets,the neutrophil-to-lymphocyte ratio(NLR),and the platelet-to-lymphocyte ratio(PLR)—for seizure risk in patients with TBI.Methods This investigation involved the enrollment of patients admitted to the Department of Neurology/Surgery at the First Affiliated Hospital of Dali University in Yunnan Province,China,spanning the period from January 2020 to May 2023.Our cohort comprised 138 individuals with PTE,150 with TBI,142 with epilepsy of unknown origin,and 130 healthy controls(HC).We retrospectively analysed demographic characteristics and peripheral blood cell inflammation markers for all participants.Results 1.In the PTE group,both neutrophil count and NLR exhibited higher levels compared to the TBI group,the epilepsy of unknown origin group,and the HC group.Conversely,the lymphocyte count,platelet count,and PLR in the group were lower in contrast to the TBI group,the epilepsy of unknown origin group,and the HC group.2.Neutrophil count,lymphocyte count,platelet count,NLR,and PLR were significantly different between the PTE and TBI,PTE and HC groups(P<0.05).Marked distinctions were detected in neutrophil count,platelet count,NLR,and PLR between the PTE group and the epilepsy of unknown origin group(P<0.05).3.Furthermore,our multivariate linear regression analysis unveiled that the TBI site(temporal lobe)(P<0.05),the severity of TBI(mild,moderate,severe)(P<0.05),and surgical intervention(P<0.05)are the risk factors affecting the peripheral blood inflammation indicators.4.Finally,the ROC analysis produced an AUC of 0.908 for neutrophil levels(cut-off:4.05,sensitivity:0.783,specificity:0.992)and an AUC of 0.960 for NLR(cut-off:2.945,sensitivity:0.797,specificity:0.992).Conclusions Both neutrophil count and the NLR were significantly increased in the PTE group,suggesting that these parameters may serve as predictors of epilepsy development in TBI patients.展开更多
blood cell derived inflammatory nmarker(including systemic immunoinflammatory index(SI),systemic inflammatory response index(SIRI),neutrophil count/lymphocyte count(NLR),platelet count/lymphocyte count(PLR),and monocy...blood cell derived inflammatory nmarker(including systemic immunoinflammatory index(SI),systemic inflammatory response index(SIRI),neutrophil count/lymphocyte count(NLR),platelet count/lymphocyte count(PLR),and monocyte count/lymphocyte count(MLR))and in combination with N-terminal pro-B-type natriuretic peptide(NT-proBNP)on the prognosis of patients with chronic heart failure.Methods This study was a retrospective cohort study.Patients with chronic heart failure hospitalized in the Department of Cardiovascular Medicine,Nanfang Hospital,Southern Medical University from January 2019 to August 2022 were enrolled.Patients were followed up and were divided into survival group and death group according to the follow-up results.Clinical characteristics of the two groups were compared.Receiver operating characteristic(ROC)curve was used to determine the optimal cut-off value of each whole blood cell derived inflammatory marker for predicting all-cause death in patients with chronic heart failure.Kaplan-Meier survival curve was drawn,and log-rank test was used to compare the difference in survival of chronic heart failure patients with different levels of whole blood cell derived inflammatory markers.Univariate and multivariate Cox proportional hazards models were used to analyze the effects of whole blood cell derived inflammatory markers and NT-proBNP on the all-cause death of patients with chronic heart failure.ROC curve was used to analyze the predictive value of whole blood cell derived inflammatory markers combined with NT-proBNP on the prognosis of patients with chronic heart failure.Results A total of 324 patients with heart failure aged(64.76±13.78)years were enrolled,with 212 males(65.43%).297 patients(91.67%)completed follow-up,27 patients(8.33%)were lost to follow-up.The follow-up time was 24.O(18.0,41.8)months.There were 258 patients in the survival group and 66 patients in the death group.The optimal cut-off values of SI,SIRI,NLR,PLR and MLR determined by R0C curve were 739.83,1.65,3.14,151.95 and 0.37,respectively.Kaplan-Meier survival curve analysis showed that patients with chronic heart failure with high levels of SII(≥739.83),SIRI(≥1.65),NLR(≥3.14),PLR(≥151.95)and MLR(≥0.37)had higher incidence of all-cause death than patients with low levels of inflammatory markers(all P<0.001).Multivariate Cox proportional hazard regression analysis showed that age(HR=1.04,95%CI 1.01-1.06,P=0.002),NT-proBNP(HR=2.93,95%CI 1.64-5.23,P<0.001),SII≥739.83(HR=3.27,95%CI 1.18-9.02,P=0.022)and PLR≥151.95(HR=2.67,95%CI 1.02-6.96,P=0.045)were independent predictors of all-cause death in patients with chronic heart failure.ROC curve analysis showed that the predictive value of SII and PLR combined with NTproBNP(AUC=0.850)for the prognosis of patients with chronic heart failure was better than that of SII(AUC=0.779)、PLR(AUC=0.782)、NT-proBNP(AUC=0.727)and CRP(AUC=0.668)alone(all P<0.001).Conclusion Whole blood cell derived inflammatory markers—SII,PLR,and NT-pro BNP are independently associated with all-cause death in patients with chronic heart failure.SII and PLR can independently predict the prognosis of patients with chronic heart failure,combination of SII and PLR with NT-pro BNP has better predictive value for the prognosis of patients with chronic heart failure.展开更多
Gastrointestinal stromal tumors(GISTs),the most prevalent mesenchymal tumors,often have poor outcomes due to high recurrence rates.However,the specific risk factors for GISTs,particularly those concerning the innate i...Gastrointestinal stromal tumors(GISTs),the most prevalent mesenchymal tumors,often have poor outcomes due to high recurrence rates.However,the specific risk factors for GISTs,particularly those concerning the innate immune-inflammatory response,remain poorly understood.This editorial highlights key prognostic factors that impact GIST progression and prognosis,while discussing the findings of a recent study that investigated the prognostic value of systemic inflammatory markers:systemic immune-inflammation index,neutrophil/lym-phocyte ratio,platelet/lymphocyte ratio,and monocyte/lymphocyte ratio,on recurrence-free survival in GIST patients.This editorial examines strategies to enhance the clinical applicability of the nomogram developed in the study,ensuring its effectiveness for robust implementation.Future directions outlined in the editorial stress the importance of integrating molecular insights,including KIT and PDGFRA mutations,tumor staging,and mitotic rates to refine predictive models.The editorial also underscores the value of multi-center studies to enhance the generalizability and clinical relevance of these approaches.By bridging inflammatory biomarkers with genetic and clinicopathologic factors,a more comprehensive understanding of GIST pathophysiology can be developed,paving the way for improved management strategies and patient outcomes.This perspective serves as a call to action for continued research into the interplay between genetic mutations,inflammatory marker modulation,and GIST progression,aiming to expand the scope of personalized oncology through a deeper understanding of GIST progression.展开更多
