Diagnostic Value of Neutrophil-Lymphocyte Ratio in Diagnosis of Asthma: A Case Control Study in Baghdad
doi.org/10.26538/tjnpr/v4i9.5
Keywords:
inflammation, receiver operating characteristic curve, neutrophil-lymphocyte ratio, AsthmaAbstract
Bronchial asthma is a chronic inflammatory illness of the airways accompanied by systemic inflammation in almost all affected patients. This study aimed to evaluate the diagnostic value of neutrophil-lymphocyte ratio (NLR) in the detection of asthma cases in Baghdad, Iraq. It was a case-control study that included a total of 62 adult patients with asthma who were clinically diagnosed by a consultative physician, and 68 age- and gender-matched apparently healthy subjects as a control group. Samples of peripheral blood were collected from each participant. The NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte
count. The receiver operating characteristic (ROC) curve was used to assess the diagnostic value of NLR in the detection of asthma cases. Mean NLR in asthma patients was 2.33 ± 0.89 compared with 1.82 ± 1.04 in controls with a highly significant difference. The area under the curve (AUC) was 0.886 (95% CI = 0.762-0.951), p = 0.002. The sensitivity and specificity of the test at NLR = 2.11 were 82.8% and 73%, respectively. There was a significant positive correlation between NLR and the number of asthma attacks/year (r = 0.247, p = 0.037). Thus, NLR is a reasonable, easy-to-use, and cheap test that can be routinely used to evaluate the inflammatory response in asthmatic patients.
References
Prakash AK, Datta B, Jaiswal A. Acute Exacerbation of Asthma and Chronic Obstructive Pulmonary Disease. In: Richhariya D, Fares S, Bajan K, Pawaiya S. (eds.). Textbook of Emergency and Trauma Care. Jaypee Brothers Medical Publishers, New Delhi, 2018. 228 p.
Ober C. Perspectives on The past decade of asthma genetics. J Allerg Clin Immunol. 2005; 116:274-278.
Fu JJ, McDonald VM, Gibson PG, Simpson JL. Systemic inflammation in older adults with asthma-COPD overlap syndrome. Allerg Asthma Immunol Res. 2014; 6:316-324.
Nuijsink M, Hop WC, Sterk PJ, Duiverman EJ, De Karrasch S, Linde K, Rücker G, Sommer H, Karsch-Völk M , Kleijnen J, Jörres RA, Schneider A. Accuracy of FENO for diagnosing asthma: a systematic review. J Thorax. 2016; 10:208704.
Jongste JC. Urinary eosinophil protein X in childhood asthma: relation with changes in disease control and eosinophilic airway inflammation. Mediators Inflamm. 2013; 2013:532619.
Grzela K, Litwiniuk M, Zagorska WA. Airway remodeling in chronic obstructive pulmonary disease and asthma: the role of matrix metalloproteinase-9. Arch Immunol Ther Exp. (Warsz). 2016; 64(1):47-55.
Balta S, Celik T, Mikhailidis DP, Ozturk C, Demirkol S, Aparci M, Lyisoy A. The relation between atherosclerosisand the neutrophil-lymphocyte ratio. Clin Appl Thromb Hemost. 2015; 22(5):405-411.
Wiwanitkit V. Neutrophil to lymphocyte ratio in allergic rhinitis. Eur Arch Otorhinolaryngol, 2016; 273(10):3443.
Lee H, Um SJ, Kim YS, Kim DG, Jang AS, Choi HS, Kim YH, Kim TE, Ha YK, Jung K. Association of the neutrophil-to lymphocyte ratio with lung function and exacerbations in patients with chronic obstructive pulmonary disease. PLoS One 2016; 11(6):e0156511.
Global Initiative for Asthma (GINA) [homepage on the Internet]. 2012. Available from: http://www.ginasthma.org. Accessed May 29, 2015.
Hendy RM, Elawady MA, Mansour AI. Assessment of neutrophil/lymphocyte percentage in bronchial asthma. Egypt J Chest Dis Tuberc. 2019; 68:74–79.
Dogru M, Yesiltepe Mutlu RG. The evaluation of neutrophil- lymphocyte ratio in children with asthma. Allergol Immunopathol (Madr). 2016; 44(4):292-296.
Gungen AC and Aydemir Y. The correlation between asthma disease and neutrophil to lymphocyte ratio. Res J Allergy Immunol. 2017; 1(1):1-4.
Shi G, Zhao JW, Ming L. Clinical significance of peripheral blood neutrophillymphocyte ratio and platelet-lymphocyte ratio in patients with asthma. Nan Fang Yi Ke Da Xue Xue Bao 2017; 37:84–88.
Jiang C, Yu H, Zhu W, Xu J, Lou B, Sun Q, Yang X, Meng L, Lu S. Neutrophil lymphocyte ratio in children with recurrent wheeze. Pediatr Allergy Immunol Pulmonol. 2017; 30:4.
Sagmen SB and Kiral N. The evaluation of neutrophil-tolymphocyte ratio and platelet-to-lymphocyte ratio in asthma control. Revue Francaise D’allergologie 2020; 60:20-23.
Mochimaru T, Ueda S, Suzuki Y, Asano K, Fukunaga K. Neutrophi-to-lymphocyte ratio as a novel independent predictor of severe exacerbation in patients with asthma. Ann Allergy Asthma Immunol. 2019; 122(3):337-339.
von Vietinghoff S and Ley K. Homeostatic regulation of blood neutrophil counts. J Immunol. 2008; 181(8):5183-5188.
Torun S, Tunc BD, Suvak B, Yildiz H, Tas A, Sayilir A, Ozdern YO, Beyazit Y, Kayacetin E. Assessment of neutrophil‑lymphocyte ratio in ulcerative colitis: A promising marker in predicting disease severity. Clin Res Hepatol Gastroenterol. 2012; 36:491‑497.
Nunez J, Nunez E, Bodi V, Sanchis J, Miñana G, Mainar L, Santas E, Merlos P, Rumiz E, Darmofal H, Heatta AM, Llàcer A. Usefulness of the neutrophil to lymphocyte ratio in predicting long-term mortality in ST segment elevation myocardial infarction. Am J Cardiol. 2008; 101:747-752.
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