Erythrocyte Distribution Width Research Articles

SENSITIVITY OF PLATELET-LYMPHOCYTE RATIO, MONOCYTE-LYMPHOCYTE RATIO, NEUTROPHIL-LYMPHOCYTE RATIO, RED BLOOD CELL DISTRIBUTION WIDTH AND SYSTEMIC IMMUNE INFLAMMATORY INDEX IN MULTIPLE SCLEROSIS PATIENTS: RELATIONSHIP WITH DISEASE SUBTYPES AND DISABILITY

OBJECTIVE: Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system (CNS). Although it is not clear how autoimmune responses occur, it is known that peripheral blood cells may promote the initiation and exacerbation of the inflammatory response in MS. The aim of this study was to evaluate the sensitivity and specificity of neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), erythrocyte distribution width (RDW) and systemic immune inflammation index (SIII) in MS and to determine their relationship with disability. MATERIAL AND METHODS: In this single-center, retrospective case-control study, 104 patients with MS and 65 healthy individuals were included. Disability was assessed with the Expanded Disability Status Scale (EDSS) score, and patients were classified as mild (EDSS<3), moderate (3.5 ≤ EDSS ≥4.5), and severe (EDSS≥5) disabilities. NLR, MLR, PLR, RDW and SIII values were calculated according to the complete blood counts of the patients and the control group. Inflammation markers between the control group and MS patients, MS subtypes, and relapsing-remitting MS (RRMS) attack and remission periods were compared. the relationship between these markers and duration of illness, number of attacks and disability was examined. RESULTS: MLR and RDW were higher in MS than the controls. There was no significant difference in these values between MS subtypes. It was observed that RDW increased as the disease duration, number of attacks and EDSS increased. CONCLUSIONS: In our study, in evaluating inflammation it was seen that MLR and RDW were more determinative than PLR, NLR and SIII. The fact that RDW is higher in MS patients and is affected by disease disability indicates that RDW may have an important role in the follow-up of MS patients and in evaluating the degree of disability.

Diagnostic value of basic laboratory parameters in the diagnosis of complicated appendicitis

In this investigation, we sought to examine the efficacy of laboratory parameters in predicting complicated appendicitis in patients who had surgery for acute appendicitis. 153 patients who underwent appendectomy were included and whose pathological results showed acute appendicitis. The patients were divided into two groups based on pathology findings and surgical findings: simple and complicated appendicitis groups. The patients’ age, gender, preoperative leukocyte count, neutrophil count, neutrophil percentage, neutrophil–lymphocyte ratio, erythrocyte distribution width, mean platelet volume, and C-reactive protein levels were recorded. The simple and complicated appendicitis groups comprised 97 and 56 patients, respectively. Patients with complicated appendicitis were older on average than those with simple appendicitis (p=0.007). In the complicated appendicitis group, leukocyte count (p

The importance of the erythrocyte distribution width/albumin ratio in patients with chronic obstructive pulmonary disease exacerbation.

To investigate the relationship of the erythrocyte distribution width (RDW)/albumin ratio on hospital length of stay (LOS) and prognosis in patients hospitalized with chronic obstructive pulmonary disease (COPD) exacerbation. Patients hospitalized in our clinic for COPD exacerbation were retrospectively analyzed. Demographic characteristics, comorbidities, pulmonary function tests, arterial blood gas, history of hospitalization due to exacerbation in the last year, LOS, C-reactive protein, RDW, albumin, platelet counts, and 30-day mortality status were recorded. Significant cut-off RDW/albumin ratio values that could predict hospitalization for 10 days or more were analyzed. A total of 58 patients were included in our study. With a significant cut-off value of ≥5.22 for the RDW/albumin ratio to predict a duration of hospitalization of more than 10 days, a sensitivity of 68.42% and specificity of 74.36% were obtained. No significant association was found between the RDW/albumin ratio and 30-day mortality (p=0.14). The RDW/albumin ratio (p=0.005) and mortality (p<0.001) were found to be higher in patients with an LOS of 10 days or more. The RDW/albumin ratio and mortality, which were statistically significant in patients hospitalized for 10 days or more, were analyzed using logistic regression, and no significant results were found. In further analysis results of patients hospitalized due to COPD exacerbation, there was no significant relationship between length of hospital stay, mortality, and the RDW/albumin ratio.

