Novel markers of endothelial dysfunction and inflammation in Behçet’s disease patients with ocular involvement: epicardial fat thickness, carotid intima media thickness, serum ADMA level, and neutrophil-to-lymphocyte ratio

Abstract

The etiology of Behçet's disease (BD) has not been fully elucidated. However, immunological and environmental factors, endothelial dysfunction (ED), and genetic susceptibility have been proposed to play a role. In this study, we aimed to evaluate epicardial fat thickness (EFT) together with serum asymmetric dimethylarginine (ADMA), carotid intima media thickness (CIMT), and neutrophil-to-lymphocyte ratio (NLR) in BD patients with ocular involvement. Thirty-six ocular BD patients (17 active and 19 inactive ocular involvement), and 35 age and sex-matched healthy controls were enrolled to this cross-sectional study. All patients underwent examinations with transthoracic echocardiography and carotid Doppler ultrasound. Serum ADMA levels, CIMT, EFT, and NLR were compared between groups, and their association with disease activity was evaluated. Behçet's disease patients had higher WBC counts, neutrophil counts, NLR, CIMT, EFT values, and serum ADMA levels than do healthy controls. The other biochemical, hematological, and echocardiographic parameters were comparable between the two groups. Behçet's disease duration was positively correlated with EFT and CIMT. Multivariate logistic regression analysis revealed that increased serum ADMA concentration and CIMT are independently associated with BD. Neutrophil counts, NLR, and serum ADMA level were higher, and lymphocyte count was lower in patients with active ocular BD compared to those of inactive ocular BD group. Carotid intima media thickness, serum ADMA level, EFT, and NLR were increased in ocular BD patients compared to healthy subjects. In addition, both serum ADMA level and NLR were associated with disease activity of ocular involvement. Increase in disease duration was associated with increase in CIMT and EFT which suggests that anatomical changes occur in time during the disease course. Increased CIMT, serum ADMA level, EFT, and NLR may provide new clues about the role of ED and inflammation in the etiopathogenesis of BD.

Prognostic Value of Neutrophil-To-Lymphocyte Ratio and Platelet-To-Lymphocyte Ratio for Renal Outcomes in Patients with Rapidly Progressive Glomerulonephritis

“…In recent years, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have received attention as potential new markers of systemic inflammation. In previous studies, NLR and PLR have been reported to be useful in systemic inflammatory diseases such as aortitis syndrome [6], Behçet's disease [7], Kawasaki disease [8], Henoch-Schönlein purpura [9], systemic lupus erythematosus [10], and anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) [11,12]. Furthermore, NLR and PLR have been proposed as markers of inflammation in patients with ESRD [13,14].…”

Neutrophil‐to‐lymphocyte ratio, mean platelet volume and platelet‐to‐lymphocyte ratio in Behçet’s disease and their correlation with disease activity: A meta‐analysis

“…Behçet’s disease can be classified as active and inactive diseases based on disease activity, and thrombosis occurs often in BD. Studies on MPV, NLR, and PLR in patients with BD in comparison with those in healthy controls, on the indices between active and inactive diseases, and between BD with and without thrombosis have reported controversial results . We performed the present meta‐analysis to overcome the limitations of individual studies and resolve inconsistencies .…”

High Neutrophil-to-Lymphocyte Ratio Predicts Cardiovascular Mortality in Chronic Hemodialysis Patients

“…NLR is a novel simple and inexpensive index for assessing inflammation [3]. Emerging evidence suggested that increased NLR was a potential marker of poor prognosis in multiple tumors [4–6] and cardiovascular diseases [7–9] in general population.…”