BACKGROUND Portal vein thrombosis(PVT),a complication of liver cirrhosis,is a major public health concern.PVT prediction is the most effective method for PVT diagnosis and treatment.AIM To develop and validate a nomog...BACKGROUND Portal vein thrombosis(PVT),a complication of liver cirrhosis,is a major public health concern.PVT prediction is the most effective method for PVT diagnosis and treatment.AIM To develop and validate a nomogram and network calculator based on clinical indicators to predict PVT in patients with cirrhosis.METHODS Patients with cirrhosis hospitalized between January 2016 and December 2021 at the First Hospital of Lanzhou University were screened and 643 patients with cirrhosis who met the eligibility criteria were retrieved.Following a 1:1 propensity score matching 572 patients with cirrhosis were screened,and relevant clinical data were collected.PVT risk factors were identified using the least absolute shrinkage and selection operator(LASSO)and multivariate logistic regression analysis.Variance inflation factors and correlation matrix plots were used to analyze multicollinearity among the variables.A nomogram was constructed to predict the probability of PVT based on independent risk factors for PVT,and its predictive performance was verified using a receiver operating characteristic curve(ROC),calibration curves,and decision curve analysis(DCA).Finally,a network calculator was constructed based on the nomograms.RESULTS This study enrolled 286 cirrhosis patients with PVT and 286 without PVT.LASSO analysis revealed 13 variables as strongly associated with PVT occurrence.Multivariate logistic regression analysis revealed nine indicators as independent PVT risk factors,including etiology,ascites,gastroesophageal varices,platelet count,D-dimer,portal vein diameter,portal vein velocity,aspartate transaminase to neutrophil ratio index,and platelet-to-lymphocyte ratio.LASSO and correlation matrix plot results revealed no significant multicollinearity or correlation among the variables.A nomogram was constructed based on the screened independent risk factors.The nomogram had excellent predictive performance,with an area under the ROC curve of 0.821 and 0.829 in the training and testing groups,respectively.Calibration curves and DCA revealed its good clinical performance.Finally,the optimal cutoff value for the total nomogram score was 0.513.The sensitivity and specificity of the optimal cutoff values were 0.822 and 0.706,respectively.CONCLUSION A nomogram for predicting PVT occurrence was successfully developed and validated,and a network calculator was constructed.This can enable clinicians to rapidly and easily identify high PVT risk groups.展开更多
Pancreatitis is an inflammatory condition affecting the pancreas and is classified into 2 types,acute and chronic,which can manifest in various forms.This review article summarizes the role of predictive and prognosti...Pancreatitis is an inflammatory condition affecting the pancreas and is classified into 2 types,acute and chronic,which can manifest in various forms.This review article summarizes the role of predictive and prognostic values of inflammatory markers in the pathogenesis of acute pancreatitis,mainly focused on preclinical and clinical studies.It includes serum amyloid A(SAA),monocyte chemotactic protein-1(MCP-1),erythrocyte sedimentation rate(ESR),interleukin-6(IL-6),C-reactive protein(CRP),IL-10,myeloperoxidase,pentraxin 3,and plasminogen activator inhibitor 1.SAA3 plays a crucial role in developing acute pancreatitis by triggering a receptor-interacting protein 3-dependent necroptosis pathway in acinar cells.Targeting SAA3 could be a potential strategy for treating acute pancreatitis.The recruitment of monocytes/macrophages and the activation of the systemic MCP-1 signaling pathway play a role in the progression of pancreatitis,and blocking MCP-1 may have a suppressive effect on the development of pancreatic fibrosis.The ESR can predict severe acute pancreatitis with slightly lower accuracy than CRP.When ESR and CRP levels are combined at 24 hours,they predict severe acute pancreatitis accurately.IL-6 plays a crucial role in activating the Janus kinase/signal transducers and activators of the transcription pathway,exacerbating pancreatitis and contributing to the initiation and progression of pancreatic cancer.Endogenous IL-10 plays a crucial role in controlling the regenerative phase and limiting the severity of fibrosis and glandular atrophy induced by repeated episodes of acute pancreatitis in mice.The predictive and diagnostic roles of these inflammatory factors in pancreatitis were introduced in detail in this review.展开更多
The prognosis of colorectal cancer(CRC)patients with peritoneal metastasis remains poor despite advancements in detection and treatment.Preoperative inflammatory and nutritional markers have emerged as significant pre...The prognosis of colorectal cancer(CRC)patients with peritoneal metastasis remains poor despite advancements in detection and treatment.Preoperative inflammatory and nutritional markers have emerged as significant predictors of prognosis in CRC,potentially guiding treatment decisions and improving patient outcomes.This editorial explores the prognostic value of markers such as the neutrophil-to-lymphocyte ratio,hemoglobin,and serum albumin levels.By integrating these markers into prognostic models,clinicians can better stratify patients,personalize treatment strategies,and ultimately enhance clinical outcomes.This review highlights the importance of these markers in providing a comprehensive assessment of patient condition and underscores the need for further research to validate their clinical utility and uncover underlying mecha-nisms.展开更多
文摘Parkinson’s disease(PD)is a common neurodegenerative disorder with increasing incidence and disability rates globally,placing a heavy burden on patients and their families.In the prodromal phase of PD,nonmotor symptoms,particularly depression and sleep disorders,are frequent,with profound effects on disease progression and patient quality of life.Emerging research highlights the critical role of inflammatory markers-including interleukins and tumor necrosis factor-in the pathogenesis of prodromal PD.These inflammatory mediators participate in neurodegenerative processes and may induce or exacerbate depressive symptoms and sleep disorders by disrupting the function of the hypothala-micpituitary-adrenal axis and affecting neurotransmitter,including serotonin,metabolism.Understanding their correlations with nonmotor symptoms in prodromal PD remains incomplete,limiting our ability to develop targeted interventions.This comprehensive review aims to investigate the specific correlations between inflammatory markers and nonmotor symptoms-particularly depression and sleep disorders-in prodromal PD.The findings could have important practical applications,potentially leading to the development of new diagnostic tools and therapeutic strategies for managing PD.By identifying and understanding these correlations,healthcare providers may better predict disease progression and implement more effective treatments for nonmotor symptoms in PD.
