Skip to main content
Erschienen in: Inflammation 2/2014

01.04.2014

Neutrophil-to-Lymphocyte Ratio in Chronic Obstructive Pulmonary Disease: A Retrospective Study

verfasst von: Ersin Günay, Sevinç Sarınç Ulaşlı, Olcay Akar, Ahmet Ahsen, Sibel Günay, Tülay Koyuncu, Mehmet Ünlü

Erschienen in: Inflammation | Ausgabe 2/2014

Einloggen, um Zugang zu erhalten

Abstract

Chronic obstructive pulmonary disease (COPD) is a common chronic inflammatory disease of the lung with a high mortality and morbidity rate. Some of the inflammatory markers such as C-reactive protein (CRP), leukocyte count are associated with COPD. In this study, we aimed to evaluate the role of neutrophil-to-lymphocyte ratio (NLR) in COPD patients comparing with the other well-known inflammatory markers. We retrospectively enrolled the laboratory results of 269 COPD patients of which 178 patients at stable period and 91 patients during acute exacerbation and 50 sex- and age- matched healthy controls. We found that NLR values of the stable COPD patients were significantly higher than those of the controls (P < 0.001). During acute exacerbation of the disease there was a further increase compared to stable period (P < 0.001). NLR values were also positively correlated with serum CRP levels and red cell distribution width (RDW) and negatively correlated with mean platelet volume (MPV) in both COPD groups. In conclusion, NLR could be considered as a new inflammatory marker for assessment of inflammation in COPD patients with its quick, cheap, easily measurable property with routine complete blood count analysis.
Literatur
1.
Zurück zum Zitat MacNee, W. 2012. Chronic obstructive pulmonary disease: Epidemiology, pathophysiology, and clinical evaluation. In Clinical respiratory medicine, 4th ed, ed. S.G. Spiro, G.A. Silvestri, and A. Agusti, 531–561. Philadelphia: Elsevier Saunders.CrossRef MacNee, W. 2012. Chronic obstructive pulmonary disease: Epidemiology, pathophysiology, and clinical evaluation. In Clinical respiratory medicine, 4th ed, ed. S.G. Spiro, G.A. Silvestri, and A. Agusti, 531–561. Philadelphia: Elsevier Saunders.CrossRef
2.
Zurück zum Zitat Hogg, J.C., F. Chu, S. Utokaparch, R. Woods, W.M. Elliott, L. Buzatu, et al. 2004. The nature of small airway obstruction in chronic obstructive pulmonary disease. New England Journal of Medicine 350: 2645–2653.PubMedCrossRef Hogg, J.C., F. Chu, S. Utokaparch, R. Woods, W.M. Elliott, L. Buzatu, et al. 2004. The nature of small airway obstruction in chronic obstructive pulmonary disease. New England Journal of Medicine 350: 2645–2653.PubMedCrossRef
3.
Zurück zum Zitat Eagan, T.M., J.K. Damås, T. Ueland, M. Voll-Aanerud, T.E. Mollnes, J.A. Hardie, et al. 2010. Neutrophil gelatinase-associated lipocalin: A biomarker in COPD. Chest 138: 888–895.PubMedCrossRef Eagan, T.M., J.K. Damås, T. Ueland, M. Voll-Aanerud, T.E. Mollnes, J.A. Hardie, et al. 2010. Neutrophil gelatinase-associated lipocalin: A biomarker in COPD. Chest 138: 888–895.PubMedCrossRef
4.
Zurück zum Zitat Agustí, A.G., A. Noguera, J. Sauleda, E. Sala, J. Pons, and X. Busquets. 2003. Systemic effects of chronic obstructive pulmonary disease. European Respiratory Journal 21: 347–360.PubMedCrossRef Agustí, A.G., A. Noguera, J. Sauleda, E. Sala, J. Pons, and X. Busquets. 2003. Systemic effects of chronic obstructive pulmonary disease. European Respiratory Journal 21: 347–360.PubMedCrossRef
5.
Zurück zum Zitat Gan, W.Q., S.F. Man, A. Senthilselvan, and D.D. Sin. 2004. Association between chronic obstructive pulmonary disease and systemic inflammation: A systematic review and a meta-analysis. Thorax 59: 574–580.PubMedCentralPubMedCrossRef Gan, W.Q., S.F. Man, A. Senthilselvan, and D.D. Sin. 2004. Association between chronic obstructive pulmonary disease and systemic inflammation: A systematic review and a meta-analysis. Thorax 59: 574–580.PubMedCentralPubMedCrossRef
6.
