Platelet-to-Lymphocyte Ratio and Neutrophil-to-Lymphocyte Ratio in Patients With Newly Diagnosed Moyamoya Disease: A Cross-Sectional Study

Abstract

Inflammation has been proven to be one of the key factors in the pathogenesis of moyamoya disease (MMD). Platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) are cheap and reliable biomarkers of inflammation. Nevertheless, evidence regarding the relationship among PLR and NLR in patients with MMD is limited. The focus of this subject was to explore the relationship between PLR and NLR in patients with newly diagnosed MMD.Patients and methods: A cross-sectional study was performed including 261 patients with diagnosed MMD for the first time who were enrolled from our hospital, from 24 March 2013 to 24 December 2018. The clinical characteristics were collected for each patient. Univariate analysis, smooth curve fitting and multivariate piecewise linear regression were showed.Results: The mean levels or median values (interquartile range) of PLR and NLR were 146.979 ± 51.203 and 2.241 (1.589–2.984), respectively. A significant positive correlation between PLR and NLR levels (P < 0.001) was showed by the univariate analysis. Furthermore, a non-linear relationship was detected between PLR and NLR by smooth curve fitting after adjusting for potential confounders. A multivariate piecewise linear regression model revealed a significant positive correlation between PLR and NLR when the PLR level was lower than 219.82 (β 0.012, 95% CI 0.005, 0.019; P = 0.001). PLR was also significantly positively associated with NLR when PLR concentrations were >219.82 (β 0.098, 95% CI 0.069, 0.128; P < 0.001).Conclusion: There seemed to be a positive association between PLR and NLR in patients with MMD. This may help to further explain the role of inflammation in the occurrence and progress of MMD.

Correlation Between Platelet-Lymphocyte Ratio and Neutrophil-Lymphocyte Ratio in Patients with Uterine Leiomyoma: A Cross-Sectional Study

“…Several studies [34][35][36] have pointed out that inflammation plays an important role in the pathogenesis of uterine leiomyoma, as well as in the development of fibroid fibrosis and disease progression. Many studies [20,23,37,38] have also reported that PLR and NLR can reflect the inflammatory state of the body in the absence of infectious diseases. In the current study, NLR showed an upward trend with an increase in PLR in patients with multiple uterine fibroids.…”

Plasma-derived exosomes contributes to Endothelial-to-mesenchymal transition in moyamoya disease

“…The pathogenesis of moyamoya disease was not fully understood, and it was currently believed to be related to genetic, in ammatory, environmental and other factors [1,4]. Our experimental results indicated that there may be a biological process of EndMTin the blood vessels of moyamoya disease.…”

Clinical value of the systemic immune-inflammation index in moyamoya disease

“…MMD was more common in East Asian countries, such as Japan, Korea, and China, and according to a report, the annual incidence of MMD was 1.14 per 100,000 inhabitants in China from 2016 to 2018, and it increased year by year (3). The underlying pathophysiological mechanism of moyamoya disease remains to be elucidated, but recent studies have increasingly highlighted that an abnormal immune response may be a potential trigger for MMD (4)(5)(6)(7)(8). For example, histopathological examination of intracranial vessels in patients with moyamoya disease revealed smooth muscle hyperplasia with infiltrating macrophages and T cells in the vessel wall, and immunohistochemical studies also showed abnormal expressions of IgG and S100A4 proteins in vascular smooth muscle cells (2,8,9).…”

“…Recently, platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR), as new easily available and economical biomarkers of systemic inflammation, have been confirmed in a variety of immune-inflammation diseases, including moyamoya disease ( 5 , 19 , 20 ). When there is no obvious infection, PLR and NLR are considered to be indicators of systemic inflammation ( 21 – 23 ).…”