文摘Background:Diabetes mellitus(DM)is a prevalent chronic metabolic condition characterized by high blood sugar levels,resulting from insufficient insulin production or ineffective insulin use,posing substantial global health issues.Research on the relationship between glycemic status and the ratio of neutrophils to lymphocytes(NLR)and monocytes to lymphocytes(MLR)is limited.This study aimed to fill these knowledge gaps by examining the connection between DM and inflammatory markers within the Asir region.Methods:Data from 3545 participants were retrospectively analyzed.The dataset,gathered between 2021 and 2023,comprises 38 laboratory tests obtained from the Future Lab Pioneer database.The study's inclusion criteria focused on diabetes profile tests(glycated hemoglobin[HbA1c]and fasting blood glucose[FBG])and manually computed inflammatory markers(NLR and MLR),which were stratified by age and sex.Results:This study demonstrated significant differences in NLR levels compared with FBG levels across all adult age groups and adult female participants(p<0.0001),as well as among all elderly age groups(p=0.0006)and elderly women(p=0.01).MLR levels were significant in all adult age groups(p=0.04)and in adult women(p=0.02).When NLR and MLR were compared to HbA1c levels,a significant difference in the mean NLR was found in adult women(p=0.005).Additionally,the mean MLR levels were significant in all adult age groups(p=0.04)and adult women(p=0.02).Conclusion:Although a larger sample size is necessary for this research,the results indicate that NLR and MLR could serve as valuable indicators for evaluating inflammation in people with disrupted glucose metabolism,particularly in adult and female populations.
基金This study was approved by the Agrı Training and Research Hospital Scientific Research Ethics Committee(No.E-95531838-050.99-86900)conducted in accordance with the Declaration of Helsinki.
文摘BACKGROUND Gastric cancer is a major global health concern,often diagnosed at advanced stages,leading to poor prognosis.Proximal and distal gastric cancers exhibit distinct clinicopathological features.AIM To investigate the diagnostic value of hematological and inflammatory markers in differentiating proximal and distal gastric cancers and to evaluate their association with clinical outcomes.METHODS A retrospective cohort study was conducted on 150 patients diagnosed with gastric adenocarcinoma through histopathological analysis.Patients were categorized into proximal gastric cancer and distal gastric cancer groups.Laboratory parameters were analyzed.RESULTS Of the 150 patients,84 had proximal gastric cancer and 66 had distal gastric cancer.Dysphagia was significantly more common in the proximal gastric cancer group,while anemia and higher platelet-to-lymphocyte ratio values were observed in the distal gastric cancer group(P=0.031).Tumor stage and neutrophil-to-lymphocyte ratio emerged as independent predictors of all-cause mortality.No significant differences were found in other laboratory or biochemical parameters between the groups.CONCLUSION Proximal and distal gastric cancers demonstrate distinct clinical and laboratory profiles.The platelet-to-lymphocyte ratio may serve as a valuable marker in differentiating cancer localization,while the neutrophil-to-lymphocyte ratio is a prognostic indicator for mortality.These findings highlight the potential of hematological markers in optimizing diagnosis and treatment strategies for gastric cancer.
文摘BACKGROUND Obesity in children and adolescents is a serious problem,and the efficacy of exercise therapy for these patients is controversial.AIM To assess the efficacy of exercise training on overweight and obese children based on glucose metabolism indicators and inflammatory markers.METHODS The PubMed,Web of Science,and Embase databases were searched for randomized controlled trials related to exercise training and obese children until October 2023.The meta-analysis was conducted using RevMan 5.3 software to evaluate the efficacy of exercise therapy on glucose metabolism indicators and inflammatory markers in obese children.RESULTS In total,1010 patients from 28 studies were included.Exercise therapy reduced the levels of fasting blood glucose(FBG)[standardized mean difference(SMD):-0.78;95%confidence interval(CI):-1.24 to-0.32,P=0.0008],fasting insulin(FINS)(SMD:-1.55;95%CI:-2.12 to-0.98,P<0.00001),homeostatic model assessment for insulin resistance(HOMA-IR)(SMD:-1.58;95%CI:-2.20 to-0.97,P<0.00001),interleukin-6(IL-6)(SMD:-1.31;95%CI:-2.07 to-0.55,P=0.0007),C-reactive protein(CRP)(SMD:-0.64;95%CI:-1.21 to-0.08,P=0.03),and leptin(SMD:-3.43;95%CI:-5.82 to-1.05,P=0.005)in overweight and obese children.Exercise training increased adiponectin levels(SMD:1.24;95%CI:0.30 to 2.18,P=0.01)but did not improve tumor necrosis factor-alpha(TNF-α)levels(SMD:-0.80;95%CI:-1.77 to 0.18,P=0.11).CONCLUSION In summary,exercise therapy improves glucose metabolism by reducing levels of FBG,FINS,HOMA-IR,as well as improves inflammatory status by reducing levels of IL-6,CRP,leptin,and increasing levels of adiponectin in overweight and obese children.There was no statistically significant effect between exercise training and levels of TNF-α.Additional long-term trials should be conducted to explore this therapeutic perspective and confirm these results.