Zurück zum Zitat Thomsen, M., T.S. Ingebrigtsen, J.L. Marott, M. Dahl, P. Lange, J. Vestbo, et al. 2013. Inflammatory biomarkers and exacerbations in chronic obstructive pulmonary disease. JAMA 309: 2353–2361.PubMedCrossRef Thomsen, M., T.S. Ingebrigtsen, J.L. Marott, M. Dahl, P. Lange, J. Vestbo, et al. 2013. Inflammatory biomarkers and exacerbations in chronic obstructive pulmonary disease. JAMA 309: 2353–2361.PubMedCrossRef
7.
Zurück zum Zitat Pinto-Plata, V.M., H. Müllerova, J.F. Toso, M. Feudjo-Tepie, J.B. Soriano, R.S. Vessey, et al. 2006. C-reactive protein in patients with COPD, control smokers and non-smokers. Thorax 61: 23–28.PubMedCentralPubMedCrossRef Pinto-Plata, V.M., H. Müllerova, J.F. Toso, M. Feudjo-Tepie, J.B. Soriano, R.S. Vessey, et al. 2006. C-reactive protein in patients with COPD, control smokers and non-smokers. Thorax 61: 23–28.PubMedCentralPubMedCrossRef
8.
Zurück zum Zitat Antonescu-Turcu, A.L., and R. Tomic. 2009. C-reactive protein and copeptin: Prognostic predictors in chronic obstructive pulmonary disease exacerbations. Current Opinion in Pulmonary Medicine 15: 120–125.PubMedCrossRef Antonescu-Turcu, A.L., and R. Tomic. 2009. C-reactive protein and copeptin: Prognostic predictors in chronic obstructive pulmonary disease exacerbations. Current Opinion in Pulmonary Medicine 15: 120–125.PubMedCrossRef
9.
Zurück zum Zitat Hotchkiss, R.S., and I.E. Karl. 2003. The pathophysiology and treatment of sepsis. New England Journal of Medicine 348: 138–150.PubMedCrossRef Hotchkiss, R.S., and I.E. Karl. 2003. The pathophysiology and treatment of sepsis. New England Journal of Medicine 348: 138–150.PubMedCrossRef
10.
Zurück zum Zitat Ahsen, A., M.S. Ulu, S. Yuksel, K. Demir, M. Uysal, M. Erdogan, et al. 2013. As a new inflammatory marker for familial Mediterranean fever: Neutrophil-to-lymphocyte ratio. Inflammation [Epub ahead of print]. Ahsen, A., M.S. Ulu, S. Yuksel, K. Demir, M. Uysal, M. Erdogan, et al. 2013. As a new inflammatory marker for familial Mediterranean fever: Neutrophil-to-lymphocyte ratio. Inflammation [Epub ahead of print].
11.
Zurück zum Zitat Núñez, J., E. Núñez, V. Bodí, J. Sanchis, G. Miñana, L. Mainar, et al. 2008. Usefulness of the neutrophil to lymphocyte ratio in predicting long-term mortality in ST segment elevation myocardial infarction. American Journal of Cardiology 101: 747–752.PubMedCrossRef Núñez, J., E. Núñez, V. Bodí, J. Sanchis, G. Miñana, L. Mainar, et al. 2008. Usefulness of the neutrophil to lymphocyte ratio in predicting long-term mortality in ST segment elevation myocardial infarction. American Journal of Cardiology 101: 747–752.PubMedCrossRef
12.
Zurück zum Zitat Turkmen, K., F.M. Erdur, F. Ozcicek, A. Ozcicek, E.M. Akbas, A. Ozbicer, et al. 2013. Platelet-to-lymphocyte ratio better predicts inflammation than neutrophil-to-lymphocyte ratio in end-stage renal disease patients. Hemodialysis International 17: 391–396.PubMedCrossRef Turkmen, K., F.M. Erdur, F. Ozcicek, A. Ozcicek, E.M. Akbas, A. Ozbicer, et al. 2013. Platelet-to-lymphocyte ratio better predicts inflammation than neutrophil-to-lymphocyte ratio in end-stage renal disease patients. Hemodialysis International 17: 391–396.PubMedCrossRef
13.
Zurück zum Zitat Ertaş, G., O. Sönmez, M. Turfan, S. Kul, E. Erdoğan, A. Tasal, et al. 2013. Neutrophil/lymphocyte ratio is associated with thromboembolic stroke in patients with non-valvular atrial fibrillation. Journal of the Neurological Sciences 324: 49–52.PubMedCrossRef Ertaş, G., O. Sönmez, M. Turfan, S. Kul, E. Erdoğan, A. Tasal, et al. 2013. Neutrophil/lymphocyte ratio is associated with thromboembolic stroke in patients with non-valvular atrial fibrillation. Journal of the Neurological Sciences 324: 49–52.PubMedCrossRef
14.
Zurück zum Zitat Celli, B.R., W. MacNee, and ATS/ERS Task Force. 2004. Standards for the diagnosis and treatment of patients with COPD: A summary of the ATS/ERS position paper. European Respiratory Journal 23: 932–946.PubMedCrossRef Celli, B.R., W. MacNee, and ATS/ERS Task Force. 2004. Standards for the diagnosis and treatment of patients with COPD: A summary of the ATS/ERS position paper. European Respiratory Journal 23: 932–946.PubMedCrossRef
