Mean Platelet Volume-to-platelet Ratio Research Articles

Investigation of the predictive value of systemic immune inflammation index (SII) and prognostic nutritional index (PNI) on mortality in patients with endoprosthesis after hip fracture.

In this research, we aimed to investigate the predictive value of the systemic immune inflammation index and prognostic nutritional index on mortality among patients with an endoprosthesis after a hip fracture. In this retrospective, cross-sectional study, a total of 915 patient files applied to our hospital between 2020 and 2023 with an endoprosthesis after a hip fracture were subjected to the study. The patients were divided into 2 groups: alive (n = 396; 43.3%) and deceased (n = 519; 56.7%). The eosinophil-to-lymphocyte ratio, hemoglobin-to-red cell distribution width ratio (HRR), mean platelet volume-to-platelet ratio (MPVPR), neutrophil-to-lymphocyte ratio, monocyte/lymphocyte ratio, platelet-to-lymphocyte ratio, MPV-to-lymphocyte ratio, monocyte-to-eosinophil ratio (MER), neutrophile-to-monocyte ratio, systemic inflammation index (SII), and prognostic nutritional index (PNI) parameters of the patients were evaluated. The mortality rate was higher among male patients, with a statistically significant difference (P < .05). The follow-up duration, albumin, HGB, eosinophil, lymphocyte, eosinophil %, eosinophil-to-lymphocyte ratio, HRR, and PNI means were significantly higher in the living group (P < .05). Age, MPV, MPVPR, neutrophil-to-lymphocyte ratio, monocyte/lymphocyte ratio, platelet-to-lymphocyte ratio, MPV-to-lymphocyte ratio, MER, and systemic inflammation index were significantly higher in the deceased group (P < .05). The predictive value of gender (B = -0.362; P < .01), age (B = 0.036; P < .01), HRR (B = -1.100; P < .01), MPVPR (B = 8.209; P < .01), MER (B = 0.006; P < .01), and PNI (B = -0.078; P < .01) were statistically significant at the multivariate level. The time of death was significantly predicted by gender (B = 0.10; P < .05), age (B = -0.02; P < 0 = 1), HRR (B = 0.61; P < .01), MPVPR (r = -4.16; P < .01), MER (B = -0.01; P < .05), and PNI (B = 0.03; P < .01). The predictive value of PNI for the 30-day mortality rate was statistically significant (AUC: 0.643; P < .01). For a PNI cutoff value of 34.475, sensitivity was 69.7%, and specificity was 51.1%. The PNI has predictive value both in estimating overall mortality and in predicting the 30-day mortality rates among patients undergoing endoprosthesis after a hip fracture.

Decreased NK cell count is a high-risk factor for convulsion in children with COVID-19

BackgroundThe neurological symptoms caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are of increasing concern. Convulsions are among the main neurological manifestations reported in children with coronavirus disease-2019 (COVID-19), and cause serious harm to physical and mental health. This study aimed to investigate the risk factors for convulsion in children with COVID-19.MethodsThis prospective study was conducted at the Children’s Hospital of Soochow University. In total, 102 COVID-19 patients with convulsion, 172 COVID-19 patients without convulsion, and 50 healthy controls were enrolled in the study. The children’s clinical and laboratory data were analyzed to assess the risk factors for convulsion in COVID-19 patients.ResultsConvulsions occurred in 37.2% of children, mostly those aged 1–3 years, who were hospitalized with the Omicron variant. The neutrophil count, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume-to-platelet ratio (MPR) were significantly higher in the convulsion group than those in the non-convulsion and control groups (P < 0.01). However, the counts of lymphocytes, eosinophils, platelets, lymphocyte subsets, CD3+ T cells, CD4+ T cells, CD8+ T cells, and NK cells were lower in the convulsion group than those in the non-convulsion and control groups (P < 0.01). Multivariate regression analysis indicated that NK cell count (OR = 0.081, 95% CI: 0.010–0.652) and a history of febrile seizure (OR = 10.359, 95% CI: 2.115–50.746) were independent risk factors for the appearance of convulsions in COVID-19.ConclusionsHistory of febrile seizure and decreased NK cell count were high-risk factors for convulsions in COVID-19 patients.

