Research Article
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Platelet Lymphocyte Ratio is Associated With Carotid Atherosclerosis in Hemodialysis Patients

Year 2019, , 199 - 205, 31.12.2019
https://doi.org/10.19127/mbsjohs.601400

Abstract

Objective: We aimed to demonstrate whether there is a correlation
between Platelet Lymphocyte Ratio (PLR) and carotid intima-media thickness
(CIMT) which is an early marker of atherosclerosis in patients receiving
dialysis where there is a chronic inflammatory process in the body.

Methods: 53 patients receiving dialysis 3 days a week and 54
persons as the control group were included. The exclusion criteria were determined
as infection, using drugs that increase or decrease the number of leukocytes
such as steroids, antithyroid, chronic liver diseases, rheumatic disease,
maling disease and prior cardiovascular or cerebrovascular diseases. Patients’
age, gender, body mass index, hemogram and biochemical parameters were
recorded. CIMT values were measured by Carotid Doppler examination.

Results: When the two groups were compared; there was no
significant difference between them in terms of age, gender, blood pressures,
DM, ejection fractions, lipid levels. PLR, neutrophil-to-lymphocyte ratio (NLR)
and CIMT were significantly higher (p=0.009, p<0.001, p<0.001;
respectively) in the dialysis patients group. A positive correlation was found
between CIMT and PLR, NLR (r=0.59 p<0.001, r=0.38, p=0.004). As a result of
the linear regression analysis, PLR (B:0.714, 95%CI:3.425/14.393, p=0.002) and
NLR were found as independent predictors in showing CIMT.







Conclusion: PLR is independently associated with subclinical
atherosclerosis assessed by CIMT in people with dialysis patients