基金supported by the grant from the Ministry of Science and Higher Education of the Russian Federation(agreement 075-15-2020-800)。
文摘Heart failure is common in adult population,accounting for substantial morbidity and mortality worldwide.The main risk factors for heart failure are coronary artery disease,hypertension,obesity,diabetes mellitus,chronic pulmonary diseases,family history of cardiovascular diseases,cardiotoxic therapy.The main factor associated with poor outcome of these patients is constant progression of heart failure.In the current review we present evidence on the role of established and candidate neurohumoral biomarkers for heart failure progression management and diagnostics.A growing number of biomarkers have been proposed as potentially useful in heart failure patients,but not one of them still resembles the characteristics of the"ideal biomarker."A single marker will hardly perform well for screening,diagnostic,prognostic,and therapeutic management purposes.Moreover,the pathophysiological and clinical significance of biomarkers may depend on the presentation,stage,and severity of the disease.The authors cover main classification of heart failure phenotypes,based on the measurement of left ventricular ejection fraction,including heart failure with preserved ejection fraction,heart failure with reduced ejection fraction,and the recently proposed category heart failure with mid-range ejection fraction.One could envisage specific sets of biomarker with different performances in heart failure progression with different left ventricular ejection fraction especially as concerns prediction of the future course of the disease and of left ventricular adverse/reverse remodeling.This article is intended to provide an overview of basic and additional mechanisms of heart failure progression will contribute to a more comprehensive knowledge of the disease pathogenesis.
文摘BACKGROUND Locally advanced rectal cancer is treated using neoadjuvant chemoradiation(nCRT),followed by total mesorectal excision(TME).Tumor regression and pathological post-treatment stage are prognostic for oncological outcomes.There is a significant correlation between markers representing cancer-related inflammation,including high neutrophil-to-lymphocyte ratio(NLR),monocyteto-lymphocyte ratio(MLR),and platelet-to-lymphocyte(MLR)and unfavorable oncological outcomes.However,the predictive role of these markers on the effect of chemoradiation is unknown.AIM To evaluate the predictive roles of NLR,MLR,and PLR in patients with locally advanced rectal cancer receiving neoadjuvant chemoradiation.METHODS Patients(n=111)with locally advanced rectal cancer who underwent nCRT followed by TME at the Minimally Invasive Surgery Unit,Siriraj Hospital between 2012 and 2018 were retrospectively analyzed.The associations between post-treatment pathological stages,neoadjuvant rectal(NAR)score and the pretreatment ratios of markers of inflammation(NLR,MLR,and PLR)were analyzed.RESULTS Clinical stages determined using computed tomography,magnetic resonance imaging,or both were T4(n=16),T3(n=94),and T2(n=1).The NAR scores were categorized as high(score>16)in 23.4%,intermediate(score 8-16)in 41.4%,and low(score<8)in 35.2%.The mean values of the NLR,PLR,and MLR correlated with pathological tumor staging(ypT)and the NAR score.The values of NLR,PLR and MLR were higher in patients with advanced pathological stage and high NAR scores,but not statistically significant.CONCLUSION In patients with locally advanced rectal cancer,pretreatment NLR,MLR and PLR are higher in those with advanced pathological stage but the differences are not significantly different.
文摘BACKGROUND The distinction between foot and ankle wound healing complications as opposed to infection is crucial for the appropriate and efficacious allocation of antibiotic therapy.Multiple reports have focused on the diagnostic accuracy of different inflammatory markers,however,mainly in the diabetic population.AIM To evaluate the diagnostic accuracy of white cell count(WCC)and C-reactive protein(CRP)as diagnostic tools for this distinction in the non-diabetic cohort.METHODS Data was reviewed from a prospectively maintained Infectious Diseases Unit database of 216 patients admitted at Leicester University Hospitals–United Kingdom with musculoskeletal infections over the period between July 2014 and February 2020(68 mo).All patients with confirmed diagnosis of diabetes were excluded while only those with confirmed microbiological or clinical diagnosis of foot or ankle infection were included in our study.For the included patients,we retrospectively retrieved the inflammatory markers(WCCs and CRP)at the time of presentation.Values of CRP 0-10 mg/L and WCC 4.0-11.0×109/L were considered normal.RESULTS After exclusion of patients with confirmed diabetes,25 patients with confirmed foot or ankle infections were included.All infections were confirmed microbiolo-gically with positive intra-operative culture results.7(28%)patients with osteomyelitis(OM)of the foot,11(44%)with OM of the ankle,5(20%)with ankle septic arthritis and 2(8%)patients with post-surgical wound infection were identified.Previous bony surgery was identified in 13(52%)patients,either a corrective osteotomy or an open reduction and internal fixation for a foot or ankle fracture with the infection developing on top of the existing metalwork.21(84%)patients did have raised inflammatory markers while 4(16%)patients failed to mount an inflammatory response even with subsequent debridement and removal of metal work.CRP sensitivity was 84%,while WCC sensitivity was only 28%.CONCLUSION CRP has a relatively good sensitivity in the diagnosis of foot and ankle infections in non-diabetic patients,whereas WCC is a poor inflammatory marker in the detection of such cases.In presence of clinically high level of suspicion of foot or ankle infection,a normal CRP should not rule out the diagnosis of OM.
