Comparison of the Neutrophil/Lymphocyte Ratio and C-Reactive Protein Levels in Patients With Amputation for Diabetic Foot Ulcers

Metineren, Hasan; Dülgeroğlu, Turan Cihan

doi:10.1177/1534734617696729

Cited by 18 publications

(14 citation statements)

References 27 publications

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“…Given the divergent mechanisms involved in the pathophysiology of these diseases, it might as well be argued that NLR and PLR are mere indicators of a general immune disorder similar to acute phase response. However since their correlation with markers of acute phase response is not consistent across studies, we reason that they probably represent a different aspect/dimension of an immune disorder other than the acute phase response [3,4,[22][23][24].…”

Section: Nlrmentioning

confidence: 87%

Neutrophil- and Platelet- to Lymphocyte Ratio in Patients with Euthyroid Hashimoto’s Thyroiditis

Bilge

Yeşilova

Adaş

et al. 2018

Exp Clin Endocrinol Diabetes

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Background Hashimoto's thyroiditis (HT) is the most prevalent autoimmune thyroid disorder. Both neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are reported to be increased in various inflammation-related diseases, but their clinical significance in HT remains unclear. Objectives The aim of this study was to investigate the relationship between thyroid autommunity and NLR and PLR as markers of systemic inflammation in HT. Methods In this study, we evaluated 145 women with HT and 60 age-matched healthy controls. We compared the PLR and the NLR of HT patients with controls and the correlation between the NLR, PLR, and C-reactive protein (CRP), thyroid-stimulating hormone (TSH) and thyroid antibody titers in the patient group. Also we compared the PLR and the NLR of HT patients that received levothyroxine with those who did not receive levothyroxine Results There were no significant differences between patient and control groups in terms of overall leukocyte counts, neutrophil counts, and other laboratory tests. In the patient group lymphocyte counts were lower while the platelet counts, NLR (2.29±0.65 vs1.68±0.40), PLR (164.95±55.14 vs106.88±32.19) were higher than those of the control (p<0.001 for all comparisons). Conclusion In this study we found that NLR and PLR were higher in euthyroid Hashimoto patients than in a healthy control group. NLR and PLR are likely non-specific indicators of immune disorder and their implications for HT and other conditions remain to be elucidated.

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Section: Nlrmentioning

confidence: 87%

Neutrophil- and Platelet- to Lymphocyte Ratio in Patients with Euthyroid Hashimoto’s Thyroiditis

Bilge

Yeşilova

Adaş

et al. 2018

Exp Clin Endocrinol Diabetes

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“…Other studies have shown that WBC, CRP and ESR are also risk factors of a high amputation rate. 15,18,20,28,32,33 However, controversy still exists. 18,32 34-39 Inflammatory markers are essential tools in the decision-making process for lower extremity infections.…”

Section: Discussionmentioning

confidence: 99%

Predictive Laboratory Findings of Lower Extremity Amputation in Diabetic Patients: Meta-analysis

Kim

Shin

Roh

et al. 2017

The International Journal of Lower Extremity Wounds

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Lower extremity amputation is a source of morbidity and mortality among diabetic patients. This meta-analysis aimed to identify significant laboratory data in patients with diabetic foot ulcer with high rates of lower extremity amputation. We performed a systematic literature review and meta-analysis using MEDLINE, EMBASE, and Cochrane databases. We extracted and evaluated 11 variables from the included studies based on amputation rates. This study used the Newcastle-Ottawa Scale to assess the quality of the studies. The search strategy identified 101 publications from which we selected 16 articles for review. We identified HbA1c, fasting blood glucose, white blood cells, C-reactive protein, and erythrocyte sedimentation rate as predictive variables of higher major amputation rate. Although further investigation of long-term and prospective studies is needed, we identified 5 variables as predisposing factors for higher major amputation in diabetic patients through meta-analysis.

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“…Studies have also shown that the severity of DFUs may be in part determined by the deficiency of the immune response in DFUs via deregulation of IL-6, macrophage migration inhibitory factor (MIF), and interferon-inducible protein (IP)-10 [ 118 ], and a compromised neutrophil response [ 119 , 120 , 121 ]. In recent years, it has been proposed that high platelet-to-lymphocyte (PLR) and neutrophil-to-lymphocyte ratios (NLR) may be a biomarker for DFU severity [ 122 , 123 ], where high PLR levels reflect the increased platelet activity, inflammation, and the risk for thrombosis and atherogenesis [ 122 , 124 , 125 ], while high NLR levels lead to the upregulation of cytokines and of proteolytic enzymes that can cause tissue damage [ 122 , 123 ].…”

Section: Pathophysiology Associated With Diabetic Wound Healingmentioning

confidence: 99%

Diabetic Wound-Healing Science

et al. 2021

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Diabetes mellitus is an increasingly prevalent chronic metabolic disease characterized by prolonged hyperglycemia that leads to long-term health consequences. It is estimated that impaired healing of diabetic wounds affects approximately 25% of all patients with diabetes mellitus, often resulting in lower limb amputation, with subsequent high economic and psychosocial costs. The hyperglycemic environment promotes the formation of biofilms and makes diabetic wounds difficult to treat. In this review, we present updates regarding recent advances in our understanding of the pathophysiology of diabetic wounds focusing on impaired angiogenesis, neuropathy, sub-optimal chronic inflammatory response, barrier disruption, and subsequent polymicrobial infection, followed by current and future treatment strategies designed to tackle the various pathologies associated with diabetic wounds. Given the alarming increase in the prevalence of diabetes, and subsequently diabetic wounds, it is imperative that future treatment strategies target multiple causes of impaired healing in diabetic wounds.

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Comparison of the Neutrophil/Lymphocyte Ratio and C-Reactive Protein Levels in Patients With Amputation for Diabetic Foot Ulcers

Cited by 18 publications

References 27 publications

Neutrophil- and Platelet- to Lymphocyte Ratio in Patients with Euthyroid Hashimoto’s Thyroiditis

Neutrophil- and Platelet- to Lymphocyte Ratio in Patients with Euthyroid Hashimoto’s Thyroiditis

Predictive Laboratory Findings of Lower Extremity Amputation in Diabetic Patients: Meta-analysis

Diabetic Wound-Healing Science

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