Selected hematology ratios in cats with non-septic effusions highly suspected of feline infectious peritonitis

In veterinary medicine, knowledge about hematologic ratios (neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and mean platelet volume-to-platelet ratio (MPV/PLT)) is limited, particularly in cats. While the roles of these ratios have been proven in oncology, systemic inflammation with or without systemic inflammatory response syndrome (SIRS), and sepsis, information is lacking about their alterations in non-septic effusions, like feline infectious peritonitis (FIP). This study aimed to describe whether NLR, PLR, and MPV/PLT were changed and whether they correlated with routine hematologic and biochemical parameters in 16 cats with non-septic effusions, highly suspected to be the effusive form of FIP without SIRS, compared to nine clinically healthy cats. The NLR was calculated as the absolute count of neutrophils divided by the absolute count of lymphocytes, PLR by calculating the absolute platelet divided by the absolute lymphocyte count, and MPV/PLT by dividing mean platelet volume by absolute platelet count. The NLR, MPV, and MPV/PLT ratios were higher in cats with non-septic effusions suspected to be FIP, but PLR did not differ, when compared to healthy cats. Correlation analysis did not show any association between the selected ratios and hematological and biochemical parameters. In the absence of leukocytosis, increased NLR could help us to confirm the presence of systemic inflammation in cats with non-septic effusions indicative of FIP. However, a high MPV/PLT ratio should be interpreted with caution, especially in cats.

Hematological characteristics of COVID-19 patients with fever infected by the Omicron variant in Shanghai: A retrospective cohort study in China.

A wave of the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has rapidly spread in Shanghai, China. Hematological abnormalities have been reported in coronavirus disease 2019 (COVID-19) patients; however, the difference in hematological parameters between COVID-19 patients with fever and patients who are febrile from other causes remains unexplored. This retrospective cohort study enrolled 663 SARS-CoV-2 positive patients identified by RT-PCR. Clinical parameters, including age, sex, and threshold cycle values of all COVID-19 patients, and hematological parameters of COVID-19 patients in the fever clinic were abstracted for analysis. Overall, 60.8% of COVID-19 patients were male, and the median age was 45 years. Most of COVID-19 patients were asymptomatic, while 25.8% of patients showed fever and 10.9% of patients had other emergencies. COVID-19 patients with fever had significantly lower white blood cells (WBCs), neutrophils, lymphocytes, platelets and C-reactive protein (CRP), and significantly higher monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), and mean platelet volume-to-platelet ratio (MPR) levels, compared with those in SARS-CoV-2 negative patients with fever from other causes (p < 0.05). Neutrophil-to-lymphocyte ratio (NLR), PLR, and systemic inflammatory index (SII) levels were significantly higher in COVID-19 patients with emergencies (p < 0.05). WBCs showed the best performance with an area under the curve (0.756), followed by neutrophils (0.730) and lymphocytes (0.694) in the diagnosis of COVID-19 in the fever clinic. WBCs, neutrophils, lymphocytes, platelets, CRP and MLR, PLR, and MPR may be useful in early diagnosis of COVID-19 in the fever clinic.

