Usefulness of neutrophil to lymphocyte ratio in patients with chronic obstructive pulmonary disease: a prospective observational study
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background/Aims: Neutrophil to lymphocyte ratio (NLR) in peripheral blood is a useful systemic inflammatory response biomarker. However, NLR has not been studied in patients with chronic obstructive pulmonary disease (COPD). This study was aimed to evaluate the usefulness of NLR in patients with COPD. Methods: NLR was prospectively measured and compared in patients with COPD exacerbation (n = 59), patients with stable COPD (n = 61), and healthy controls (n = 28). NLR in patients with COPD exacerbation was repeatedly measured in the convalescent period. The correlation between NLR and clinical parameters was evaluated, and the predictors for respiratory hospitalization were analyzed by multivariate logistic regression. Results: NLR values were significantly higher in patients with COPD exacerbation compared with stable COPD patients and controls (12.4 ± 10.6, 2.4 ± 0.7, 1.4 ± 0.5, respectively; p < 0.001). NLR was significantly decreased during the convalescent period in patients with COPD exacerbation (4.5 ± 4.6 vs. 11.5 ± 8.8, p < 0.001). NLR exhibited a significant correlation with the body mass index, degree of airway obstruction, dyspnea, and exercise capacity (BODE) index, the 6-minute walk test, and the modified Medical Research Council scale. NLR ≥ 2.8 was an independent predictor with a borderline significance for respiratory hospitalization (odds ratio, 2.083; p = 0.079). Body mass index and forced expiratory volume in 1 second were independent predictors for respiratory hospitalization. Conclusions: NLR is a straightforward and effective biomarker of COPD exacerbation that may serve as a predictor for respiratory hospitalization in patients with COPD.
Abstract
Background/Aims: Neutrophil to lymphocyte ratio (NLR) in peripheral blood is a useful systemic inflammatory response biomarker. However, NLR has not been studied in patients with chronic obstructive pulmonary disease (COPD). This study was aimed to evaluate the usefulness of NLR in patients with COPD. Methods: NLR was prospectively measured and compared in patients with COPD exacerbation (n = 59), patients with stable COPD (n = 61), and healthy controls (n = 28). NLR in patients with COPD exacerbation was repeatedly measured in the convalescent period. The correlation between NLR and clinical parameters was evaluated, and the predictors for respiratory hospitalization were analyzed by multivariate logistic regression. Results: NLR values were significantly higher in patients with COPD exacerbation compared with stable COPD patients and controls (12.4 ± 10.6, 2.4 ± 0.7, 1.4 ± 0.5, respectively; p < 0.001). NLR was significantly decreased during the convalescent period in patients with COPD exacerbation (4.5 ± 4.6 vs. 11.5 ± 8.8, p < 0.001). NLR exhibited a significant correlation with the body mass index, degree of airway obstruction, dyspnea, and exercise capacity (BODE) index, the 6-minute walk test, and the modified Medical Research Council scale. NLR ≥ 2.8 was an independent predictor with a borderline significance for respiratory hospitalization (odds ratio, 2.083; p = 0.079). Body mass index and forced expiratory volume in 1 second were independent predictors for respiratory hospitalization. Conclusions: NLR is a straightforward and effective biomarker of COPD exacerbation that may serve as a predictor for respiratory hospitalization in patients with COPD.