红细胞分布宽度与心房颤动的研究进展

红细胞分布宽度与心房颤动的研究进展

Can Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios Predict the Risk of Developing New Ischemic Lesions After Carotid Stenting?

Aim: It has been reported that the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are associated with carotid artery stenosis rate, risk of restenosis after stenting, and clinical outcome after an ischemic stroke, and are also predictive markers. The objective of this study is to evaluate whether NLR and PLR values and the associated temporal changes are indicators of the risk for newly developing ischemic lesions. Material and Methods: Patients who underwent stenting in our clinic between November 2019 and January 2022 and who had a complete blood count and a diffusion magnetic resonance imaging scan before and after the procedure, were included in the study and evaluated in two groups; patients with and without newly developing ischemic lesions. Results: Newly developing ischemic lesions were detected in 27 of the 50 patients included in the study. There was no difference in baseline and 48th-hour NLR and PLR rates and the temporal variation of these rates between patients with and without newly developing ischemic lesions. Erythrocyte distribution width (RDW) and hemoglobin (HGB) values were higher in the without newly developing ischemic lesions group at 48 hours, but there was only a significant difference between the RDW temporal change between the two groups. In the correlation analysis, no significant correlation was found between NLR, PLR, and their temporal changes, ipsilateral and contralateral stenosis rates, age, and residual stenosis rates. Conclusion: There was no significant relationship between the development of newly developing ischemic lesions and NLR and PLR values and the associated temporal changes.

The Relationship Between Recurrent Cerebrovascular Stroke and Erythrocyte Distribution Width in Atrial Fibrillation Patients with Cerebrovascular Stroke

Amaç: Atriyal fibrilasyon tromboembolik olaylara sebep olan bir sık görülen bir aritmi türüdür.&#x0D; Kardiyoembolik inme önemli bir morbidite ve mortalite nedenidir. Kırmızı kan hücresi dağılım genişliği&#x0D; (KDG, ‘Red blood cell distribution width’:RDW), kronik inflamasyon ve yüksek oksidatif stres durumunda&#x0D; artabilen bir belirteçtir. Çalışmamızda akut iskemik inme geçiren atriyal fibrilasyon hastalarında KDG&#x0D; düzeyi ile tekrarlayan erken serebrovasküler inme sıklığı arasındaki ilişkiyi incelemek amaçlandı.&#x0D; Gereç ve Yöntemler: İskemik inme tanısı alarak nöroloji servisine yatış yapılan, kardiyoloji&#x0D; konsültasyonu esnasında elektrokardiyografisinde atriyal fibrilasyon saptanan hastalar çalışmaya&#x0D; dahil edildi. Hastaların kronik hastalık durumu, kullanılan ilaçlar, yatış sırasında rutin yapılmış olan kan&#x0D; tetkikleri, ekokardiyografi bulguları kayıt altına alındı. Hastalar 3 ay süresince takip edildi.&#x0D; Bulgular: Çalışmaya dahil edilen 164 hastanın yaş ortalaması 73,6 ± 9,3 idi. Hastaların 97’si (%59,1)&#x0D; kadın, 67’si (%40,9) erkek cinsiyette idi. Doksan günlük takip sonucunda 31(%18,9) hastanın tekrarlayan&#x0D; iskemik inme geçirdiği saptandı. Tekrarlayan inme geçirenler ile geçirmeyenler arasında yaş, cinsiyet,&#x0D; kronik hastalık, dislipidemi, sigara kullanımı, ejeksiyon fraksiyonu, CHA2DS2-VASc skoru, NIHHS&#x0D; Skoru düzeyleri, serum CRP düzeyleri, kan trombosit sayısı arasında istatistiksel olarak anlamlı fark&#x0D; saptanmazken; KDG düzeyleri (14,6 ± 1,4 vs 13,3 ± 0,8) tekrarlayan inme geçiren hastalarda daha&#x0D; yüksek saptandı (p

RDW Predicts Fibrosis in Patients with Chronic Hepatitis B Having Persistently Normal ALT Levels.