文摘BACKGROUND Coronary artery disease(CAD)is a major cause of death worldwide,and India contributes to about one-fifth of total CAD deaths.The development of CAD has been linked to the accumulation of Nε-carboxymethyl-lysine(CML)in heart muscle,which correlates with fibrosis.AIM To assess the impact of CML and inflammatory markers on the biochemical and cardiovascular characteristics of CAD patients with and without diabetes.METHODS We enrolled 200 consecutive CAD patients who were undergoing coronary angiography and categorized them into two groups based on their serum glycosylated hemoglobin(HbA1c)levels(group I:HbA1c≥6.5;group II:HbA1c<6.5).We analyzed the levels of lipoproteins,plasma HbA1c levels,CML,interleukin-6(IL-6),tumor necrosis factor alpha(TNF-α),and nitric oxide.RESULTS Group I (81 males and 19 females) patients had a mean age of 54.2 ± 10.2 years, with a mean diabetes duration of4.9 ± 2.2 years. Group II (89 males and 11 females) patients had a mean age of 53.2 ± 10.3 years. Group I had moresevere CAD, with a higher percentage of patients with single vessel disease and greater stenosis severity in the leftanterior descending coronary artery compared to group II. Group I also exhibited a larger left atrium diameter.Group I patients exhibited significantly higher levels of CML, TNF-α, and IL-6 and lower levels of nitric oxide ascompared with group II patients. Additionally, CML showed a significant positive correlation with IL-6 (r = 0.596,P = 0.001) and TNF-α (r = 0.337, P = 0.001) and a negative correlation with nitric oxide (r=-4.16, P = 0.001). Oddsratio analysis revealed that patients with CML in the third quartile (264.43-364.31 ng/mL) were significantlyassociated with diabetic CAD at unadjusted and adjusted levels with covariates.
文摘BACKGROUND Studies have shown elevated C-reactive protein(CRP)to predict mechanical ventilation(MV)in patients with coronavirus disease 2019(COVID-19).Its utility is unknown in patients with chronic kidney disease(CKD),who have elevated baseline CRP levels due to chronic inflammation and reduced renal clearance.AIM To assess whether an association exists between elevated inflammatory markers and MV rate in patients with stagesⅢb-ⅤCKD and COVID-19.METHODS We conducted a retrospective cohort study on patients with COVID-19 and stagesⅢb-ⅤCKD.The primary outcome was the rate of invasive MV,the rate of noninvasive MV,and the rate of no MV.Statistical analyses used unpaired t-test for continuous variables and chi-square analysis for categorical variables.Cutoffs for variables were CRP:100 mg/L,ferritin:530 ng/mL,D-dimer:0.5 mg/L,and lactate dehydrogenase(LDH):590 U/L.RESULTS 290 were screened,and 118 met the inclusion criteria.CRP,D-dimer,and ferritin were significantly different among the three groups.On univariate analysis for invasive MV(IMV),CRP had an odds ratio(OR)-5.44;ferritin,OR-2.8;LDH,OR-7.7;D-dimer,OR-3.9,(P<0.05).The admission CRP level had an area under curve-receiver operator characteristic(AUROC):0.747 for the IMV group(sensitivity-80.8%,specificity-50%)and 0.663 for the non-IMV(NIMV)group(area under the curve,sensitivity-69.2%,specificity-53%).CONCLUSION Our results demonstrate a positive correlation between CRP,ferritin,and D-dimer levels and MV and NIMV rates in CKD patients.The AUROC demonstrates a good sensitivity for CRP levels in detecting the need for MV in patients with stagesⅢb-ⅤCKD.This may be because of the greater magnitude of increased inflammation due to COVID-19 itself compared with increased inflammation and reduced clearance due to CKD alone.
基金The study was reviewed and approved by our local Medical Center Institutional Review Board(Approval No.2020-035).
文摘BACKGROUND New onset hyperglycemia is common in patients with severe coronavirus disease 2019(COVID-19)infection.Cytokine storm due to COVID-19 infection is an essential etiology for new-onset hyperglycemia,but factors like direct severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)-induced pancreaticβ-cell failure have also been postulated to play a role.AIM We plan to investigate further the mechanisms underlying SARS-CoV-2 infection-induced hyperglycemia,particularly the rationale of the cytokine-induced hyperglycemia hypothesis,by evaluating the association between inflammatory markers and new onset hyperglycemia in non-diabetic patients with COVID-19 infection.METHODS We conducted a retrospective case-control study on adults without diabetes mellitus hospitalized for COVID-19 infection.The serum levels of glucose and inflammatory markers at presentation before initiation of corticosteroid were collected.Hyperglycemia was defined as glucose levels≥140 mg/dL.C-Reactive protein(CRP)≥100 mg/L,ferritin≥530 ng/mL,lactate dehydrogenase(LDH)≥590 U/L,and D-dimer≥0.5 mg/L were considered elevated.We used theχ2 test for categorical variables and the Mann-Whitney U test for continuous variables and calculated the logistic regression for hyperglycemia.RESULTS Of the 520 patients screened,248 met the inclusion criteria.Baseline demographics were equally distributed between patients with hyperglycemia and those who were normoglycemic.Serum inflammatory markers in patients with or without new-onset hyperglycemia were elevated as follows:CRP(58.1%vs 65.6%,P=0.29),ferritin(48.4%vs 34.9%,P=0.14),D-dimer(37.1%vs 37.1%,P=0.76)and LDH(19.4%vs 11.8%,P=0.02).Logistic regression analysis showed LDH odds ratio(OR)=1.623(P=0.256).We observed significantly higher mortality(24.2%vs 9.1%,P=0.001;OR=2.528,P=0.024)and length of stay(8.89 vs 6.69,P=0.026)in patients with hyperglycemia.CONCLUSION Our study showed no association between CRP,ferritin,LDH,D-dimer levels,and new-onset hyperglycemia in non-diabetic patients with COVID-19 infection.It also shows an increased mortality risk and length of stay in patients with hyperglycemia.With new-onset hyperglycemia being closely associated with poor prognostic indices,it becomes pivotal to understand the underlying pathophysiological mechanisms behind the SARS-CoV-2 infection-induced hyperglycemia.We conclude that the stress hyperglycemia hypothesis is not the only mechanism of SARS-CoV-2 infection-induced hyperglycemia but rather a multicausal pathogenesis leading to hyperglycemia that requires further research and understanding.This would help us improve not only the clinical outcomes of COVID-19 disease and inpatient hyperglycemia management but also understand the long-term effects of SARS-CoV-2 infection and further management.