The relationship between platelet indices and residual SYNTAX score in patients with ST-segment elevation myocardial infarction

Objectives: Our aim is to investigate the relationship between thrombocyte indices, which have previously been proven to be associated with many cardiovascular diseases and adverse events, and residual SYNTAX (SYNergy between percutaneous coronary interventionwith TAXus and cardiac surgery) score (rSS) in patients with ST-segment elevation myocardial infarction (STEMI). Methods: Our study included 534 patients who underwent primary percutaneous coronary intervention (PCI) for STEMI between January 2018 and June 2021. In our study, only patients who underwent infarct-related coronary artery revascularization in the index procedure were evaluated. First of all, patients were compared as two groups as low rSS (rSS ≤ 8) and high rSS (rSS &amp;gt; 8). Our definition of platelet indices includes mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (Pct), MPV to platelet ratio (MPVPR), platelet to lymphocyte ratio (PLR), and MPV to lymphocyte ratio (MPVLR). Results: The mean age of the study patients was 56.4 ± 10.3 years and 78.8% were male. The high rSS group had higher C-reactive protein, lower lymphocyte count, and significantly higher platelet indices other than PLR and MPV. Among the platelet indices, MPVLR was found to have the best correlation with rSS (r: 0.398, p &amp;lt; 0.001). MPVLR (AUC: 0.820, 95% CI: 0.701-0.899) was determined as the best diagnostic power index with 5.08 cut-off value in predicting high rSS with 88% sensitivity and 76% specificity (Youden index: 0.64). Age, right coronary artery involvement as culprit lesion, ejection fraction, diabetes mellitus and MPVLR (OR: 5.966 [2.489-8.413], p &amp;lt; 0.001) and PDW were identified as independent risk factors for predicting high rSS. Conclusions: In conclusion, increased MPVLR is associated with high rSS in STEMI patients. There is a significant positive correlation between MPVLR and rSS. MPVLR is an independent predictor of high rSS.

The Usefulness of Extended Inflammation Parameters and Systemic Inflammatory Response Markers in the Diagnostics of Autoimmune Hepatitis.

(1) Introduction: Autoimmune hepatitis (AIH) is a chronic disease. A persistent autoimmune reaction in the liver is significantly related to the systemic inflammatory response. Extended Inflammation Parameters (EIP) can be used to assess the activation of immune cells such as activated neutrophils (NEUT-RI and NEUT-GI) and activated lymphocytes (RE-LYMP and AS-LYMP) in the phase of active inflammation. The role of the systemic inflammatory response markers should also be emphasised, especially: NLR, PLR, and RLR, which have recently been widely studied as markers in autoimmune skin diseases or liver diseases. (2) Materials and Methods: The study included 30 patients with AIH and 30 healthy volunteers. The parameters of the EIP group (RE-LYMP, AS-LYMP, NEUT-RI, NEUT-GI), calculated haematological indices Red Blood Cell Distribution Width-to-Platelet Ratio (RPR), Mean Platelet Volume-to-Platelet Ratio (MPR), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), Red Blood Cell Distribution Width-to-Lymphocyte Ratio (RLR), and selected blood morphological and biochemical indices were analysed. The aim of the study was to assess the usefulness of the EIP and systemic inflammatory response markers in the diagnostics of AIH. (3) Results: Compared to the controls, the patients with AIH showed significantly higher EIP values: NEUT-RI (48.05 vs. 43.30), NEUT-GI (152.65 vs. 147.40), RE-LYMP (0.07 vs. 0.03), and the inflammatory response markers: MPR (0.05 vs. 0.04), RPR (0.07 vs. 0.05), and NLR (2.81 vs. 1.42. Among the examined markers, EIP has significant diagnostic potential: NEUT-RI (AUC = 0.86), NEUT-GI (AUC = 0.80), and RE-LYMP (AUC = 0.78), and so do calculated haematological indices, i.e., MPR (AUC = 0.75), PLR (AUC = 1.00), and RLR (AUC = 1.00) Moreover, the importance of NEUT-GI (AUC = 0.89), MPR (AUC = 0.93), PLR (AUC = 0.86), RPR (AUC = 0.91), and FIB-4 (AUC = 0.83) in the detection of liver fibrosis in the course of AIH has also been proven. (4) Conclusions: EIP and systemic inflammatory response markers may turn out to be useful in detecting AIH and in looking for features of already developed liver cirrhosis in its course.