15.
Zurück zum Zitat Anthonisen, N.R., J. Manfreda, C.P. Warren, E.S. Hershfield, G.K. Harding, and N.A. Nelson. 1987. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Annals of Internal Medicine 106: 196–204.PubMedCrossRef Anthonisen, N.R., J. Manfreda, C.P. Warren, E.S. Hershfield, G.K. Harding, and N.A. Nelson. 1987. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Annals of Internal Medicine 106: 196–204.PubMedCrossRef
16.
Zurück zum Zitat Günay, E., S.S. Ulasli, E. Kacar, B. Halici, E. Unlu, K. Tünay, et al. 2013. Can platelet indices predict obstruction level of pulmonary vascular bed in patients with acute pulmonary embolism? Clinical Respiratory Journal [Epub ahead of print]. Günay, E., S.S. Ulasli, E. Kacar, B. Halici, E. Unlu, K. Tünay, et al. 2013. Can platelet indices predict obstruction level of pulmonary vascular bed in patients with acute pulmonary embolism? Clinical Respiratory Journal [Epub ahead of print].
18.
Zurück zum Zitat Stockley, R.A. 2009. Progression of chronic obstructive pulmonary disease: Impact of inflammation, comorbidities and therapeutic intervention. Current Medical Research and Opinion 25: 1235–1245.PubMedCrossRef Stockley, R.A. 2009. Progression of chronic obstructive pulmonary disease: Impact of inflammation, comorbidities and therapeutic intervention. Current Medical Research and Opinion 25: 1235–1245.PubMedCrossRef
19.
Zurück zum Zitat Schols, A.M., W.A. Buurman, A.J. Staal van den Brekel, M.A. Dentener, and E.F. Wouters. 1996. Evidence for a relation between metabolic derangements and increased levels of inflammatory mediators in a subgroup of patients with chronic obstructive pulmonary disease. Thorax 51: 819–824.PubMedCentralPubMedCrossRef Schols, A.M., W.A. Buurman, A.J. Staal van den Brekel, M.A. Dentener, and E.F. Wouters. 1996. Evidence for a relation between metabolic derangements and increased levels of inflammatory mediators in a subgroup of patients with chronic obstructive pulmonary disease. Thorax 51: 819–824.PubMedCentralPubMedCrossRef
20.
Zurück zum Zitat Nural, S., E. Günay, B. Halici, S. Celik, and M. Ünlü. 2013. Inflammatory processes and effects of continuous positive airway pressure (CPAP) in overlap syndrome. Inflammation 36: 66–74.PubMedCrossRef Nural, S., E. Günay, B. Halici, S. Celik, and M. Ünlü. 2013. Inflammatory processes and effects of continuous positive airway pressure (CPAP) in overlap syndrome. Inflammation 36: 66–74.PubMedCrossRef
21.
Zurück zum Zitat Donaldson, G.C., T.A. Seemungal, I.S. Patel, A. Bhowmik, T.M. Wilkinson, J.R. Hurst, et al. 2005. Airway and systemic inflammation and decline in lung function in patients with COPD. Chest 128: 1995–2004.PubMedCrossRef Donaldson, G.C., T.A. Seemungal, I.S. Patel, A. Bhowmik, T.M. Wilkinson, J.R. Hurst, et al. 2005. Airway and systemic inflammation and decline in lung function in patients with COPD. Chest 128: 1995–2004.PubMedCrossRef
22.
Zurück zum Zitat Ulasli, S.S., B.A. Ozyurek, E.B. Yilmaz, and G. Ulubay. 2012. Mean platelet volume as an inflammatory marker in acute exacerbation of chronic obstructive pulmonary disease. Polskie Archiwum Medycyny Wewnętrznej 122: 284–290.PubMed Ulasli, S.S., B.A. Ozyurek, E.B. Yilmaz, and G. Ulubay. 2012. Mean platelet volume as an inflammatory marker in acute exacerbation of chronic obstructive pulmonary disease. Polskie Archiwum Medycyny Wewnętrznej 122: 284–290.PubMed
23.
Zurück zum Zitat Wang, R.T., J.Y. Li, Z.G. Cao, and Y. Li. 2013. The Mean Platelet volume is decreased during an acute exacerbation of chronic obstructive pulmonary disease. Respirology [Epub ahead of print]. Wang, R.T., J.Y. Li, Z.G. Cao, and Y. Li. 2013. The Mean Platelet volume is decreased during an acute exacerbation of chronic obstructive pulmonary disease. Respirology [Epub ahead of print].
24.