There are studies on the determination of hepatic fibrosis with noninvasive markers but data about liver biopsy results and noninvasive markers in patients with chronic hepatitis B (CHB) are limited. The aim of this study is to determine the relationship between pathological findings and noninvasive markers, and to determine the marker that predicts fibrosis in patients with consistently normal serum alanine aminotransferase (ALT) levels, diagnosed with CHB and undergoing liver biopsy. A total of 122 patients with CHB, 29 of them with HbeAg (+), aged 30 years and older, HBV DNA > 2000 IU / ml, and serum ALT levels measured four times in the last year, were consistently normal, and 93 of them with HbeAg (-) were included in the study. Demographic characteristics of patients, laboratory parameters, histological activity index (HAI) and fibrosis values obtained in liver biopsy, and noninvasive markers (AP (age-platelet) index, APRI (AST/Platelet ratio) and FIB-4 score, neutrophil/lymphocyte ratio, mean platelet volume (MPV) and erythrocyte distribution width (RDW) were recorded. The relationship between RDW value and fibrosis was statistically significant in the HbeAg (+) group (p<0.001). The relationship between AP index, APRI and FIB-4 score, neutrophil/lymphocyte ratio and MPV with fibrosis was not statistically significant (>0.05 for each). It has been shown that the RDW value can be used to predict fibrosis in CHB patients with normal ALT and HbeAg (+), and the cut-off value for RDW is 12.

Correlation between peripheral blood hemoglobin/erythrocyte distribution width ratio and prognosis of patients with primary colorectal cancer.

The prognostic value of peripheral blood hemoglobin/red blood cell distribution width ratio (HRR) in colorectal cancer (CRC) is unclear. The aim of this study was to analyze the correlation between peripheral blood HRR and the prognosis of CRC. A retrospective study analyzed the medical records of 284 CRC patients who attended Linyi People Hospital between June 1, 2017 and June 1, 2021. The optimal diagnostic cutoff value for hemoglobin (Hb)/erythrocyte distribution width was determined by ROC curve as 3.098, and patients were divided into high- and low-level groups for comparative analysis of clinical data. Kaplan-Meier method was used for survival analysis, and logrank test was used to assess survival differences. In univariate and multifactorial analyses, Cox proportional risk regression models were used to assess independent risk factors for overall survival (OS) and progression-free survival (PFS). All statistical tests were bilateral probability tests with α = 0.05, and P < .05 was considered statistically significant. There were 284 patients who were finally included in the statistical analysis. Gender, tumor stage, Hb, platelets, and CEA were associated with PFS and OS. Tumor stage, Hb, and HRR (P < .05) were independent risk factors for PFS and OS. Low-level HRR was associated with poor patient prognosis. Low-level HRR is associated with poor patient prognosis and is a potential tumor prognostic marker.

Lower omega-3 status associated with higher erythrocyte distribution width and neutrophil-lymphocyte ratio in UK Biobank cohort

High red blood distribution width (RDW) is associated with decreased red blood cell deformability, and high neutrophil-lymphocyte ratio (NLR) is a biomarker of systemic inflammation and innate-adaptive immune system imbalance. Both RDW and NLR are predictors of chronic disease risk and mortality. Omega-3 index (O3I) values have previously been shown to be inversely associated with RDW and NLR levels. Our objective was to determine if total plasma long chain omega-3 fatty acids (Omega3%) measured in the UK Biobank cohort were associated with RDW and NLR values. RDW- and NLR- relationships with Omega3% were characterized in 109,191 adults (58.4% female). RDW- and NLR-Omega3% relationships were inversely associated with Omega3% (both p < 0.0001). These cross-sectional associations confirm previous findings that increasing RDW and NLR values are associated with low O3I. The hypothesis that RDW and/or NLR values can be reduced in individuals with less-than optimal long chain omega 3 values need to be tested in randomized controlled intervention trials using EPA and/or DHA.