文摘C-reactive protein (CRP) is associated with unfavorable outcome in patients with acute ischemic syndromes and in patients with chronic stable angina.Elevated CRP levels suggestive of heightened inflammatory state in vascular conditions are often associated with elevated interleukin-6 (IL-6) levels.The aim of our study was to show the predictive importance of CRP and IL-6 levels in patients with ischemic stroke that has not been fully elucidated.Design We studied 647 consecutive elderly patients (>65 years) with stroke who were documented with ischemic stroke,presence of significant carotid atherosderosis and absence of atrial fibrillation.The study population included 150 patients (74 men,76 women,mean age 74±2).Patients underwent evaluation of high sensitive CRP and IL-6 levels at baseline,during hospitalization and at discharge.Results In-hospital mortality was 6%,1 year mertality was 15% and a second cerebrovascular event occurred in 12% of patients.Those with in- hospital events had significantly higher baseline CRP and IL-6 levels than patients without events (3.8+1.1 vs 1.9±0.9 mg/L,P<0.01 and 13.8±3.4 vs 6.3±2.1 pg/ml,P<0.01,respectively).Also CRP and IL-6 levels were significantly higher in those patients with an event within 3 months of discharge compared to patients without an event (3.6±1.3 vs 1.1±0.7 mg/L,P<0.01 and 14.2±3.7 vs 5.4±1.6 pg/ml,P<001, respectively).Both base line CRP levels and IL-6 were predictive of events both in-hospital and after 3 months while CRP and IL-6 levels at baseline were not associated with a poor 1 year prognosis.Elevated CRP levels were associated with an unfavorable outcome only when IL-6 levels were also elevated.In a stepwise multivariate analysis IL-6 level was a stronger predictor of outcome than CRP.Conclusions In conclusion,elevated CRP and IL-6 levels may identify elderly patients at increased medium term risk,but do not predict one year events in this subset of patients.CRP levels predict events only when they are coupled with IL-6 levels.(J Ceriatr Cardiol 2004;1:44- 48.)
文摘Pyrethroid esters are widely used as insecticides worldwide. In this study, we aimed to evaluate the harmful effect of deltamethrin on the male reproductive system through the assessment of reproductive hormones, inflammatorymarkers, and testicular function. To achieve our aim, eighty male 7-9-week-old, Wistar rats were taken, weighed, and divided into four experimental groups. The first group was kept as a control group, and the other three groups were given deltamethrin orally at different concentrations (0.87, 8.7, and 17.4 mg/kg body weight) for nine weeks. The resultsindicated that deltamethrin administration associated with a significant decrease in reproductive hormones, especially FSH, LH, and significant elevation in the interleukin 2 (IL2), interleukin 6 (IL6), histamine, and cortisol levels. Also, thesignificance of inhibition of sperm motility and viability, decreased testis weights, sperm count, and fructose in semen were noted. These findings clarify the harmful effect of deltamethrin on the male reproductive system by producing a significant alteration in reproductive hormones, inflammatory markers as well as testicular function.
文摘BACKGROUND Familial Mediterranean fever(FMF)is an autosomal recessive autoinflammatory disorder marked by recurrent episodes of fever and serositis.Resistin,a proinflammatory cytokine,may play a role in FMF pathogenesis by promoting the release of interleukin-1beta,tumour necrosis factor alpha,and interleukin-6.AIM To evaluate serum resistin levels in children with FMF during acute attacks and remission,and to assess its potential as a biomarker for disease activity and progression.METHODS A case-control study was conducted involving 40 pediatric patients with FMF and 40 age-and sex-matched healthy controls.Serum resistin and inflammatory markers—including total leukocyte count(TLC),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),serum amyloid A(SAA),and fibrinogen—were measured using enzyme-linked immunosorbent assay and standard assays.RESULTS No significant differences were found in age or sex between FMF patients and controls.Among FMF patients,fever was the most prevalent symptom(95%),followed by abdominal pain(75%).The most frequently detected genetic mutation was M694I,followed by M694V,E148Q,M680I,and V726A.Compound heterozygous mutations,including M694I/V726A and M694I/M694V,were equally represented.During acute attacks,FMF patients exhibited significantly elevated levels of TLC,ESR,CRP,SAA,and fibrinogen compared to attack-free periods and controls.Serum resistin levels were markedly higher during acute attacks and showed a strong positive correlation with other acute inflammatory markers.Receiver operating characteristic curve analysis demonstrated high sensitivity and specificity of resistin as a potential biomarker for FMF.CONCLUSION Resistin is significantly elevated in children with FMF during acute episodes and correlates with established inflammatory markers.These findings support its potential role as a non-invasive biomarker for disease activity and severity in pediatric FMF.
文摘In this article,we critically appraise the study by Wu et al,which investigated the prognostic value of preoperative inflammatory and nutritional markers in colorectal cancer patients with peritoneal metastasis.This retrospective cohort study included 133 patients.The findings indicate that patients with high neutrophil-to-lymphocyte ratios(NLRs)or lower hemoglobin(Hb)levels have significantly shorter overall survival(OS)than those with lower NLRs or normal Hb levels,respectively.Furthermore,age,carbohydrate antigen 199 levels,the NLR,Hb,and the peritoneal cancer index were identified as independent prognostic factors for OS.A nomogram was subsequently developed,demon-strating its ability to accurately predict the OS of colorectal cancer patients with peritoneal metastasis.This study introduces a potentially valuable prognostic tool for these patients.However,further validation in multicenter cohorts is needed to confirm its clinical applicability,to assess its limitations,and to elucidate the underlying mechanism of these identified biomarkers.