References

  • Davi G, Patrono C. Platelet activation and atherothrombosis. N Engl J Med 2007;357:2482-94.
  • Fukuda H, Takagi T, Kondo T, Shimizu S, Tanabe K. et al. Predictive value of inflammation-based prognostic scores in patients with metastatic renal cell carcinoma treated with cytoreductive nephrectomy. Oncotarget. 2018;9(18):14296-14305.
  • Gary T, Pichler M, Belaj K, Hafner F, Gerger A, Froehlich H. et al. Platelet-to-lymphocyte ratio: a novel marker for critical limb ischemia in peripheral arterial occlusive disease patients. PLoS One 2013;8:e67688.
  • Ikeda U. Inflammation and coronary artery disease. Curr Vasc Pharmacol 2003; 1:65–70
  • Jiang Y, Qu S, Xinbin Pan X, Huang S, Zhu X. Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in intensity modulated radiation therapy for nasopharyngeal carcinoma. Oncotarget. 2018; 9(11): 9992–10004
  • Kalay N, Dogdu O, Koc F, Yarlioglues M, Ardic I, Akpek M. et al. Hematologic parameters and angiographic progression of coronary atherosclerosis. Angiology. 2012;63:213–7.
  • Ozcan Cetin EH, Cetin MS, Aras D, Topaloglu S, Temizhan A, Kisacik HL.et al. Platelet to lymphocyte ratio as a prognostic marker of in-hospital and long-term major adverse cardiovascular events in ST-segment elevation myocardial infarction. Angiology 2016;67:336-45
  • Tola EN. The association between in vitro fertilization outcome and the inflammatory markers of complete blood count among nonobese unexplained infertile couples. Taiwan J Obstet Gynecol. 2018;57(2):289-294
  • Trakarnwijitr I, Li B, Adams H, Layland J, Garlick J, Wilson A. Age modulates the relationship between platelet-to-lymphocyte ratio and coronary artery disease. Int J Cardiol. 2017;248:349-354. doi: 10.1016/j.ijcard.2017.06.127.
  • Wei Y, Jiang YZ, Qian WH. Prognostic role of NLR in urinary cancers: a meta-analysis. PLoS One. 2014;9(3):e92079.
  • Wróbel P, Grabowska U, Sułowicz W. The prevalence of chronic kidney disease among patients of the Emergency Department of the Regional Hospital in Kielce. Przegl Lek. 2016;73(5):310-5.
  • Xiao WK, Chen D, Li SQ, Fu SJ, Peng BG, Liang LJ. Prognostic significance of neutrophil-lymphocyte ratio in hepatocellular carcinoma: a meta-analysis. BMC Cancer. 2014;14:1–10.
  • Akbas EM, Demirtas L, Ozcicek A, Timuroglu A, Bakirci EM, Hamur H. et al. Association of epicardial adipose tissue, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with diabetic nephropathy. Int J Clin Exp Med 2014; 7: 1794–1801.
  • Bal Z, Bal U, Okyay K, Yilmaz M, Balcioglu S, Turgay O. et al. Hematological parameters can predict the extent of coronary artery disease in patients with end‑stage renal disease. Int Urol Nephrol (2015) 47:1719–1725.
  • Celik T, Bugan B. White blood cell count and stable coronary artery disease: the role of neutrophil to lymphocyte ratio. Cardiol J 2011; 18: 720- 721.
  • Corriere T, Di Marca S, Cataudella E, Pulvirenti A, Alaimo S, Stancanelli B et al. Neutrophil-to-LymphocyteRatio is a strong predictor of atherosclerotic carotid plaques in older adults. Nutr Metab Cardiovasc Dis. 2018;28(1):23-27
  • Damman P, Beijk MA, Kuijt WJ, Verouden NJ, van Geloven N, Henriques JP. et al. Multiple biomarkers at admission significantly improve the prediction of mortality in patients undergoing primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction. J Am Coll Cardiol 2011;57: 29–36.
  • Horne BD, Anderson JL, John JM, Weaver A, Bair TL, Jensen KR. et al. Inter mountain Heart Collaborative Study Group. Which white blood cell subtypes predict increased cardiovascular risk? J Am Coll Cardiol. 2005;45(10): 1638-43
  • Kaya A, Kurt M, Tanboga IH, Işık T, Günaydın ZY, Kaya Y. et al. Relation of neutrophil to lymphocyte ratio with the presence and severity of stable coronary artery disease. Clin Appl Thromb Hemost. 2014;20(5):473-7.
  • Li X, Shen J, Lu Z, Chen M, Fang X, Wang G. High neutrophil-to-lymphocyte ratio is associated with increased carotid artery intima- media thickness in type 2 diabetes. J Diabetes Investig. 2017;8(1):101-107.
  • Nimitphong H, Siwasaranond N, Saetung S, Thakkinstian A, Ongphiphadhanakul B, ReutrakulS. The relationship among breakfast time, morningness-eveningness preference and body mass index in Type 2 diabetes. Diabet Med. 2018. doi: 10.1111/dme.13642.
  • O'Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK Jr. Carotid -artery intima and media thickness as a risk factor for myocardia linfarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med 1999;340:14-22.
  • Polat M, Bugdayci G, Kaya H, Oguzman H. Evaluation of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in Turkish patients with chronic plaque psoriasis. Acta Dermatovenerol Alp Pannonica Adriat. 2017;26(4):97-100
  • Sambel M, Kilic M, Demirbas M, Onen E, Oner S, Erdogan A. et al. Relationship between erectile dysfunction and the neutrophil to lymphocyte and platelet to lymphocyte ratios. Int J ImpotRes. 2017. doi: 10.1038/s41443-017-0007-1.
  • Sinning JM, Bickel C, Messow CM, Schnabel R, Lubos E, Rupprecht HJ et al. Impact of C-reactive protein and fibrinogen on cardiovascular prognosis in patients with stable angina pectoris: the AtheroGene study. Eur Heart J 2006;27: 2962–2968
  • Tatar E, Mirili C, Isikyakar T, Yaprak M, Guvercin G, Ozay E et al. The association of neutrophil /lymphocyte ratio and platelet / lymphocyte ratio with clinical outcomes in geriatric patients with stage 3-5 chronic kidney disease. Acta Clin Belg. 2016;71(4):221-6.
  • Turkmen K, Erdur FM, Ozcicek F, Ozcicek A, Akbas EM, Ozbicer A et al. Platelet-to-lymphocyte ratio better predicts inflammation than neutrophil-to-lymphocyte ratio in end-stage renal disease patients. Hemodial Int. 2013;17:391–6.
  • Ucar FM, Açar B, Gul M, Ozeke O, Aydogdu S. The Association between Platelet / Lymphocyte Ratio and Coronary Artery Disease Severity in Asymptomatic Low Ejection Fraction Patients. Korean Circ J. 2016;46 (6):821-826.
  • Ulu SM, Dogan M, Ahsen A, Altug A, Demir K, Acartürk G et al. Neutrophil-tolymphocyte ratio as a quick and reliable predictive marker to diagnose the severity of diabetic retinopathy. Diabetes Technol Ther 2013; 15: 942–947.
  • Uysal HB, Daglı B, Akgullu C, Avcil M, Zencir C, Ayhan M et al. Blood count parameters can predict the severity of coronary artery disease. Korean J Intern Med. 2016;31(6):1093-1100.
  • Uzun F, Erturk M, Cakmak HA, Kalkan AK, Akturk IF, Yalcin AA et al. Usefulness of the platelet-to-lymphocyte ratio in predicting long-term cardiovascular mortality in patients with peripheral arterial occlusive disease. Postepy Kardiol Interwencyjnej. 2017;13(1):32-38.
  • Wang X, Xie Z, Liu X, Huang X, Lin J, Huang D et al. Association of Platelet to lymphocyte ratio with non-culprit atherosclerotic plaque vulnerability in patients with acute coronary syndrome: an optical coherence tomography study. BMC Cardiovasc Disord. 2017 Jul 3;17(1):175.
  • Yaprak M, Turan MN, Dayanan R, Akin S, Degirmen E, Yıldırım M. et al. Platelet-to lymphocyte ratio predicts mortality better than neutrophil- to- lymphocyte ratio in hemodialysis patients. Int Urol Nephrol. 2016;48 (8):1343-8.
Year 2019, , 199 - 205, 31.12.2019
https://doi.org/10.19127/mbsjohs.601400

