Association of White Blood Cell Counts, Leukocyte Ratios, and Serum Uric Acid with Clinical Outcome of Intravitreal Bevacizumab in Diabetic Macular Edema
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: To investigate the role of serum uric acid and leukocyte counts and ratios as predictors of clinical outcomes of intravitrealbevacizumab in diabetic macular edema. Methods: In this prospective study, the patients were treated with three monthly intravitreal bevacizumab. The correlationof serum uric acid and immune cell indices with the changes of best-corrected visual acuity and central macular thickness atthe end of month 3 were evaluated through univariate and multivariate linear regression analysis. Results: A total of 80 eyes from 80 diabetic patients were included in the study. The difference of uric acid level and immuneindices between groups with different retinopathy severity was not statistically significant (p > 0.05). Lower durationof diabetes (p = 0.045), monocyte count (p = 0.021), and uric acid level (p < 0.001) were correlated with larger improvementin visual acuity at 3-month visit. Higher logarithm of the minimum angle of resolution of baseline visual acuity (p = 0.007),lymphocyte count (p = 0.008), lymphocyte to neutrophil ratio (p < 0.001) and lymphocyte to platelet ratio (p < 0.001) werecorrelated with larger improvement in visual acuity at 3-month visits. According to multivariate analysis, baseline logarithm ofthe minimum angle of resolution (r = 0.125, p = 0.009), duration of diabetes (r = -0.216, p = 0.047), lymphocyte to neutrophilratio (r = 0.712, p < 0.001), lymphocyte to platelet ratio (r = 0.238, p < 0.001), and uric acid level (r = -0.397, p < 0.001) werethe significant predictors of changes in visual acuity in our subset of patients. Conclusions: Serum uric acid and leukocyte counts and ratios may predict the response of diabetic macular edema to intravitrealinjection.
Abstract
Purpose: To investigate the role of serum uric acid and leukocyte counts and ratios as predictors of clinical outcomes of intravitrealbevacizumab in diabetic macular edema. Methods: In this prospective study, the patients were treated with three monthly intravitreal bevacizumab. The correlationof serum uric acid and immune cell indices with the changes of best-corrected visual acuity and central macular thickness atthe end of month 3 were evaluated through univariate and multivariate linear regression analysis. Results: A total of 80 eyes from 80 diabetic patients were included in the study. The difference of uric acid level and immuneindices between groups with different retinopathy severity was not statistically significant (p > 0.05). Lower durationof diabetes (p = 0.045), monocyte count (p = 0.021), and uric acid level (p < 0.001) were correlated with larger improvementin visual acuity at 3-month visit. Higher logarithm of the minimum angle of resolution of baseline visual acuity (p = 0.007),lymphocyte count (p = 0.008), lymphocyte to neutrophil ratio (p < 0.001) and lymphocyte to platelet ratio (p < 0.001) werecorrelated with larger improvement in visual acuity at 3-month visits. According to multivariate analysis, baseline logarithm ofthe minimum angle of resolution (r = 0.125, p = 0.009), duration of diabetes (r = -0.216, p = 0.047), lymphocyte to neutrophilratio (r = 0.712, p < 0.001), lymphocyte to platelet ratio (r = 0.238, p < 0.001), and uric acid level (r = -0.397, p < 0.001) werethe significant predictors of changes in visual acuity in our subset of patients. Conclusions: Serum uric acid and leukocyte counts and ratios may predict the response of diabetic macular edema to intravitrealinjection.