The Charlson comorbidity index and short-term readmission in patients with heart failure: A retrospective cohort study.

The relationship between the Charlson comorbidity index (CCI) and short-term readmission is as yet unknown. Therefore, we aimed to investigate whether the CCI was independently related to short-term readmission in patients with heart failure (HF) after adjusting for other covariates. From December 2016 to June 2019, 2008 patients who underwent HF were enrolled in the study to determine the relationship between CCI and short-term readmission. Patients with HF were divided into 2 categories based on the predefined CCI (low < 3 and high > =3). The relationships between CCI and short-term readmission were analyzed in multivariable logistic regression models and a 2-piece linear regression model. In the high CCI group, the risk of short-term readmission was higher than that in the low CCI group. A curvilinear association was found between CCI and short-term readmission, with a saturation effect predicted at 2.97. In patients with HF who had CCI scores above 2.97, the risk of short-term readmission increased significantly (OR, 2.66; 95% confidence interval, 1.566-4.537). A high CCI was associated with increased short-term readmission in patients with HF, indicating that the CCI could be useful in estimating the readmission rate and has significant predictive value for clinical outcomes in patients with HF.

The effects of mean platelet volume and red cell distribution width on prognosis in patients with myelodysplastic syndrome

Objective: In this study, the relationship between changes in mean platelet volume (MPV) and erythrocyte distribution width (RDW)&#x0D; with hematological response and survival in patients with myelodysplastic syndrome was investigated.&#x0D; Patients and Methods: Between 1 January 2011 and 31 December 2018, patient characteristics and hemogram results were evaluated&#x0D; during the treatment process among 158 patients diagnosed with myelodysplastic syndrome.&#x0D; Results: The mean age of the patients who were included in the study was 71.53±12.6 years. The MPV percentage change in the 2-year&#x0D; follow-up of the patients with and without hematological response was significant, at 0.022±0.11 (2.2%) in those who responded and&#x0D; at 0.069±0.15 (6.9%) in those who did not (p=0.049). Throughout the same period, the degree of RDW changes in the patients who&#x0D; died was 13.23±22.97, the degree in those who survived was 2.86±21.42, and the difference between the two groups was statistically&#x0D; significant (p=0.006).&#x0D; Conclusion: In patients diagnosed with myelodysplastic syndrome, MPV and RDW values can be considered inexpensive and simple&#x0D; laboratory markers that can be used in follow-ups and promising tests to predict both treatment response and survival in the early&#x0D; period and change treatment modalities.

Iron Deficiency may be a Risk Factor for Inguinal Hernia Development in Children.

This case control study aimed to investigate whether the routine hemogram and biochemical parameters of pediatric patients who have undergone surgery for inguinal hernia are associated with the etiopathogenesis of the disease. Eighty cases of inguinal hernia surgery performed between January 2019 and November 2022 were included in the study. A control group was also established using hospital records, consisting of eighty pediatric patients without any known history of hematological or metabolic disease or use of regular medication. Statistical analysis was conducted to compare the total hemoglobin (Hgb), hematocrit (Htc), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), erythrocyte distribution width (RDW) and thrombocyte (PLT) values in both groups. The age range of the pediatric patients was 1-14 years. Of the eighty children, 47 (58.8%) were male and 33 (41.3%) were female, with a mean age of 5.79±3.26. The values of Hgb, Htc, MCH, MCHC, and MCV in the inguinal hernia patients were found to be statistically significantly lower than those in the control group (p<0.05). Additionally, the patient RDW values were found to be statistically significantly higher than those in the control group (p<0.05). Compared to the control group, the observed decrease in MCH, MCHC, MCV, Hgb, HTC values, as well as the increase in RDW in patient group, suggests a predisposing effect of iron deficiency. These specific changes suggested that iron deficiency may lead structural changes in the collagen construction and may contribute the etiopathogenesis of childhood inguinal hernia.