Abstract

References

  • Davi G, Patrono C. Platelet activation and atherothrombosis. N Engl J Med 2007;357:2482-94.
  • Fukuda H, Takagi T, Kondo T, Shimizu S, Tanabe K. et al. Predictive value of inflammation-based prognostic scores in patients with metastatic renal cell carcinoma treated with cytoreductive nephrectomy. Oncotarget. 2018;9(18):14296-14305.
  • Gary T, Pichler M, Belaj K, Hafner F, Gerger A, Froehlich H. et al. Platelet-to-lymphocyte ratio: a novel marker for critical limb ischemia in peripheral arterial occlusive disease patients. PLoS One 2013;8:e67688.
  • Ikeda U. Inflammation and coronary artery disease. Curr Vasc Pharmacol 2003; 1:65–70
  • Jiang Y, Qu S, Xinbin Pan X, Huang S, Zhu X. Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in intensity modulated radiation therapy for nasopharyngeal carcinoma. Oncotarget. 2018; 9(11): 9992–10004
  • Kalay N, Dogdu O, Koc F, Yarlioglues M, Ardic I, Akpek M. et al. Hematologic parameters and angiographic progression of coronary atherosclerosis. Angiology. 2012;63:213–7.
  • Ozcan Cetin EH, Cetin MS, Aras D, Topaloglu S, Temizhan A, Kisacik HL.et al. Platelet to lymphocyte ratio as a prognostic marker of in-hospital and long-term major adverse cardiovascular events in ST-segment elevation myocardial infarction. Angiology 2016;67:336-45
  • Tola EN. The association between in vitro fertilization outcome and the inflammatory markers of complete blood count among nonobese unexplained infertile couples. Taiwan J Obstet Gynecol. 2018;57(2):289-294
  • Trakarnwijitr I, Li B, Adams H, Layland J, Garlick J, Wilson A. Age modulates the relationship between platelet-to-lymphocyte ratio and coronary artery disease. Int J Cardiol. 2017;248:349-354. doi: 10.1016/j.ijcard.2017.06.127.
  • Wei Y, Jiang YZ, Qian WH. Prognostic role of NLR in urinary cancers: a meta-analysis. PLoS One. 2014;9(3):e92079.
  • Wróbel P, Grabowska U, Sułowicz W. The prevalence of chronic kidney disease among patients of the Emergency Department of the Regional Hospital in Kielce. Przegl Lek. 2016;73(5):310-5.
  • Xiao WK, Chen D, Li SQ, Fu SJ, Peng BG, Liang LJ. Prognostic significance of neutrophil-lymphocyte ratio in hepatocellular carcinoma: a meta-analysis. BMC Cancer. 2014;14:1–10.
  • Akbas EM, Demirtas L, Ozcicek A, Timuroglu A, Bakirci EM, Hamur H. et al. Association of epicardial adipose tissue, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with diabetic nephropathy. Int J Clin Exp Med 2014; 7: 1794–1801.
  • Bal Z, Bal U, Okyay K, Yilmaz M, Balcioglu S, Turgay O. et al. Hematological parameters can predict the extent of coronary artery disease in patients with end‑stage renal disease. Int Urol Nephrol (2015) 47:1719–1725.
  • Celik T, Bugan B. White blood cell count and stable coronary artery disease: the role of neutrophil to lymphocyte ratio. Cardiol J 2011; 18: 720- 721.
  • Corriere T, Di Marca S, Cataudella E, Pulvirenti A, Alaimo S, Stancanelli B et al. Neutrophil-to-LymphocyteRatio is a strong predictor of atherosclerotic carotid plaques in older adults. Nutr Metab Cardiovasc Dis. 2018;28(1):23-27
  • Damman P, Beijk MA, Kuijt WJ, Verouden NJ, van Geloven N, Henriques JP. et al. Multiple biomarkers at admission significantly improve the prediction of mortality in patients undergoing primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction. J Am Coll Cardiol 2011;57: 29–36.
  • Horne BD, Anderson JL, John JM, Weaver A, Bair TL, Jensen KR. et al. Inter mountain Heart Collaborative Study Group. Which white blood cell subtypes predict increased cardiovascular risk? J Am Coll Cardiol. 2005;45(10): 1638-43
  • Kaya A, Kurt M, Tanboga IH, Işık T, Günaydın ZY, Kaya Y. et al. Relation of neutrophil to lymphocyte ratio with the presence and severity of stable coronary artery disease. Clin Appl Thromb Hemost. 2014;20(5):473-7.