Sex-Dependent Performance of the Neutrophil-to-Lymphocyte, Monocyte-to-Lymphocyte, Platelet-to-Lymphocyte and Mean Platelet Volume-to-Platelet Ratios in Discriminating COVID-19 Severity.

BackgroundThe neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and mean platelet volume-to-platelet ratio (MPR) are combined hematology tests that predict COVID-19 severity, although with different cut-off values. Because sex significantly impacts immune responses and the course of COVID-19, the ratios could be biased by sex.PurposeThis study aims to evaluate sex-dependent differences in the contribution of NLR, PLR, MLR, and MPR to COVID-19 severity and mortality upon hospital admission using a sample of pneumonia patients with SARS-CoV-2 infection.MethodsThis single-center observational cross-sectional study included 3,280 confirmed COVID-19 cases (CDC 2019-Novel Coronavirus real-time RT-PCR Diagnostic) from Quito (Ecuador). The receiver operating characteristic (ROC) curve analysis was conducted to identify optimal cut-offs of the above parameters when discriminating severe COVID-19 pneumonia and mortality risks after segregation by sex. Severe COVID-19 pneumonia was defined as having PaO2 < 60 mmHg and SpO2 < 94%, whereas non-severe COVID-19 pneumonia was defined as having PaO2 ≥ 60 mmHg and SpO2 ≥ 94%.ResultsThe mortality rate of COVID-19 among men was double that in women. Severe COVID-19 pneumonia and non-surviving patients had a higher level of NLR, MLR, PLR, and MPR. The medians of NLR, MLR, and MPR in men were significantly higher, but PLR was not different between men and women. In men, these ratios had lower cut-offs than in women (NLR: 2.42 vs. 3.31, MLR: 0.24 vs. 0.35, and PLR: 83.9 vs. 151.9). The sensitivity of NLR, MLR, and PLR to predict pneumonia severity was better in men (69–77%), whereas their specificity was enhanced in women compared to men (70–76% vs. 23–48%).ConclusionThese ratios may represent widely available biomarkers in COVID-19 since they were significant predictors for disease severity and mortality although with different performances in men and women.

The predictive role of monocyte-lymphocyte ratio and plateletlymphocyte ratio in postmenopausal osteoporosis

Objective. To investigate the relationship between neutrophil to lymphocyte ratio (NEU/LY), monocyte to lymphocyte ratio (MO/LY), platelet to lymphocyte ratio (PLT/LY), mean platelet volume to lymphocyte ratio (MPV/LY), mean platelet volume to platelet ratio (MPV/PLT), plateletcrit to platelet ratio (PCT/PLT) and postmenopausal osteoporosis. Materials and Methods. The data of the patients who were admitted to Ümraniye Training and Research Hospital between January 2017 and July 2020 and had both bone mineral densitometry and hemogram tests on the same day were retrospectively scanned. A number of 177 patients who had been in natural menopause for at least one year and did not have any chronic disease nor used any medication were first divided into 3 groups: a number of 48 patients with osteoporosis, 103 with osteopenia and 26 patients included in the control group. Later on, 177 patients were divided into two groups: 151 patients with low bone mineral density and 26 patients were included in the control group. Results. There was no difference between the three groups in terms of NEU/LY, MPV/LY, MPV/PLT and PCT/PLT. The MO/LY ratio and PLT/LY ratio were statistically significantly higher in the osteoporosis group (p = 0.002, p &lt;0.001, respectively). The MO/LY ratio was significantly higher in the group with low bone mineral density compared to the control group (p = 0.011), while there was no statistical difference between the two groups in terms of PLT/LY ratio (p = 0.281). Conclusions. This study shows that MO/LY and PLT/LY are quite simple and cheap markers that can be used in the diagnosis of postmenopausal osteoporosis and MO/LY in the diagnosis of postmenopausal low bone mineral density.