基金This research did not receive any specific grant from funding agencies in the public,commercial,or not-for-profit sectors.Science Research Foundation of Yunnan Education Bureau,2023Y0974,sheng xue Wang。
文摘Background Post-traumatic epilepsy(PTE)is characterised by recurrent epileptic seizures following traumatic brain injury(TBI).PTE has a high incidence and leads to significant disability rates,posing a substantial socioeconomic burden.This study aimed to evaluate the predictive value of peripheral blood inflammatory markers—including neutrophils,lymphocytes,platelets,the neutrophil-to-lymphocyte ratio(NLR),and the platelet-to-lymphocyte ratio(PLR)—for seizure risk in patients with TBI.Methods This investigation involved the enrollment of patients admitted to the Department of Neurology/Surgery at the First Affiliated Hospital of Dali University in Yunnan Province,China,spanning the period from January 2020 to May 2023.Our cohort comprised 138 individuals with PTE,150 with TBI,142 with epilepsy of unknown origin,and 130 healthy controls(HC).We retrospectively analysed demographic characteristics and peripheral blood cell inflammation markers for all participants.Results 1.In the PTE group,both neutrophil count and NLR exhibited higher levels compared to the TBI group,the epilepsy of unknown origin group,and the HC group.Conversely,the lymphocyte count,platelet count,and PLR in the group were lower in contrast to the TBI group,the epilepsy of unknown origin group,and the HC group.2.Neutrophil count,lymphocyte count,platelet count,NLR,and PLR were significantly different between the PTE and TBI,PTE and HC groups(P<0.05).Marked distinctions were detected in neutrophil count,platelet count,NLR,and PLR between the PTE group and the epilepsy of unknown origin group(P<0.05).3.Furthermore,our multivariate linear regression analysis unveiled that the TBI site(temporal lobe)(P<0.05),the severity of TBI(mild,moderate,severe)(P<0.05),and surgical intervention(P<0.05)are the risk factors affecting the peripheral blood inflammation indicators.4.Finally,the ROC analysis produced an AUC of 0.908 for neutrophil levels(cut-off:4.05,sensitivity:0.783,specificity:0.992)and an AUC of 0.960 for NLR(cut-off:2.945,sensitivity:0.797,specificity:0.992).Conclusions Both neutrophil count and the NLR were significantly increased in the PTE group,suggesting that these parameters may serve as predictors of epilepsy development in TBI patients.
文摘blood cell derived inflammatory nmarker(including systemic immunoinflammatory index(SI),systemic inflammatory response index(SIRI),neutrophil count/lymphocyte count(NLR),platelet count/lymphocyte count(PLR),and monocyte count/lymphocyte count(MLR))and in combination with N-terminal pro-B-type natriuretic peptide(NT-proBNP)on the prognosis of patients with chronic heart failure.Methods This study was a retrospective cohort study.Patients with chronic heart failure hospitalized in the Department of Cardiovascular Medicine,Nanfang Hospital,Southern Medical University from January 2019 to August 2022 were enrolled.Patients were followed up and were divided into survival group and death group according to the follow-up results.Clinical characteristics of the two groups were compared.Receiver operating characteristic(ROC)curve was used to determine the optimal cut-off value of each whole blood cell derived inflammatory marker for predicting all-cause death in patients with chronic heart failure.Kaplan-Meier survival curve was drawn,and log-rank test was used to compare the difference in survival of chronic heart failure patients with different levels of whole blood cell derived inflammatory markers.Univariate and multivariate Cox proportional hazards models were used to analyze the effects of whole blood cell derived inflammatory markers and NT-proBNP on the all-cause death of patients with chronic heart failure.ROC curve was used to analyze the predictive value of whole blood cell derived inflammatory markers combined with NT-proBNP on the prognosis of patients with chronic heart failure.Results A total of 324 patients with heart failure aged(64.76±13.78)years were enrolled,with 212 males(65.43%).297 patients(91.67%)completed follow-up,27 patients(8.33%)were lost to follow-up.The follow-up time was 24.O(18.0,41.8)months.There were 258 patients in the survival group and 66 patients in the death group.The optimal cut-off values of SI,SIRI,NLR,PLR and MLR determined by R0C curve were 739.83,1.65,3.14,151.95 and 0.37,respectively.Kaplan-Meier survival curve analysis showed that patients with chronic heart failure with high levels of SII(≥739.83),SIRI(≥1.65),NLR(≥3.14),PLR(≥151.95)and MLR(≥0.37)had higher incidence of all-cause death than patients with low levels of inflammatory markers(all P<0.001).Multivariate Cox proportional hazard regression analysis showed that age(HR=1.04,95%CI 1.01-1.06,P=0.002),NT-proBNP(HR=2.93,95%CI 1.64-5.23,P<0.001),SII≥739.83(HR=3.27,95%CI 1.18-9.02,P=0.022)and PLR≥151.95(HR=2.67,95%CI 1.02-6.96,P=0.045)were independent predictors of all-cause death in patients with chronic heart failure.ROC curve analysis showed that the predictive value of SII and PLR combined with NTproBNP(AUC=0.850)for the prognosis of patients with chronic heart failure was better than that of SII(AUC=0.779)、PLR(AUC=0.782)、NT-proBNP(AUC=0.727)and CRP(AUC=0.668)alone(all P<0.001).Conclusion Whole blood cell derived inflammatory markers—SII,PLR,and NT-pro BNP are independently associated with all-cause death in patients with chronic heart failure.SII and PLR can independently predict the prognosis of patients with chronic heart failure,combination of SII and PLR with NT-pro BNP has better predictive value for the prognosis of patients with chronic heart failure.
