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Article

Platelet‑to‑lymphocyte ratio, neutrophil‑to‑lymphocyte ratio and monocyte‑to‑HDL cholesterol ratio as markers of peripheral artery disease in elderly patients

  • Authors:
    • Stefano Selvaggio
    • Angela Abate
    • Giuseppe Brugaletta
    • Cinzia Musso
    • Mario Di Guardo
    • Caterina Di Guardo
    • Enzo Saretto Dante Vicari
    • Marcello Romano
    • Salvatore Luca
    • Salvatore Santo Signorelli
  • View Affiliations / Copyright

    Affiliations: Geriatric Unit, ‘Maggiore’ Hospital, Modica, I‑97015 Ragusa, Italy, Villa Aurelia Hospital, 96100 Siracusa, Italy, Geriatric Unit, General Hospital ‘Garibaldi’ Nesima, I‑95122 Catania, Italy, Department of Agriculture, Food and Environment (Di3A), University of Catania, I‑95123 Catania, Italy, Geriatric Unit, General Hospital Cannizzaro, Department of Clinical and Experimental Medicine, University of Catania, I‑95123 Catania, Italy, Geriatric Unit, Department of General Surgery and Medical‑Surgical Specialties, University of Catania, I‑95123 Catania, Italy, Department of Clinical and Experimental Medicine, University of Catania, Internal Medicine Unit, University Hospital ‘G. Rodolico’, I‑95123 Catania, Italy
  • Pages: 1210-1216
    |
    Published online on: June 16, 2020
       https://doi.org/10.3892/ijmm.2020.4644
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Abstract

Solid evidence underlines the pivotal role played by inflammation regarding atherosclerosis. Peripheral artery disease (PAD) is one of atherosclerotic cardiovascular diseases (CVDs), it is highly frequently diagnosed in older individuals. In the present study we carried out an investigation on the association between platelet‑to‑lymphocytes ratio (PLR), neutrophil‑to‑lymphocyte ratio (NLR), monocyte‑to‑HDL cholesterol ratio (MHR) with PAD as favourable markers. We identified 300 subjects aged over 70 years, without any concomitant CVDs. The PLR, NLR and MHR were assessed from peripheral venous blood routinely drawn in the ward during hospitalization. Patients were divided in groups according to ankle brachial index (ABI) value (>0.9; 0.9‑0.99; 1‑1.4; >1.4). Higher PLR (P=0.007), NLR (P=0.0001) and MHR (P=0.0001) were associated with <0.9 ABI. Patients with a >1.4 ABI showed NLR values higher compared to >0.9l ABI (P<0.01). Univariate linear regression analysis demonstrated the direct correlation between increase in PLR (P=0.0023)and MHR (P<0.0001) with the decrease in ABI value. In multivariate linear regression analysis including main cardiovascular risk factors we found that PLR, NLR and MHR were independently associated with lower ABI (P=0.0011). Results show and suggest that the elevated PLR, NLR and MHR are related to PAD evaluated with ABI measurement. PLR and MHR seem to be more reliable markers than NLR in PAD. NLR seems to be more related to incompressibility of arterial wall. It is hypothesized that these three indexes may play a role as simple and repetitive markers of PAD.
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1 

Writing group Members; Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, Das SR, de Ferranti S, Després JP, Fullerton HJ, et al American Heart Association Statistics Committee; Stroke Statistics Subcommittee: Heart disease and stroke statistics-2016 update: A report from the American Heart Association. Circulation. 133:e38–360. 2016.

2 

Townsend N, Wilson L, Bhatnagar P, Wickramasinghe K, Rayner M and Nichols M: Cardiovascular disease in Europe: Epidemiological update 2016. Eur Heart J. 37:3232–3245. 2016. View Article : Google Scholar : PubMed/NCBI

3 

Corrado E, Rizzo M, Muratori I, Coppola G and Novo S: Older age and markers of inflammation are strong predictors of clinical events in women with asymptomatic carotid lesions. Menopause. 15:240–247. 2008. View Article : Google Scholar

4 

Corrado E and Novo S: High sensitivity of C-reactive protein in primary prevention. G Ital Cardiol (Rome). 8:327–334. 2007.In Italian.