Association between systemic immune inflammation index and newly diagnosed adult celiac disease

Abstract Objectives The systemic immune inflammation index (SII) is a novel biomarker based on platelet, neutrophil and lymphocyte counts. SII serum levels have diagnostic, prognostic degrees and correlations with various immune, inflammatory diseases. Celiac disease (CD) is an immune-mediated chronic enteropathy with inflammatory situations. Here we aimed to evaluate clinical significance of SII and to compare SII with other inflammatory markers in CD. Methods 161 pathologically confirmed CD and 75 dyspeptic patients were enrolled. Hemogram, biochemical markers, SII, platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), mean platelet volume-to-platelet ratio (MPR) and monocyte-to-high density lipoprotein cholesterol ratio (MHR) were evaluated. Results There was a statistically significant difference between groups for SII (p&lt;0.001). SII was statistically correlated with and superior to inflammatory markers in relation with CD. There were also statistically significant differences between groups for hsCRP, PLR, NLR, MPR, haemoglobin, platelet count, platelet volume distribution width, plateletcrit, ferritin, total cholesterol and HDL cholesterol (p=0.034; 0.015; 0.032; &lt;0.001; &lt;0.001; &lt;0.001; 0.030; 0.001; &lt;0.001; &lt;0.001; 0.048, respectively). Correlations between SII and NLR, PLR, MHR, hsCRP were statistically significant (p≤0.001; &lt;0.001; 0.033; 0.030, respectively). ROC analysis was used to determine the optimal cut-off value for CD by SII. A baseline SII level &gt;560.0 was associated with CD with 64% specificity, 78% sensitivity (p&lt;0.001). Conclusions To the best of our knowledge, this is the first study analyzed the diagnostic value of SII in CD. SII may serve as a beneficial marker for the diagnosis of inflammatory state superior to that of hsCRP, PLR, NLR, MHR, MPR and WBC.

Evaluation of diagnostic performance of haematological parameters in Behçet's disease.

Behçet's Disease (BD) is a polygenic and chronic autoinflammatory multisystemic vasculitis disease characterised by mucocutaneous, musculoskeletal, neurological, gastrointestinal and ophthalmologic lesions. There has been no specific test or serum marker to measure and determine the diagnosis and severity of BD. The study aimed to investigate the diagnostic performance of haematological parameters as MLR (monocyte to lymphocyte ratio), NLR (neutrophil to lymphocyte ratio), PLR (platelet to lymphocyte ratio), MPV (mean platelet volume), MPVPR (mean platelet volume to platelet ratio), LMR (lymphocyte to monocyte ratio), LPM (lymphocyte and platelet multiplication), WLP (lymphocyte and leukocyte multiplication), RDW (red blood cell distribution width) and PCT (plateletcrit) in BD and compare these with disease activity and clinical findings. A total of 266 participants (49 healthy control and 217 BD patients) were recruited from the rheumatology department in a single-centre as a case-control study. The laboratory data were obtained from the electronic registration database. BD Activity scores (BDCAF/Behcet's Disease Current Activity Form) were calculated. Laboratory findings of BD patients and healthy controls were compared and evaluated. RDW, Platelet, PCT, NLR and PLR values were significantly higher in patient group than in the healthy controls. However, haemoglobin, MPVPR and LMR were significantly lower in the patient group which compared with the healthy controls. LPM in BD with genital ulcers, WLP in BD with genital ulcers and arthritis, MPR in BD with uveitis, RDW in BD with thrombosis and neuro-Behçet's disease (NBD), PLR in NBD were observed to be higher. However, LMR in NBD and MPV in BD with thrombosis were lower than those without. There was a positive correlation between BDCAF score and RDW, and NLR. Haemoglobin, RDW, Platelet, PCT, NLR, LMR, PLR and MPVPR were statistically significant predictors for BD. RDW, PCT and NLR are the most valuable predictors for BD.

