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

Wenyuan Ma,Feng Jin,Jilan Liu,Yawei Hu,Guangkui Han,Mengjie Wang,Lu Zhang,Song Feng,Changmeng Cui,Genhua Li,Xianyun Qin

doi:10.3389/fneur.2021.631454

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.

Highlights

Moyamoya disease (MMD) is a rare cerebrovascular disease characterized by progressive stenosis of large intracranial arteries and a hazy network of basal collaterals called moyamoya vessels [1]
platelet-to-lymphocyte ratio (PLR) was significantly positively associated with neutrophil-to-lymphocyte ratio (NLR) when PLR concentrations were >219.82 (β 0.098, 95% CI 0.069, 0.128; P < 0.001)
We found that NLR levels displayed an increasing trend as PLR increased in MMD patients with intracranial ischemia and intracranial hemorrhage

Summary

Introduction

Moyamoya disease (MMD) is a rare cerebrovascular disease characterized by progressive stenosis of large intracranial arteries and a hazy network of basal collaterals called moyamoya vessels [1]. With the deepening of research on MMD, systemic inflammation has been shown to play a critical role in the pathogenesis of MMD [2,3,4]. A previous study reported a secure epidemiological association among MMD and certain diseases that have a segment of inflammation [5]. These discoveries may demonstrate that in some patients with MMD, pathological vessel shapes may be a sequela of systemic inflammation [6]. Existing studies on MMD and inflammation have focused on inflammatory cytokines such as interleukin-1β (IL-1β), interleukin-12 (IL-12), transforming growth factor-β1 (TGF-β1) and tumor necrosis factor-α (TNF-α) [5, 7,8,9]. Evidence regarding the relationship between platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) in patients with MMD is limited

Objectives

Methods

Results

Discussion

Conclusion