The relationship between erythrocyte distribution width (RDW) and functional status in patients with acute ischemic stroke who received mechanical thrombectomy

The relationship between erythrocyte distribution width (RDW) and functional status in patients with acute ischemic stroke who received mechanical thrombectomy

Effect of Iron-Erythrocyte Metabolism-Related Indexes on Posttraumatic Growth in Patients on Maintenance Hemodialysis (MHD).

To investigate the effect of iron-erythrocyte metabolism-related indexes on posttraumatic growth in MHD patients and their caregivers. A total of 170 pairs of MHD patients and their caregivers in Shanghai Changhai Hospital were enrolled in this research, which used sociodemographic characteristics, the Posttraumatic Growth Inventory (PTGI), the Perceived Social Support Scale (PSSS), and the Medical Coping Modes Questionnaire (MCMQ). The test data of 141 patients were retrieved from the hospital database. Single-factor analysis showed that the PTGI score of patients with a mean corpuscular erythrocyte volume ≥ 100 fL was 85.4 ± 19.8 and those with a mean corpuscular erythrocyte volume lower than 100 fL were 70.6 ± 24.7; the PTGI scores of patients with reticulocytes >1.5% were 68.8 ± 25.8, and those with reticulocytes <1.5% were 78.4 ± 21.1; the PTGI scores of the caregivers whose serum iron was >10.6 µmol /L were 78.2 ± 21.6, and those with serum iron <10.6 µmol /L were 67.9 ± 22.8. The difference in MCMQ scores between the caregivers with transferrin saturation>50% and with transferrin saturation<20% was 18.9 ± 8.4. For the correlation test of serum iron, reticulocyte and PTGI scores for patients, the Pearson correlation coefficients were 0.239 and -0.193, respectively, and the correlation test between erythrocyte distribution width SD and the score of caregivers MCMQ scale, the Pearson correlation coefficient was 0.225; p for all was< 0.05, with significant differences. There was no significant difference in the scores of different scales for total iron binding capacity (TIBC) at different levels. The indexes related to iron erythrocyte metabolism in MHD patients are correlated with ruminant meditation of patients and their caregivers and promotion of posttraumatic growth. Good nutritional status, adequate hematopoietic material, and normal erythrocyte count and function are also important for them.

The Relationship of Erythrocyte Distribution Width Value with Mortality in Patients with COVID-19 Pneumonia

The Relationship of Erythrocyte Distribution Width Value with Mortality in Patients with COVID-19 Pneumonia

Risk assessment and prediction model of renal damage in childhood immunoglobulin A vasculitis

ObjectivesTo explore the risk factors for renal damage in childhood immunoglobulin A vasculitis (IgAV) within 6 months and construct a clinical model for individual risk prediction.MethodsWe retrospectively analyzed the clinical data of 1,007 children in our hospital and 287 children in other hospitals who were diagnosed with IgAV. Approximately 70% of the cases in our hospital were randomly selected using statistical product service soltions (SPSS) software for modeling. The remaining 30% of the cases were selected for internal verification, and the other hospital's cases were reviewed for external verification. A clinical prediction model for renal damage in children with IgAV was constructed by analyzing the modeling data through single-factor and multiple-factor logistic regression analyses. Then, we assessed and verified the degree of discrimination, calibration and clinical usefulness of the model. Finally, the prediction model was rendered in the form of a nomogram.ResultsAge, persistent cutaneous purpura, erythrocyte distribution width, complement C3, immunoglobulin G and triglycerides were independent influencing factors of renal damage in IgAV. Based on these factors, the area under the curve (AUC) for the prediction model was 0.772; the calibration curve did not significantly deviate from the ideal curve; and the clinical decision curve was higher than two extreme lines when the prediction probability was ~15–82%. When the internal and external verification datasets were applied to the prediction model, the AUC was 0.729 and 0.750, respectively, and the Z test was compared with the modeling AUC, P > 0.05. The calibration curves fluctuated around the ideal curve, and the clinical decision curve was higher than two extreme lines when the prediction probability was 25~84% and 14~73%, respectively.ConclusionThe prediction model has a good degree of discrimination, calibration and clinical usefulness. Either the internal or external verification has better clinical efficacy, indicating that the model has repeatability and portability.Clinical trial registration:www.chictr.org.cn, identifier ChiCTR2000033435.