Predictive Value of Inflammation Biomarkers in Patients with Portal Vein Thrombosis.

Background and AimsTo investigate the usefulness of inflammation biomarkers to serve as a predictors of portal vein thrombosis (PVT) postoperatively (post) in patients with portal hypertension after splenectomy and periesophagogastric devascularization.MethodsA total of 177 liver cirrhosis patients were recruited from January 2013 to December 2017. They were divided into a PVT group (n=71) and a non-PVT group (n=106), according to ultrasound examination findings at 7-day post. Inflammation biomarkers involving platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), red blood cell distribution width-to-platelet ratio(RPR), mean platelet volume-to-platelet ratio (MPR) preoperatively (pre) and at 1, 3, 7-days post were recorded.ResultsThe univariate logistic regression analysis indicated that PLR (pre) (odds ratio (OR)=3.963, 95% confidence interval (CI)=2.070–7.587, p<0.000), MLR (pre) (OR=2.760, 95% CI=1.386–5.497, p=0.004), PLR (post-day 7) (OR=3.345, 95% CI=1.767–6.332, p=0.000) were significantly associated with the presence of PVT. The multivariate logistic regression analysis results indicated that PLR (pre) (OR=3.037, 95% CI=1.463–6.305, p=0.003), MLR (pre) (OR=2.188, 95% CI=1.003–4.772, p=0.049), PLR(post-day 7) (OR=2.166, 95% CI=1.053–4.454, p=0.036) were independent factors for predicting PVT.ConclusionsThe PLR (pre), MLR (pre), and PLR (post-day 7) are predictors of portal vein thrombosis post in patients with portal hypertension after splenectomy and periesophagogastric devascularization.

Towards an evaluation of alcoholic liver cirrhosis and nonalcoholic fatty liver disease patients with hematological scales.

BACKGROUNDSeeking potentially novel blood markers of liver fibrosis and steatosis is constantly of crucial importance. Despite a growing number of studies in this field of hepatology, a certain role of hematological indices in the course of liver disorders has not been fully elucidated, yet.AIMTo evaluate a diagnostic accuracy of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and mean platelet volume-to-platelet-ratio (MPR) in the course of alcoholic liver cirrhosis (ALC) and nonalcoholic fatty liver disease (NAFLD).METHODSOne hundred forty-two patients with ALC, 92 with NAFLD and 68 persons in control group were enrolled in the study. Hematological indices (NLR, PLR and MPR), indirect and direct markers of liver fibrosis (aspartate transaminase to alkaline transaminase ratio, aspartate transaminase to platelet ratio index, fibrosis-4, gamma-glutamyl transpeptidase to platelet ratio, procollagen I carboxyterminal propeptide, procollagen III aminoterminal propeptide, transforming growth factor-α, platelet-derived growth factor AB, laminin) were measured in each person. Model for end-stage liver disease (MELD) score in ALC group and NAFLD fibrosis score together with BARD score were calculated in NAFLD patients. Receiver operating characteristic (ROC) curves and area under the curve (AUC) values were applied to assess the sensitivity and specificity of examined markers and to evaluate proposed cut-offs of measured indices in the course of ALC and NAFLD.RESULTSMPR and NLR values in ALC patients were significantly higher in comparison to control group; PLR level was significantly lower. MPR and PLR correlated with assessed indirect and direct markers of liver fibrosis. MPR, NLR and PLR correlated with MELD score. NLR level in NAFLD patients was significantly higher in comparison to controls. MPR correlated with indirect markers of liver fibrosis and NAFLD fibrosis score. AUC values and proposed cut-offs for NLR, PLR and MPR in ALC patients were: 0.821 (> 2.227), 0.675 (< 70.445) and 0.929 (> 0.048), respectively. AUC values and proposed cut-offs for NLR, PLR and MPR in NAFLD group were: 0.725 (> 2.034), 0.528 (> 97.101) and 0.547 (> 0.038), respectively.CONCLUSIONHematological markers are inseparably connected with serological indices of liver fibrosis in ALC and NAFLD patients. MPR and NLR turned out to be the most powerful parameters in ALC patients.