Zurück zum Zitat Steiropoulos, P., N. Papanas, E. Nena, M. Xanthoudaki, T. Goula, M. Froudarakis, et al. 2012. Mean platelet volume and platelet distribution width in patients with chronic obstructive pulmonary disease: The role of comorbidities. Angiology [Epub ahead of print]. Steiropoulos, P., N. Papanas, E. Nena, M. Xanthoudaki, T. Goula, M. Froudarakis, et al. 2012. Mean platelet volume and platelet distribution width in patients with chronic obstructive pulmonary disease: The role of comorbidities. Angiology [Epub ahead of print].
25.
Zurück zum Zitat Güngör, B., K.S. Ozcan, I. Erdinler, A. Ekmekçi, A.T. Alper, D. Osmonov, et al. 2013. Elevated levels of RDW is associated with non-valvular atrial fibrillation. Journal of Thrombosis and Thrombolysis [Epub ahead of print]. Güngör, B., K.S. Ozcan, I. Erdinler, A. Ekmekçi, A.T. Alper, D. Osmonov, et al. 2013. Elevated levels of RDW is associated with non-valvular atrial fibrillation. Journal of Thrombosis and Thrombolysis [Epub ahead of print].
26.
Zurück zum Zitat Ozsu, S., Y. Abul, S. Gunaydin, A. Orem, and T. Ozlu. 2012. Prognostic value of red cell distribution width in patients with pulmonary embolism. Clinical and Applied Thrombosis/Hemostasis [Epub ahead of print]. Ozsu, S., Y. Abul, S. Gunaydin, A. Orem, and T. Ozlu. 2012. Prognostic value of red cell distribution width in patients with pulmonary embolism. Clinical and Applied Thrombosis/Hemostasis [Epub ahead of print].
27.
Zurück zum Zitat Ozsu, S., Y. Abul, A. Gulsoy, Y. Bulbul, S. Yaman, and T. Ozlu. 2012. Red cell distribution width in patients with obstructive sleep apnea syndrome. Lung 190: 319–326.PubMedCrossRef Ozsu, S., Y. Abul, A. Gulsoy, Y. Bulbul, S. Yaman, and T. Ozlu. 2012. Red cell distribution width in patients with obstructive sleep apnea syndrome. Lung 190: 319–326.PubMedCrossRef
28.
Zurück zum Zitat Seyhan, E.C., M.A. Ozgül, N. Tutar, I. Omür, A. Uysal, and S. Altın. 2013. Red blood cell distribution and survival in patients with chronic obstructive pulmonary disease. COPD 10: 416–424.PubMedCrossRef Seyhan, E.C., M.A. Ozgül, N. Tutar, I. Omür, A. Uysal, and S. Altın. 2013. Red blood cell distribution and survival in patients with chronic obstructive pulmonary disease. COPD 10: 416–424.PubMedCrossRef
29.
Zurück zum Zitat Sincer, I., A. Zorlu, M.B. Yilmaz, O.T. Dogan, M.R. Ege, G. Amioglu, et al. 2012. Relationship between red cell distribution width and right ventricular dysfunction in patients with chronic obstructive pulmonary disease. Heart and Lung 41: 238–243.PubMedCrossRef Sincer, I., A. Zorlu, M.B. Yilmaz, O.T. Dogan, M.R. Ege, G. Amioglu, et al. 2012. Relationship between red cell distribution width and right ventricular dysfunction in patients with chronic obstructive pulmonary disease. Heart and Lung 41: 238–243.PubMedCrossRef
30.
Zurück zum Zitat Celikbilek, M., S. Dogan, O. Ozbakır, G. Zararsız, H. Kücük, S. Gürsoy, et al. 2013. Neutrophil–lymphocyte ratio as a predictor of disease severity in ulcerative colitis. Journal of Clinical Laboratory Analysis 27: 72–76.PubMedCrossRef Celikbilek, M., S. Dogan, O. Ozbakır, G. Zararsız, H. Kücük, S. Gürsoy, et al. 2013. Neutrophil–lymphocyte ratio as a predictor of disease severity in ulcerative colitis. Journal of Clinical Laboratory Analysis 27: 72–76.PubMedCrossRef
31.
Zurück zum Zitat Okyay, G.U., S. Inal, K. Oneç, R.E. Er, O. Paşaoğlu, H. Paşaoğlu, et al. 2013. Neutrophil to lymphocyte ratio in evaluation of inflammation in patients with chronic kidney disease. Renal Failure 35: 29–36.PubMedCrossRef Okyay, G.U., S. Inal, K. Oneç, R.E. Er, O. Paşaoğlu, H. Paşaoğlu, et al. 2013. Neutrophil to lymphocyte ratio in evaluation of inflammation in patients with chronic kidney disease. Renal Failure 35: 29–36.PubMedCrossRef
Metadaten
Titel
Neutrophil-to-Lymphocyte Ratio in Chronic Obstructive Pulmonary Disease: A Retrospective Study
verfasst von
Ersin Günay
Sevinç Sarınç Ulaşlı
Olcay Akar
Ahmet Ahsen
Sibel Günay
Tülay Koyuncu
Mehmet Ünlü
Publikationsdatum
01.04.2014
Verlag
Springer US
Erschienen in
Inflammation / Ausgabe 2/2014
Print ISSN: 0360-3997
Elektronische ISSN: 1573-2576
DOI
https://doi.org/10.1007/s10753-013-9749-1

