The diagnostic value of white blood cell, neutrophil, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio in patients with primary angle closure glaucoma.

Shengjie Li,Jianping Han,Binghua Tang,Xinghuai Sun,Wenjun Cao

doi:10.18632/oncotarget.16571

Shengjie Li, Jianping Han + Show 3 more

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https://doi.org/10.18632/oncotarget.16571

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Abstract

ObjectiveInflammatory mechanisms may have a role in the pathogenesis of primary angle closure glaucoma (PACG). The objective of this study was to investigate the diagnostic value of white blood cell (WBC), neutrophil, neutrophil to lymphocyte ratio (NLR), and lymphocyte to monocyte ratio (LMR) in patients with PACG and its association with glaucoma severity.MethodThe study was retrospectively assessed in 771 consecutive PACG patients and 770 control subjects, laboratory parameters and clinical parameters were obtained from a medical data platform. Patients were divided into three groups with different severity based on perimetry, i.e. mild (mean deviation (MD) ≤6.00 dB), moderate (12 dB≥ MD>6 dB) and severe (MD>12 dB). We developed a nomogram to specifically identify individual patient’s risk.ResultsThe mean levels of neutrophil, NLR and WBC was higher in PACG than control group, and lowest in the mild PACG group, followed by moderate PACG and severe PACG (p<0.05). The AUROC value of NLR and LMR was found to be 0.719, 0.699, respectively. Multiple linear regressions showed that there was a significant correlation between WBC and MD (B=0.151, p<0.001), neutrophil and MD (B=0.143, p=0.003), NLR and MD (B=0.144, p=0.001), LMR and MD (B=-0.100, p=0.034). Logistic regression analyses revealed that WBC (OR=1.208, 95%CI=1.179-1.238), neutrophil (OR=1.598, 95%CI=1.541-1.656), NLR (OR=2.313, 95%CI=2.200-2.431), and LMR (OR=0.682, 95%CI=0.666-0.699) were associated with PACG.ConclusionOur study suggested that WBC, neutrophil, NLR, and LMR was related with PACG, and NLR and LMR may be useful as biomarkers.

Highlights

Primary glaucoma represents a major public health burden with unknown cause characterized by the degeneration of retinal ganglion cells and their axons associated with progressively irreversible blindness
Logistic regression analyses revealed that white blood cell (WBC) (OR=1.208, 95% confidence intervals (95%CIs)=1.179-1.238), neutrophil (OR=1.598, 95%CI=1.541-1.656), neutrophil to lymphocyte ratio (NLR) (OR=2.313, 95%CI=2.200-2.431), and lymphocyte to monocyte ratio (LMR) (OR=0.682, 95%CI=0.666-0.699) were associated with Primary angle closure glaucoma (PACG)
Our study suggested that WBC, neutrophil, NLR, and LMR was related with PACG, and NLR and LMR may be useful as biomarkers

Summary

Introduction

Primary glaucoma represents a major public health burden with unknown cause characterized by the degeneration of retinal ganglion cells and their axons associated with progressively irreversible blindness. This is especially so with a rapidly aging global society and the relatively high prevalence of glaucoma being observed among the elderly [1, 2]. Our previous studies found that the level of complement C3 was decreased in patients with PACG [9]. These studies provide critical information that there is a potential role for inflammation as an initiating or exacerbating factor in some patients with PACG, and this should be further assessed

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