Routine blood parameters are helpful for early identification of influenza infection in children

BackgroundRoutine blood parameters, such as the lymphocyte (LYM) count, platelet (PLT) count, lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), lymphocytes multiplied by platelets (LYM*PLT) and mean platelet volume-to-platelet ratio (MPV/PLT), are widely used to predict the prognosis of infectious diseases. We aimed to explore the value of these parameters in the early identification of influenza virus infection in children.MethodsWe conducted a single-center, retrospective, observational study of fever with influenza-like symptoms in pediatric outpatients from different age groups and evaluated the predictive value of various routine blood parameters measured within 48 h of the onset of fever for influenza virus infection.ResultsThe LYM count, PLT count, LMR and LYM*PLT were lower, and the NLR and MPV/PLT were higher in children with an influenza infection (PCR-confirmed and symptomatic). The LYM count, LMR and LYM*PLT in the influenza infection group were lower in the 1- to 6-year-old subgroup, and the LMR and LYM*PLT in the influenza infection group were lower in the > 6-year-old subgroup. In the 1- to 6-year-old subgroup, the cutoff value of the LMR for predicting influenza A virus infection was 3.75, the sensitivity was 81.87%, the specificity was 84.31%, and the area under the curve (AUC) was 0.886; the cutoff value of the LMR for predicting influenza B virus infection was 3.71, the sensitivity was 73.58%, the specificity was 84.31%, and the AUC was 0.843. In the > 6-year-old subgroup, the cutoff value of the LMR for predicting influenza A virus infection was 3.05, the sensitivity was 89.27%, the specificity was 89.61%, and the AUC was 0.949; the cutoff value of the LMR for predicting influenza B virus infection was 2.88, the sensitivity was 83.19%, the specificity was 92.21%, and the AUC was 0.924.ConclusionsRoutine blood tests are simple, inexpensive and easy to perform, and they are useful for the early identification of influenza virus infection in children. The LMR had the strongest predictive value for influenza virus infection in children older than 1 year, particularly in children older than 6 years with influenza A virus infection.

Reference intervals of systemic immune-inflammation index, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume to platelet ratio, mean platelet volume and red blood cell distribution width-standard deviation in healthy Han adults in Wuhan region in central China

Low-grade inflammatory indicators are widely used in the diagnosis and prognosis of different diseases, particularly, in cancers. The establishing of reference intervals (RIs) are necessary to provide baselines for the interpretation and application of the indicators in clinical. A retrospective review was organized to include ostensibly healthy subjects aged >18 years old to establish RIs based on gender and age for systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume-to-platelet ratio (MPV/PLT), MPV and red blood cell distribution width - standard deviation (RDW-SD). Another 5012 healthy persons were included to validate the RIs. The differences among gender, age, and Body Mass Index (BMI) groups were compared to assess their influences on each indicator. A total of 26,242 males and 11,934 females were included. All indicators differed between males and females except NLR. Compared with males, the values of SII, PLR, MPV and RDW-SD were higher while MPV/PLT lower in females. The values of SII, NLR and PLR increased with age in females between 18 and 50 years old, declined in 51–60 years old group, then increased with age again. Values of MPV/PLT and RDW-SD increased with age. The values of SII increased with BMI while PLR, MPV, and MPV/PLT decreased. We effectively established RIs for the indicators. They will help with predicting disease progression in various clinical practices. Gender, age, and BMI were suggested to be taken into consideration when these parameters were applied in clinical.