5 

Maresca G, Di Blasio A, Marchioli R and Di Minno G: Measuring plasma fibrinogen to predict stroke and myocardial infarction: An update. Arterioscler Thromb Vasc Biol. 19:1368–1377. 1999. View Article : Google Scholar : PubMed/NCBI

6 

Wierzbicki AS: Homocysteine and cardiovascular disease: A review of the evidence. Diab Vasc Dis Res. 4:143–150. 2007. View Article : Google Scholar : PubMed/NCBI

7 

Michaud M, Balardy L, Moulis G, Gaudin C, Peyrot C, Vellas B, Cesari M and Nourhashemi F: Proinflammatory cytokines, aging, and age-related diseases. J Am Med Dir Assoc. 14:877–882. 2013. View Article : Google Scholar : PubMed/NCBI

8 

Kim NY, Chun DH, Kim SY, Kim NK, Baik SH, Hong JH, Kim KS and Shin CS: Prognostic value of systemic inflammatory indices, NLR, PLR, and MPV, for predicting 1-year survival of patients undergoing cytoreductive surgery with HIPEC. J Clin Med. 8:5892019. View Article : Google Scholar :

9 

Kurtul A and Ornek E: Platelet to lymphocyte ratio in cardiovascular diseases: A systematic review. Angiology. 70:802–818. 2019. View Article : Google Scholar : PubMed/NCBI

10 

Ganjali S, Gotto AM Jr, Ruscica M, Atkin SL, Butler AE, Banach M and Sahebkar A: Monocyte-to-HDL-cholesterol ratio as a prognostic marker in cardiovascular diseases. J Cell Physiol. 233:9237–9246. 2018. View Article : Google Scholar : PubMed/NCBI

11 

Toor IS, Jaumdally RJ, Moss MS and Babu SB: Preprocedural neutrophil count predicts outcome in patients with advanced peripheral vascular disease undergoing percutaneous trans-luminal angioplasty. J Vasc Surg. 48:1504–1508. 2008. View Article : Google Scholar

12 

Liang RF, Li M, Li JH, Zuo MR, Yang Y and Liu YH: The significance of preoperative haematological inflammatory markers in patients with meningiomas. Clin Neurol Neurosurg. 182:1–4. 2019. View Article : Google Scholar : PubMed/NCBI

13 

American Diabetes Association: Standards of medical care in diabetes - 2012. Diabetes Care. 35(Suppl 1): S11–S63. 2012. View Article : Google Scholar

14 

Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, et al National High Blood Pressure Education Program Coordinating Committee: The seventh report of the Joint Ntional Committee on prevention, detection, evaluation, and treatment of high blood pressure: The JNC 7 report. JAMA. 289:2560–2572. 2003. View Article : Google Scholar : PubMed/NCBI

15 

Grundy SM, Cleeman JI, Merz CN, Brewer HB Jr, Clark LT, Hunninghake DB, Pasternak RC, Smith SC Jr and Stone NJ; National Heart, Lung, and Blood Institute; American College of Cardiology Foundation; American Heart Association: Implications of recent clinical trials for the national cholesterol education program adult treatment panel III guidelines. Circulation. 110:227–239. 2004. View Article : Google Scholar : PubMed/NCBI

16 

Khan TH, Farooqui FA and Niazi K: Critical review of the ankle brachial index. Curr Cardiol Rev. 4:101–106. 2008. View Article : Google Scholar : PubMed/NCBI

17 

Balta S and Ozturk C: The platelet-lymphocyte ratio: A simple, inexpensive and rapid prognostic marker for cardiovascular events. Platelets. 26:680–681. 2015. View Article : Google Scholar