참고문헌 (38)
- "The top 10 causes of death" (2015)[URL]
- Vestbo J, "Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary", Am J Respir Crit Care Med, 187, pp.347~365 (2013)
- Franciosi LG, "Markers of disease severity in chronic obstructive pulmonary disease", Pulm Pharmacol Ther, 19, pp.189~199 (2006)
- Franciosi LG, "Markers of exacerbation severity in chronic obstructive pulmonary disease", Respir Res, 7, pp.74~ (2006)
- Barnes PJ, "Pulmonary biomarkers in chronic obstructive pulmonary disease", Am J Respir Crit Care Med, 174, pp.6~14 (2006)
- Sinden NJ, "Systemic inflammation and comorbidity in COPD: a result of ‘overspill’ of inflammatory mediators from the lungs? Review of the evidence", Thorax, 65, pp.930~936 (2010)
- Walter RE, "Systemic inflammation and COPD: the Framingham Heart Study", Chest, 133, pp.19~25 (2008)
- Vestbo J, "Systemic inflammation and progression of COPD", Thorax, 62, pp.469~470 (2007)
- Williams KA, "Prognostic significance and predictors of the neutrophil-to-lymphocyte ratio in ovarian cancer", Gynecol Oncol, 132, pp.542~550 (2014)
- Roxburgh CS, "Role of systemic inflammatory response in predicting survival in patients with primary operable cancer", Future Oncol, 6, pp.149~163 (2010)
- Kacan T, "Could the neutrophil to lymphocyte ratio be a poor prognostic factor for non small cell lung cancers?", Asian Pac J Cancer Prev, 15, pp.2089~2094 (2014)
- Walsh SR, "Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer", J Surg Oncol, 91, pp.181~184 (2005)
- Azab B, "Usefulness of the neutrophil-to-lymphocyte ratio in predicting short-and long-term mortality in breast cancer patients", Ann Surg Oncol, 19, pp.217~224 (2012)
- Stotz M, "Increased neutrophil-lymphocyte ratio is a poor prognostic factor in patients with primary operable and inoperable pancreatic cancer", Br J Cancer, 109, pp.416~421 (2013)
- Guasti L, "Neutrophils and clinical outcomes in patients with acute coronary syndromes and", or cardiac revascularisation: a systematic review on more than 34,000 subjects, 2011, pp.106, 591~599
- Bhat T, "Neutrophil to lymphocyte ratio and cardiovascular diseases: a review", Expert Rev Cardiovasc Ther, 11, pp.55~59 (2013)
- MacNee W, "Systemic inflammatory biomarkers and co-morbidities of chronic obstructive pulmonary disease", Ann Med, 45, pp.291~300 (2013)
- Agustí AG, "Systemic effects of chronic obstructive pulmonary disease", Eur Respir J, 21, pp.347~360 (2003)
- Gan WQ, "Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a meta-analysis", Thorax, 59, pp.574~580 (2004)
- Agusti AG, "COPD, a multicomponent disease: implications for management", Respir Med, 99, pp.670~682 (2005)
- Berger JS, "Effect of chronic obstructive pulmonary disease on survival of patients with coronary heart disease having percutaneous coronary intervention", Am J Cardiol, 94, pp.649~651 (2004)
- Curkendall SM, "Cardiovascular disease in patients with chronic obstructive pulmonary disease, Saskatchewan Canada cardiovascular disease in COPD patients", Ann Epidemiol, 16, pp.63~70 (2006)
- Mannino DM, "Low lung function and incident lung cancer in the United States:data from the first National Health and Nutrition Examination Survey follow-up", Arch Intern Med, 163, pp.1475~1480 (2003)
- Schols AM, "Pulmonary cachexia", Int J Cardiol, 85, pp.101~110 (2002)
- Biskobing DM, "COPD and osteoporosis", Chest, 121, pp.609~620 (2002)
- Yao Y, "Pretreatment neutrophil to lymphocyte ratio is associated with response to therapy and prognosis of advanced non-small cell lung", Cancer Immunol Immunother, 62, pp.471~479 (2013)
- Yilmaz H, "Neutrophil-lymphocyte ratio may be superior to C-reactive protein for predicting the occurrence of postmenopausal osteoporosis", Endocr Regul, 48, pp.25~33 (2014)
- Kang MH, "The prognostic impact of the neutrophil-to-lymphocyte ratio in patients with small-cell lung cancer", Br J Cancer, 111, pp.452~460 (2014)
- Hurst JR, "Use of plasma biomarkers at exacerbation of chronic obstructive pulmonary disease", Am J Respir Crit Care Med, 174, pp.867~874 (2006)
- Celli BR, "The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease", N Engl J Med, 350, pp.1005~1012 (2004)
- Marin JM, "Prediction of risk of COPD exacerbations by the BODE index", Respir Med, 103, pp.373~378 (2009)
- Pinto-Plata V, "Profiling serum biomarkers in patients with COPD: associations with clinical parameters", Thorax, 62, pp.595~601 (2007)
- Liu SF, "Correlation between serum biomarkers and BODE index in patients with stable COPD", Respirology, 14, pp.999~1004 (2009)
- Gaki E, "Associations between BODE index and systemic inflammatory biomarkers in COPD", COPD, 8, pp.408~413 (2011)
- Hallin R, "Nutritional status, dietary energy intake and the risk of exacerbations in patients with chronic obstructive pulmonary disease (COPD)", Respir Med, 100, pp.561~567 (2006)
- Pouw EM, "Early non-elective readmission for chronic obstructive pulmonary disease is associated with weight loss", Clin Nutr, 19, pp.95~99 (2000)
- Bahadori K, "Risk factors of hospitalization and readmission of patients with COPD exacerbation:systematic review", Int J Chron Obstruct Pulmon Dis, 2, pp.241~251 (2007)
- inganayagam A, "Predictors of mortality in hospitalized adults with acute exacerbation of chronic obstructive pulmonary disease", Ann Am Thorac Soc, 10, pp.81~89 (2013)