Comparison of platelet volume indices in acute coronary syndrome

Aim: To compare the parameters showing the platelet volume index in unstable angina pectoris (USAP), non-ST elevation myocardial infarction (non-STEMI) and ST elevation myocardial infarction (STEMI). Methods: The platelet volume indices of 94 USAP, 161 non-STEMI and 86 STEMI cases with a total of 341 patients (245 men, 96 women) were compared. The patients between March 2015 and October 2018 who admitted to Bolu Abant Izzet Baysal University Hospital with the diagnosis of acute coronary syndrome were compared using platelet distribution width (PDW), PDW to platelet ratio (PPR), mean platelet volume (MPV), MPV to platelet ratio (MPR). Results: No significant difference was found between the 3 groups in terms of PDW (p = 0.26), PPR (p = 0.87), MPV (p = 0.41) and MPR (p = 0.78) values. Conclusion: In our study, there was no statistically significant difference between the types of acute coronary syndrome and platelet volume indices.

Mean Platelet Volume to Platelet ratio as a promising marker of hepatosteatosis

Aim: Hepatosteatosis confers increased lipid accumulation in the hepatocytes which is associated with inflammation. Hemogram parameters, such as mean platelet volume (MPV) and MPV to platelet ratio (MPR) are proposed as novel inflammatory markers in recent studies. We aimed to compare MPR of subjects with hepatosteatosis to those in healthy controls. Methods: Patient admissions to our clinic with a diagnosis of hepatosteatosis were retrospectively analyzed MPR values compared to those in healthy controls. Results: Mean MPR of hepatosteatosis group (0,04 ± 0,01fL/mm3) was significantly higher than the MPR of control subjects (0,03 ± 0,01 fL/mm3) (p=0.04). A Pearson’s Correlation analyze was revealed significant correlations between MPR and fasting plasma glucose (r=0.26, p=0.004) and between MPR and LDL-cholesterol (r=0.19, p=0.04). Conclusion: An elevated MPR should alert physicians for hepatosteatosis in otherwise healthy subjects. Therefore, calculation of MPR by automatic hemogram analyzers is advised.

Association of mean platelet volume and red blood cell distribution width with coronary collateral development in stable coronary artery disease.

IntroductionThe prognostic value of hematological indices in cardiovascular diseases and the association between these parameters and cardiovascular conditions have been established in the literature.AimIn this study, we aimed to investigate the relation of mean platelet volume (MPV), MPV to platelet ratio (MPR) and red cell distribution width (RDW) with degree of coronary collateral development (CCD) in stable coronary artery disease (CAD) subjects with established critical coronary artery stenosis.Material and methodsA total of 306 patients with stable angina pectoris undergoing coronary arteriography were enrolled and divided on the basis of the development of CCD into two groups: a group with adequate CCD (n = 214) and a group with impaired CCD (n = 92). Routine complete blood count and biochemical parameters were measured before coronary arteriography.ResultsThe MPV and MPR levels were significantly higher in the inadequate CCD group (10.5 ±1.8 fl vs. 8.7 ±1.9 fl, p < 0.001 and 0.06 ±0.08 vs. 0.05 ±0.07, p = 0.036). Patients with inadequate CCD had significantly higher RDW levels compared to patients with adequate CCD (15.5 ±1.7% vs. 15.0 ±1.9%, p = 0.01). MPV and RDW were significantly associated with Rentrop collateral grading (r = –0.523, p < 0.001 and r = –0.239, p < 0.001, respectively), whereas the association with MPR was not significant. An MPV value greater than 9.95 fl, determined with ROC curve analysis, had 71% sensitivity and 70% specificity in predicting inadequate CCD. An RDW greater than 14.3% has 71% sensitivity and 53% specificity in selecting patients with adequate CCD.ConclusionsThe present study suggests that MPV and MPR may be associated with the degree of collateral development in chronic stable CAD. However, the negative association of RDW with inadequate CCD, in combination with previous contradictory reports, raises a doubt about the possible value of RDW in stable CAD. Although these parameters may be affected by various conditions, a high MPV may lead clinicians to suspect possible inadequate collateral development in stable CAD patients.