18 

Gary T, Pichler M, Belaj K, Hafner F, Gerger A, Froehlich H, Eller P, Rief P, Hackl G, Pilger E, et al: Platelet-to-lymphocyte ratio: A novel marker for critical limb ischemia in peripheral arterial occlusive disease patients. PLoS One. 8:e676882013. View Article : Google Scholar : PubMed/NCBI

19 

Çiçek G, Açıkgoz SK, Bozbay M, Altay S, Uğur M, Uluganyan M and Uyarel H: Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio combination can predict prognosis in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Angiology. 66:441–447. 2015. View Article : Google Scholar

20 

Paquissi FC: The role of inflammation in cardiovascular diseases: The predictive value of neutrophil-lymphocyte ratio as a marker in peripheral arterial disease. Ther Clin Risk Manag. 12:851–860. 2016. View Article : Google Scholar : PubMed/NCBI

21 

Belaj K, Pichler M, Hackl G, Rief P, Eller P, Hafner F, Brodmann M and Gary T: Association of the derived neutrophil-lymphocyte ratio with critical limb ischemia. Angiology. 67:350–354. 2016. View Article : Google Scholar

22 

Tacke F, Alvarez D, Kaplan TJ, Jakubzick C, Spanbroek R, Llodra J, Garin A, Liu J, Mack M, van Rooijen N, et al: Monocyte subsets differentially employ CCR2, CCR5, and CX3CR1 to accumulate within atherosclerotic plaques. J Clin Invest. 117:185–194. 2007. View Article : Google Scholar : PubMed/NCBI

23 

Sala F, Cutuli L, Grigore L, Pirillo A, Chiesa G, Catapano AL and Norata GD: Prevalence of classical CD14++/CD16− but not of intermediate CD14++/CD16+ monocytes in hypoalphalipoproteinemia. Int J Cardiol. 168:2886–2889. 2013. View Article : Google Scholar : PubMed/NCBI

24 

Cetin MS, Ozcan Cetin EH, Kalender E, Aydin S, Topaloglu S, Kisacik HL and Temizhan A: Monocyte to HDL cholesterol ratio predicts coronary artery disease severity and future major cardiovascular adverse events in acute coronary syndrome. Heart Lung Circ. 25:1077–1086. 2016. View Article : Google Scholar : PubMed/NCBI

25 

Criqui MH and Aboyans V: Epidemiology of peripheral artery disease. Circ Res. 116:1509–1526. 2015. View Article : Google Scholar : PubMed/NCBI

26 

Xue G, Deng H and Zhang L: Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio predict severity and prognosis of lower limb arteriosclerosis obliterans. Ann Vasc Surg. 64:221–227. 2020. View Article : Google Scholar

27 

Signorelli SS, Malaponte G, Libra M, Di Pino L, Celotta G, Bevelacqua V, Petrina M, Nicotra GS, Indelicato M, Navolanic PM, et al: Plasma levels and zymographic activities of matrix metal-loproteinases 2 and 9 in type II diabetics with peripheral arterial disease. Vasc Med. 10:1–6. 2005. View Article : Google Scholar : PubMed/NCBI

28 

Signorelli SS, Anzaldi M, Libra M, Navolanic PM, Malaponte G, Mangano K, Quattrocchi C, Di Marco R, Fiore V and Neri S: Plasma levels of Inflammatory Biomarkers in Peripheral Arterial Disease: Results of a cohort study. Angiology. 67:870–874. 2016. View Article : Google Scholar : PubMed/NCBI

29 

Signorelli SS, Mazzarino MC, Spandidos DA and Malaponte G: Proinflammatory circulating molecules in peripheral arterial disease. Int J Mol Med. 20:279–286. 2007.PubMed/NCBI

