The diagnostic value of blood cell-derived indexes in subacute thyroiditis patients with thyrotoxicosis: a retrospective study

Abstract

Background: Both subacute thyroiditis (SAT) and Graves' disease (GD) can lead to thyrotoxicosis, but the methods to distinguish these two diseases are relatively complex. Therefore, it is necessary to find biomarkers which can quickly and efficiently identify the two kinds of thyrotoxicosis. Blood cell-derived indexes are widely used to evaluate systemic inflammation. We aimed to evaluate the diagnostic value of blood cellderived indexes in SAT patients with thyrotoxicosis.Methods: Totally 139 SAT patients with thyrotoxicosis, 146 GD patients, and 100 euthyroid individuals were enrolled in the study. Complete blood cell (CBC) count, thyroid function, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), systemic immuneinflammatory index (SII), systemic inflammation response index (SIRI), aggregate inflammation systemic index (AISI), and mean platelet volume to platelet ratio (MPR) were evaluated in all subjects. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the capacity of blood cell-derived indexes in differentiating SAT patients with thyrotoxicosis from GD patients. We also evaluated the association between blood cell-derived indexes and other laboratory indicators and clinical outcomes in SAT patients.Results: NLR, PLR, MLR, SII, SIRI, and AISI were significantly higher in the SAT group. MPR was significantly lower in the SAT group. A formula including NLR, PLR, MLR, SII, SIRI, AISI and MPR was developed. The combination formula with an optimal cutoff of 0.426 showed the better diagnostic value [area under the curve (AUC) =0.921; 95% confidence interval (CI): 0.891-0.950; P<0.001; sensitivity, 87.1%; specificity, 83.6%]. However, thyroid function, erythrocyte sedimentation rate (ESR), thyroid peroxidase antibodies (TPOAb), and blood cell-derived indexes, were not found to be significantly associated with hypothyroidism and recurrence. Conclusions:We developed a formula combining 7 blood cell-derived indexes. The combination formula could be a novel biomarker to distinguish SAT patients with thyrotoxicosis from GD patients. However, we did not find significant association between the blood cell-derived indexes and clinical outcomes in SAT patients.

Platelet abnormalities in autoimmune thyroid diseases: A systematic review and meta-analysis

“…Through database searches, 759 records were found. After screening, 19 articles ( 5 , 9 , 11 , 23 – 38 ) were finally selected for the meta-analysis. The specific screening process is shown in Figure 1 , articles excluded after full text review are listed in Methods 4.…”

“…The characteristics of the 19 included articles are shown in Table S4 . Among them, part of the data from 4 articles ( 23 , 30 , 36 , 37 ) were presented as median (min-max) or median (25–75th percentile), which were transformed according to the methods mentioned in Data Synthesis and Data Analysis. A comparison table of the original data and the corresponding converted data is shown in Table S5 .…”

Kombine hematolojik inflamatuar indekslerin akut pankreatit hastalarında kötü sonlanımı öngörmedeki rolü

“…In addition to hematological parameters, hematological inflammatory indices were used in different diseases with inflammatory pathophysiology. In a study performed for the differential diagnosis of subacute thyroiditis and including 285 patients, neutrophil, lymphocyte, NLR, SIRI, and AISI values were significantly higher in patients with subacute thyroiditis than in patients in the graves and control group (P < 0.05) (4). In a study conducted in patients with rheumatoid arthritis, although NLR, SIRI, and AISI were found to be statistically significantly higher in patients with rheumatoid arthritis than in the control group, they were not found to be superior to each other (AUCs < 0.7) (5).…”

“…[1][2][3] Lymphocyte, neutrophil, and thrombocyte counts can be effective in the inflammation process as well as with the proportional indices between them, and they are also the subject of studies on many chronic inflammatory diseases since they are associated with the prognosis. [4,5] The neutrophil to lymphocyte ratio (NLR) was studied in relation to asthma, [7] chronic obstructive pulmonary disease (COPD), [8] and intensive care patients. [9] The neutrophil to lymphocyte ratio (NLR), neutrophil/lymphocyte*platelet ratio (NLPR), systemic inflammation response index (SIRI), and aggregate inflammation systemic index (AISI) were examined in patients diagnosed with thyroiditis, [4] rheumatoid arthritis, [5] and pulmonary fibrosis [6] in order to examine the post-operative inflammatory processes [10] even in patients diagnosed with COVID-19.…”

“…[4,5] The neutrophil to lymphocyte ratio (NLR) was studied in relation to asthma, [7] chronic obstructive pulmonary disease (COPD), [8] and intensive care patients. [9] The neutrophil to lymphocyte ratio (NLR), neutrophil/lymphocyte*platelet ratio (NLPR), systemic inflammation response index (SIRI), and aggregate inflammation systemic index (AISI) were examined in patients diagnosed with thyroiditis, [4] rheumatoid arthritis, [5] and pulmonary fibrosis [6] in order to examine the post-operative inflammatory processes [10] even in patients diagnosed with COVID-19. [11][12][13] Although we know that the effects of hematological parameters on prognosis in patients with pancreatitis have been examined, [3,14] there was no pancreatitis study using hematological inflammatory indices other than NLR, [1,14] and related to the length of hospital stay, mortality, or intensive care hospitalization rates, as far as we can detect.…”