참고문헌 (34)
- Bandello F, "Diabetic macular edema", Dev Ophthalmol, 58, pp.102~138 (2017)
- Antonetti DA, "Molecular mechanisms of vascular permeability in diabetic retinopathy", Semin Ophthalmol, 14, pp.240~248 (1999)
- Afzal N, "Immune mechanisms in type-2 diabetic retinopathy", J Pak Med Assoc, 65, pp.159~163 (2015)
- Frostegard J, "Immune mechanisms in atherosclerosis, especially in diabetes type 2", Front Endocrinol(Lausanne), 4, pp.162~ (2013)
- Fujita T, "Complement-mediated chronic inflammation is associated with diabetic microvascular complication", Diabetes Metab Res Rev, 29, pp.220~226 (2013)
- Grossmann V, "Profile of the immune and inflammatory response in individuals with prediabetes and type 2 diabetes", Diabetes Care, 38, pp.1356~1364 (2015)
- Pitsavos C, "Association between low-grade systemic inflammation and type 2diabetes mellitus among men and women from the ATTICA study", Rev Diabet Stud, 4, pp.98~104 (2007)
- Virgili G, "Anti-vascular endothelial growth factor for diabetic macular oedema : a network meta-analysis", Cochrane Database Syst Rev, 6, pp.CD007419~ (2017)
- Sandler A, "Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer", N Engl J Med, 355, pp.2542~2550 (2006)
- Botta C, "Systemic inflammatory status at baseline predicts bevacizumab benefit in advanced non-small cell lung cancer patients", Cancer Biol Ther, 14, pp.469~475 (2013)
- Yue S, "Use of the monocyte-to-lymphocyte ratio to predict diabetic retinopathy", Int J Environ Res Public Health, 12, pp.10009~10019 (2015)
- Mene P, "Uric acid : bystander or culprit in hypertension and progressive renal disease", J Hypertens, 26, pp.2085~2092 (2008)
- Wilkinson CP, "Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales", Ophthalmology, 110, pp.1677~1682 (2003)
- Kaul K, "Is inflammation a common retinal-renal-nerve pathogenic link in diabetes", Curr Diabetes Rev, 6, pp.294~303 (2010)
- Liu J, "The association of neutrophil to lymphocyte ratio, mean platelet volume, and platelet distribution width with diabetic retinopathy and nephropathy: a meta-analysis", Biosci Rep, 38, pp.BSR20180172~ (2018)
- Lutty GA, "Relationship of polymorphonuclear leukocytes to capillary dropout in the human diabetic choroid", Am J Pathol, 151, pp.707~714 (1997)
- Powell ED, "Diabetic retinopathy and rheumatoid arthritis", Lancet, 2, pp.17~18 (1964)
- Sasongko MB, "Circulating markers of inf lammation and endothelial function, and their relationship to diabetic retinopathy", Diabet Med, 32, pp.686~691 (2015)
- Woo SJ, "Elevated systemic neutrophil count in diabetic retinopathy and diabetes: a hospital-based cross-sectional study of 30,793 Korean subjects", Invest Ophthalmol Vis Sci, 52, pp.7697~7703 (2011)
- Xia C, "Role of T lymphocytes in type 2diabetes and diabetes-associated inflammation", J Diabetes Res, 2017, pp.6494795~ (2017)
- Akyel A, "Neutrophil-to-lymphocyte ratio predicts hemodynamic significance of coronary artery stenosis", Anatol J Cardiol, 15, pp.1002~1007 (2015)
- Gunduz S, "Platelet to lymphocyte ratio as a new prognostic for patients with metastatic renal cell cancer", Asia Pac J Clin Oncol, 11, pp.288~292 (2015)
- Ozaksit G, "Value of the platelet to lymphocyte ratio in the diagnosis of ovarian neoplasms in adolescents", Asian Pac J Cancer Prev, 16, pp.2037~2041 (2015)
- Ulu SM, "Neutrophil-to-lymphocyte ratio as a quick and reliable predictive marker to diagnose the severity of diabetic retinopathy", Diabetes Technol Ther, 15, pp.942~947 (2013)
- Wang RT, "Neutrophil-Lymphocyte ratio is associated with arterial stiffness in diabetic retinopathy in type 2 diabetes", J Diabetes Complications, 29, pp.245~249 (2015)
- Ciray H, "Nephropathy, but not angiographically proven retinopathy, is associated with neutrophil to lymphocyte ratio in patients with type 2 diabetes", Exp Clin Endocrinol Diabetes, 123, pp.267~271 (2015)
- Ferrara N, "Role of myeloid cells in vascular endothelial growth factor-independent tumor angiogenesis", Curr Opin Hematol, 17, pp.219~224 (2010)
- Leontovich AA, "Effect of the lymphocyte-to-monocyte ratio on the clinical outcome of chemotherapy administration in advanced melanoma patients", Melanoma Res, 27, pp.32~42 (2017)
- Hu Y, "Pretreatment neutrophil-to-lymphocyte ratio predicts prognosis in patients with diabetic macular edema treated with ranibizumab", BMC Ophthalmol, 19, pp.194~ (2019)
- Icel E, "The relation of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio with high axial myopia", Ocul Immunol Inf lamm, 28, pp.396~401 (2020)
- Ji S, "Platelet distribution width, platelet count, and plateletcrit in diabetic retinopathy: a systematic review and meta-analysis of PRISMA guidelines", Medicine (Baltimore), 98, pp.e16510~ (2019)
- Vinik AI, "Platelet dysfunction in type 2 diabetes", Diabetes Care, 24, pp.1476~1485 (2001)
- Oh J, "Uric acid and cardiovascular risk", N Engl J Med, 360, pp.539~540 (2009)
- Liang CC, "Association of serum uric acid concentration with diabetic retinopathy and albuminuria in Taiwanese patients with type 2 diabetes mellitus", Int J Mol Sci, 17, pp.1248~ (2016)