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Copy and paste a formatted citation
Spandidos Publications style
Selvaggio S, Abate A, Brugaletta G, Musso C, Di Guardo M, Di Guardo C, Vicari ES, Romano M, Luca S, Signorelli SS, Signorelli SS, et al: Platelet‑to‑lymphocyte ratio, neutrophil‑to‑lymphocyte ratio and monocyte‑to‑HDL cholesterol ratio as markers of peripheral artery disease in elderly patients. Int J Mol Med 46: 1210-1216, 2020.
APA
Selvaggio, S., Abate, A., Brugaletta, G., Musso, C., Di Guardo, M., Di Guardo, C. ... Signorelli, S.S. (2020). Platelet‑to‑lymphocyte ratio, neutrophil‑to‑lymphocyte ratio and monocyte‑to‑HDL cholesterol ratio as markers of peripheral artery disease in elderly patients. International Journal of Molecular Medicine, 46, 1210-1216. https://doi.org/10.3892/ijmm.2020.4644
MLA
Selvaggio, S., Abate, A., Brugaletta, G., Musso, C., Di Guardo, M., Di Guardo, C., Vicari, E. S., Romano, M., Luca, S., Signorelli, S. S."Platelet‑to‑lymphocyte ratio, neutrophil‑to‑lymphocyte ratio and monocyte‑to‑HDL cholesterol ratio as markers of peripheral artery disease in elderly patients". International Journal of Molecular Medicine 46.3 (2020): 1210-1216.
Chicago
Selvaggio, S., Abate, A., Brugaletta, G., Musso, C., Di Guardo, M., Di Guardo, C., Vicari, E. S., Romano, M., Luca, S., Signorelli, S. S."Platelet‑to‑lymphocyte ratio, neutrophil‑to‑lymphocyte ratio and monocyte‑to‑HDL cholesterol ratio as markers of peripheral artery disease in elderly patients". International Journal of Molecular Medicine 46, no. 3 (2020): 1210-1216. https://doi.org/10.3892/ijmm.2020.4644
Copy and paste a formatted citation
x
Spandidos Publications style
Selvaggio S, Abate A, Brugaletta G, Musso C, Di Guardo M, Di Guardo C, Vicari ES, Romano M, Luca S, Signorelli SS, Signorelli SS, et al: Platelet‑to‑lymphocyte ratio, neutrophil‑to‑lymphocyte ratio and monocyte‑to‑HDL cholesterol ratio as markers of peripheral artery disease in elderly patients. Int J Mol Med 46: 1210-1216, 2020.
APA
Selvaggio, S., Abate, A., Brugaletta, G., Musso, C., Di Guardo, M., Di Guardo, C. ... Signorelli, S.S. (2020). Platelet‑to‑lymphocyte ratio, neutrophil‑to‑lymphocyte ratio and monocyte‑to‑HDL cholesterol ratio as markers of peripheral artery disease in elderly patients. International Journal of Molecular Medicine, 46, 1210-1216. https://doi.org/10.3892/ijmm.2020.4644
MLA
Selvaggio, S., Abate, A., Brugaletta, G., Musso, C., Di Guardo, M., Di Guardo, C., Vicari, E. S., Romano, M., Luca, S., Signorelli, S. S."Platelet‑to‑lymphocyte ratio, neutrophil‑to‑lymphocyte ratio and monocyte‑to‑HDL cholesterol ratio as markers of peripheral artery disease in elderly patients". International Journal of Molecular Medicine 46.3 (2020): 1210-1216.
Chicago
Selvaggio, S., Abate, A., Brugaletta, G., Musso, C., Di Guardo, M., Di Guardo, C., Vicari, E. S., Romano, M., Luca, S., Signorelli, S. S."Platelet‑to‑lymphocyte ratio, neutrophil‑to‑lymphocyte ratio and monocyte‑to‑HDL cholesterol ratio as markers of peripheral artery disease in elderly patients". International Journal of Molecular Medicine 46, no. 3 (2020): 1210-1216. https://doi.org/10.3892/ijmm.2020.4644
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