文摘Gastrointestinal stromal tumors(GISTs),the most prevalent mesenchymal tumors,often have poor outcomes due to high recurrence rates.However,the specific risk factors for GISTs,particularly those concerning the innate immune-inflammatory response,remain poorly understood.This editorial highlights key prognostic factors that impact GIST progression and prognosis,while discussing the findings of a recent study that investigated the prognostic value of systemic inflammatory markers:systemic immune-inflammation index,neutrophil/lym-phocyte ratio,platelet/lymphocyte ratio,and monocyte/lymphocyte ratio,on recurrence-free survival in GIST patients.This editorial examines strategies to enhance the clinical applicability of the nomogram developed in the study,ensuring its effectiveness for robust implementation.Future directions outlined in the editorial stress the importance of integrating molecular insights,including KIT and PDGFRA mutations,tumor staging,and mitotic rates to refine predictive models.The editorial also underscores the value of multi-center studies to enhance the generalizability and clinical relevance of these approaches.By bridging inflammatory biomarkers with genetic and clinicopathologic factors,a more comprehensive understanding of GIST pathophysiology can be developed,paving the way for improved management strategies and patient outcomes.This perspective serves as a call to action for continued research into the interplay between genetic mutations,inflammatory marker modulation,and GIST progression,aiming to expand the scope of personalized oncology through a deeper understanding of GIST progression.
基金This study was approved by the Ethics Committee of the First Hospital of Lanzhou University(LDYYLL2021-286)was conducted in accordance with the principles of the Declaration of Helsinki.
文摘BACKGROUND Portal vein thrombosis(PVT),a complication of liver cirrhosis,is a major public health concern.PVT prediction is the most effective method for PVT diagnosis and treatment.AIM To develop and validate a nomogram and network calculator based on clinical indicators to predict PVT in patients with cirrhosis.METHODS Patients with cirrhosis hospitalized between January 2016 and December 2021 at the First Hospital of Lanzhou University were screened and 643 patients with cirrhosis who met the eligibility criteria were retrieved.Following a 1:1 propensity score matching 572 patients with cirrhosis were screened,and relevant clinical data were collected.PVT risk factors were identified using the least absolute shrinkage and selection operator(LASSO)and multivariate logistic regression analysis.Variance inflation factors and correlation matrix plots were used to analyze multicollinearity among the variables.A nomogram was constructed to predict the probability of PVT based on independent risk factors for PVT,and its predictive performance was verified using a receiver operating characteristic curve(ROC),calibration curves,and decision curve analysis(DCA).Finally,a network calculator was constructed based on the nomograms.RESULTS This study enrolled 286 cirrhosis patients with PVT and 286 without PVT.LASSO analysis revealed 13 variables as strongly associated with PVT occurrence.Multivariate logistic regression analysis revealed nine indicators as independent PVT risk factors,including etiology,ascites,gastroesophageal varices,platelet count,D-dimer,portal vein diameter,portal vein velocity,aspartate transaminase to neutrophil ratio index,and platelet-to-lymphocyte ratio.LASSO and correlation matrix plot results revealed no significant multicollinearity or correlation among the variables.A nomogram was constructed based on the screened independent risk factors.The nomogram had excellent predictive performance,with an area under the ROC curve of 0.821 and 0.829 in the training and testing groups,respectively.Calibration curves and DCA revealed its good clinical performance.Finally,the optimal cutoff value for the total nomogram score was 0.513.The sensitivity and specificity of the optimal cutoff values were 0.822 and 0.706,respectively.CONCLUSION A nomogram for predicting PVT occurrence was successfully developed and validated,and a network calculator was constructed.This can enable clinicians to rapidly and easily identify high PVT risk groups.
文摘Pancreatitis is an inflammatory condition affecting the pancreas and is classified into 2 types,acute and chronic,which can manifest in various forms.This review article summarizes the role of predictive and prognostic values of inflammatory markers in the pathogenesis of acute pancreatitis,mainly focused on preclinical and clinical studies.It includes serum amyloid A(SAA),monocyte chemotactic protein-1(MCP-1),erythrocyte sedimentation rate(ESR),interleukin-6(IL-6),C-reactive protein(CRP),IL-10,myeloperoxidase,pentraxin 3,and plasminogen activator inhibitor 1.SAA3 plays a crucial role in developing acute pancreatitis by triggering a receptor-interacting protein 3-dependent necroptosis pathway in acinar cells.Targeting SAA3 could be a potential strategy for treating acute pancreatitis.The recruitment of monocytes/macrophages and the activation of the systemic MCP-1 signaling pathway play a role in the progression of pancreatitis,and blocking MCP-1 may have a suppressive effect on the development of pancreatic fibrosis.The ESR can predict severe acute pancreatitis with slightly lower accuracy than CRP.When ESR and CRP levels are combined at 24 hours,they predict severe acute pancreatitis accurately.IL-6 plays a crucial role in activating the Janus kinase/signal transducers and activators of the transcription pathway,exacerbating pancreatitis and contributing to the initiation and progression of pancreatic cancer.Endogenous IL-10 plays a crucial role in controlling the regenerative phase and limiting the severity of fibrosis and glandular atrophy induced by repeated episodes of acute pancreatitis in mice.The predictive and diagnostic roles of these inflammatory factors in pancreatitis were introduced in detail in this review.
文摘The prognosis of colorectal cancer(CRC)patients with peritoneal metastasis remains poor despite advancements in detection and treatment.Preoperative inflammatory and nutritional markers have emerged as significant predictors of prognosis in CRC,potentially guiding treatment decisions and improving patient outcomes.This editorial explores the prognostic value of markers such as the neutrophil-to-lymphocyte ratio,hemoglobin,and serum albumin levels.By integrating these markers into prognostic models,clinicians can better stratify patients,personalize treatment strategies,and ultimately enhance clinical outcomes.This review highlights the importance of these markers in providing a comprehensive assessment of patient condition and underscores the need for further research to validate their clinical utility and uncover underlying mecha-nisms.