Weitere Artikel der Ausgabe 2/2014

Inflammation 2/2014 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Costims – das nächste heiße Ding in der Krebstherapie?

28.05.2024 Onkologische Immuntherapie Nachrichten

„Kalte“ Tumoren werden heiß – CD28-kostimulatorische Antikörper sollen dies ermöglichen. Am besten könnten diese in Kombination mit BiTEs und Checkpointhemmern wirken. Erste klinische Studien laufen bereits.

Perioperative Checkpointhemmer-Therapie verbessert NSCLC-Prognose

28.05.2024 NSCLC Nachrichten

Eine perioperative Therapie mit Nivolumab reduziert das Risiko für Rezidive und Todesfälle bei operablem NSCLC im Vergleich zu einer alleinigen neoadjuvanten Chemotherapie um über 40%. Darauf deuten die Resultate der Phase-3-Studie CheckMate 77T.

Positiver FIT: Die Ursache liegt nicht immer im Dickdarm

27.05.2024 Blut im Stuhl Nachrichten

Immunchemischer Stuhltest positiv, Koloskopie negativ – in solchen Fällen kann die Blutungsquelle auch weiter proximal sitzen. Ein Forschungsteam hat nachgesehen, wie häufig und in welchen Lokalisationen das der Fall ist.

GLP-1-Agonisten können Fortschreiten diabetischer Retinopathie begünstigen

24.05.2024 Diabetische Retinopathie Nachrichten

Möglicherweise hängt es von der Art der Diabetesmedikamente ab, wie hoch das Risiko der Betroffenen ist, dass sich sehkraftgefährdende Komplikationen verschlimmern.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.