Clinical Significance of the Relationship Between D-dimer and Erythrocyte Distribution Width in Covid-19 Patients

Introduction: Red cell distribution width (RDW) is a marker that can be used in the presence of systemic inflammation and evaluating thromboembolic condition.We aimed to evaluate the relationship between RDW and the level of D-dimer known as related to adverse events in Coronavirus disease 2019 (COVID-19) in this study. Methods: One hundred twenty two patients with COVID-19 and 62 healthy individuals with age and sex-matched were enrolled in the present study. The patients were divided into two groups based on evaluating their D-dimer level. The first group contained 45 patients with higher D-dimer level whereas the second group contained 77 patients with normal D-dimer level. Results: RDWvalues were found to be higher in patients with COVID-19 and higher D-dimer level than patients with normal D-dimer level and control group. These results were found to be statistically significant (P=0.006 and P=0.013, respectively). Among patients with COVID-19, a positive correlation was observed between RDW and D-dimer level (r=0.270, P=0.003). Among the various variables associated with higher D-dimer in multivariate logistic regression analyses, RDW detected an independent predictor of higher D-dimer in COVID-19 patients (95% CI: CI:0.322-0.979, P=0.042). Conclusion: The results indicated that high RDW values in patients with COVID-19 disease could be used as a marker in clinical follow-up of patients as D-dimer.

Study of the effect of liraglutide on the correlation between NLRP3 inflammasome and non-alcoholic fatty liver disease

Objective: To observe the effect of liraglutide on the correlation between nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing protein 3 (NLRP3) infl ammasome and nonalcoholic fatty liver disease (NAFLD). Methods: Thirty-nine NAFLD cases (group N) and thirty-nine healthy subjects (group C) were selected from the physical examination center, and their general data were collected to determine the serum levels of NLRP3, IL-1β, and IL-18. The differences and correlations were analyzed between the two sets of indicators. Thirty male SD rats were randomly divided into normal (NC, n=10) and high-fat diet group (HF, n=20). The normal group were fed with normal diet and high-fat diet group were fed with high-fat diet. After 12 weeks of feeding, HF group was randomly divided into HF group (n=10) and liraglutide group (100L, n=10), and were given 0.5 ml/kg sterile isotonic saline and 100 g/kg liraglutide subcutaneously twice a day, respectively. Four weeks later, serum biochemical indicators, liver NLRP3 infl ammasome protein expression, and infl ammatory cytokine conditions were detected in each group. Statistical analysis was performed using t test, oneway analysis of variance (ANOVA) or χ2 test. Results: There were no statistically signifi cant differences between N and C group in terms of age, gender, diastolic blood pressure, glycosylated hemoglobin, mean platelet volume, erythrocyte distribution width, serum low-density lipoprotein cholesterol (HDL-Ch), total cholesterol, and total bileacid. Compared with group C, group N had elevated systolic blood pressure, body mass index (BMI), fasting blood glucose, blood creatinine, alkaline phosphatase (ALP), NLRP3, interleukin (IL)-1β, IL-18, TG, blood uric acid, γ-glutamyltransferase (GGT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and white blood cell counts, while HDL-Ch and total bilirubin were depleted than group C, and the difference was statistically significant (P< 0.05). NLRP3 was positively correlated with systolic blood pressure, BMI, fasting blood glucose, serum creatinine, IL-1β, IL-18, triglycerides, serum uric acid, GGT, ALT, AST, but negatively correlated with total bilirubin and HDL-Ch, and the difference was statistically signifi cant. Compared with NC group, HF group had significantly increased body mass, liver mass, serum biochemical indicators (triglycerides, AST, ALT), liver NLRP3 inflammasome protein expression, and inflammatory cytokines. After treatment with liraglutide, 100L group indicators were signifi cantly decreased when compared to HF group. Conclusion: Compared with healthy subjects, the infl ammation-related indicators, body mass, blood lipids and liver function-related indicators are signifi cantly changed in patients with NAFLD, which is also consistent with the results of rat model study. Liraglutide treatment had improved NAFLD to certain extent in NAFLD rats, so NLRP3 regulation may be one of the mechanisms to improve liver inflammation and steatosis.