  • Li X, Shen J, Lu Z, Chen M, Fang X, Wang G. High neutrophil-to-lymphocyte ratio is associated with increased carotid artery intima- media thickness in type 2 diabetes. J Diabetes Investig. 2017;8(1):101-107.
  • Nimitphong H, Siwasaranond N, Saetung S, Thakkinstian A, Ongphiphadhanakul B, ReutrakulS. The relationship among breakfast time, morningness-eveningness preference and body mass index in Type 2 diabetes. Diabet Med. 2018. doi: 10.1111/dme.13642.
  • O'Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK Jr. Carotid -artery intima and media thickness as a risk factor for myocardia linfarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med 1999;340:14-22.
  • Polat M, Bugdayci G, Kaya H, Oguzman H. Evaluation of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in Turkish patients with chronic plaque psoriasis. Acta Dermatovenerol Alp Pannonica Adriat. 2017;26(4):97-100
  • Sambel M, Kilic M, Demirbas M, Onen E, Oner S, Erdogan A. et al. Relationship between erectile dysfunction and the neutrophil to lymphocyte and platelet to lymphocyte ratios. Int J ImpotRes. 2017. doi: 10.1038/s41443-017-0007-1.
  • Sinning JM, Bickel C, Messow CM, Schnabel R, Lubos E, Rupprecht HJ et al. Impact of C-reactive protein and fibrinogen on cardiovascular prognosis in patients with stable angina pectoris: the AtheroGene study. Eur Heart J 2006;27: 2962–2968
  • Tatar E, Mirili C, Isikyakar T, Yaprak M, Guvercin G, Ozay E et al. The association of neutrophil /lymphocyte ratio and platelet / lymphocyte ratio with clinical outcomes in geriatric patients with stage 3-5 chronic kidney disease. Acta Clin Belg. 2016;71(4):221-6.
  • Turkmen K, Erdur FM, Ozcicek F, Ozcicek A, Akbas EM, Ozbicer A et al. Platelet-to-lymphocyte ratio better predicts inflammation than neutrophil-to-lymphocyte ratio in end-stage renal disease patients. Hemodial Int. 2013;17:391–6.
  • Ucar FM, Açar B, Gul M, Ozeke O, Aydogdu S. The Association between Platelet / Lymphocyte Ratio and Coronary Artery Disease Severity in Asymptomatic Low Ejection Fraction Patients. Korean Circ J. 2016;46 (6):821-826.
  • Ulu SM, Dogan M, Ahsen A, Altug A, Demir K, Acartürk G et al. Neutrophil-tolymphocyte ratio as a quick and reliable predictive marker to diagnose the severity of diabetic retinopathy. Diabetes Technol Ther 2013; 15: 942–947.
  • Uysal HB, Daglı B, Akgullu C, Avcil M, Zencir C, Ayhan M et al. Blood count parameters can predict the severity of coronary artery disease. Korean J Intern Med. 2016;31(6):1093-1100.
  • Uzun F, Erturk M, Cakmak HA, Kalkan AK, Akturk IF, Yalcin AA et al. Usefulness of the platelet-to-lymphocyte ratio in predicting long-term cardiovascular mortality in patients with peripheral arterial occlusive disease. Postepy Kardiol Interwencyjnej. 2017;13(1):32-38.
  • Wang X, Xie Z, Liu X, Huang X, Lin J, Huang D et al. Association of Platelet to lymphocyte ratio with non-culprit atherosclerotic plaque vulnerability in patients with acute coronary syndrome: an optical coherence tomography study. BMC Cardiovasc Disord. 2017 Jul 3;17(1):175.
  • Yaprak M, Turan MN, Dayanan R, Akin S, Degirmen E, Yıldırım M. et al. Platelet-to lymphocyte ratio predicts mortality better than neutrophil- to- lymphocyte ratio in hemodialysis patients. Int Urol Nephrol. 2016;48 (8):1343-8.
There are 33 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research articles
Authors

Yasemın Kaya 0000-0001-7360-8090

Mehmet Yaman

Ahmet Karataş 0000-0001-9095-6054

Tuba Gül This is me

Şükran Kaygısız

Hilal Altaş

Ali Yılmaz

Ahmet Kaya

Publication Date December 31, 2019
Published in Issue Year 2019

Cite

Vancouver Kaya Y, Yaman M, Karataş A, Gül T, Kaygısız Ş, Altaş H, Yılmaz A, Kaya A. Platelet Lymphocyte Ratio is Associated With Carotid Atherosclerosis in Hemodialysis Patients. Mid Blac Sea J Health Sci. 2019;5(3):199-205.

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