Association of obstructive sleep apnea syndrome with hematological parameters and comorbid diseases

Background &amp; Objective: Obstructive sleep apnea syndrome (OSAS) has a close relationship with many diseases. Hematological parameters are simple diagnostic methods and can give an idea about severity of some diseases. The aim of this study was to examine the relationship of OSAS with comorbid diseases and relationship between OSAS severity, oxygen desaturation index (ODI) and hematological parameters. Methods: This retrospective and cross-sectional study was conducted by evaluating the medical files of patients who underwent polysomnography between 2012 and 2018. 1,119 patients (198 controls; 921 OSA) were participated to the research. Results: Congestive heart failure, hypertension (HT), asthma and chronic obstructive pulmonary diseases (COPD) were seen in 143, 424, 254 and 177 patients respectively. Severe OSAS was found more common in male. Except the patients with HT; neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) levels were higher and lymphocyte levels were lower in patients with comorbid diseases. WBC and erythrocyte distribution width (RDW) levels were higher in patients with COPD than without COPD; PLT levels were higher in patients with asthma than without asthma. WBC level of the moderate-severe OSAS was significantly higher than the control and mild OSAS (p=0.001). Platelet distribution width (PDW) value of the OSAS was higher than the control group (p=0.005). The apnea-hypopnea index and ODI levels were higher in patients with comorbidity than without comorbidity (p=0.001). Conclusions: It can be said that lymphopenia, high NLR, PLR, WBC, RDW and PDW may be useful markers for predicting severity of OSAS in comorbid diseases. The presence of OSAS should be detected in order to treat comorbidity appropriately.

Decoding atopic dermatitis: patient heterogeneity and genetic variation contributing to immune-mediated dermatologic disease in the UK Biobank

Abstract Background Dupilumab is the only approved biologic used to treat moderate to severe atopic dermatitis (AD) but has a non-response rate of 55–60%. This suggests underlying heterogeneity in AD etiology, requiring alternate therapies for patients. Study Objective Identify biomarkers and disease conditions in the UK Biobank that stratify AD patients into homogenous subgroups for genetic characterization. Methods We identified 13,137 AD cases and 13,136 age and sex-matched controls using hospital ICD9/10 and primary care codes in the UK Biobank. A total of 94 biomarkers and 1,596 disease PheCodes were used to isolate traits that vary in AD patients relative to controls; K-means (quantitative) and K-modes (binary) clustering was performed to identify subgroups within AD patients. Genetic analysis was performed for subgroups vs. controls using REGENIE. Results We observed enrichment of dermatologic, gastrointestinal, and rheumatologic conditions in AD patients, as well as differences in eosinophil percentage, Cystatin C, C-reactive protein, and erythrocyte distribution width relative to controls. There were eight subgroups of AD patients including groups with co-occurring psoriasis, asthma and gastrointestinal problems, penicillin allergy, and AD with no co-morbidities. Genetic analyses revealed novel HLA and non-HLA associations with subgroups, while also replicating known associations with FLG. Conclusion There were eight distinct AD subgroups based on co-occurring disease states. Genetic analyses show subgroup-specific factors can contribute to disease pathology—signaling potential utility for differential therapies and highlight mechanisms for targeted therapeutic development in the treatment of AD.