Diagnostic nalue of C-reactive protein/albumin ratio and neutrophil/lymphocyte ratio for Parkinson's disease in elderly patients

doi:10.3877/cma.j.issn.2095-8757.2023.01.003

Abstract

Abstract:

Objective

To explore the diagnostic nalue of of C-reactive protein to albumin ratio (CAR) and neutrophil to lymphocyte ratio (NLR) for Parkinson's disease (PD) in elderly patients.

Methords

A total of 87 elderly PD patients (PD group) and 60 patients with headache and dizziness (Control group) were collected from Suqian First Hospital from January 2019 to March 2022. Basic data and blood biochemical indexes of patients in the two groups were collected, and CAR and NLR were calculated. Spearman correlation analysis was used to analyze the correlation of CAR and NLR with disease severity (Hoehn-Yahr stage) and cognitive dysfunction in PD patients. Multivariate logistic regression analysis was used to determine whether CAR and NLR were risk factors for PD. The diagnostic value of CAR and NLR for PD was evaluated using receiver operating characteristic (ROC) curve .

Results

Compared with the control group, the levels of CAR and NLR in PD group were significantly higher, and the difference was statistically significant (t=3.875, 3.212; P < 0.05). Spearman correlation analysis showed that CAR was positively correlated with Hoehn-Yahr stage and cognitive dysfunction in PD patients (r=0.614, 0.712; P < 0.01), while NLR was only positively correlated with cognitive dysfunction in PD patients (r=0.735, P < 0.01). Multivariate Logistic regression analysis showed that CAR and NLR were independent risk factors for PD (OR=2.533, 1.736; 95%CI: 1.662-4.064, 1.437-2.968; P < 0.01). ROC curve analysis results showed that the areas under the curve predicted by CAR and NLR were 0.749 (95%CI: 0.666-0.831, P < 0.05) and 0.751 (95%CI: 0.670-0.833, P < 0.05), respectively. The area under the curve predicted by CAR and NLR was 0.837(95%CI: 0.772-0.903, P < 0.01).

Conclusion

CAR and NLR are associated with the risk, severity and cognitive dysfunction of PD, and can be used as biomarkers to diagnose PD, and their combined diagnostic value is higher.

Key words: C-reactive protein, Albumin, Neutrophil, Lymphocyte, Parkinson's disease

Yuanyuan Han, Zihan Yu, Ling Yang, Hongyu Cheng, Chunjie Song. Diagnostic nalue of C-reactive protein/albumin ratio and neutrophil/lymphocyte ratio for Parkinson's disease in elderly patients[J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2023, 10(01): 14-19.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhlnbyjdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-8757.2023.01.003

https://zhlnbyjdzzz.cma-cmc.com.cn/EN/Y2023/V10/I01/14

Figures/Tables 5

References 28

[1]	中华医学会神经病学分会帕金森病及运动障碍学组. 中国帕金森病的诊断标准（2016版）[J].中华神经科杂志，2016，49（4）：268-271.
[2]	Pajares M, Rojo AI, Manda G, et al. Inflammation in Parkinson's disease: Mechanisms and therapeutic implications[J]. Cells, 2020, 9(7):1687.
[3]	Marogianni C, Sokratous M, Dardiotis E, et al. Neurodegeneration and inflammation-An interesting interplay in Parkinson's disease[J]. Int J Mol Sci, 2020, 21(22):8421.
[4]	Sheinenzon A, Shehadeh M, Michelis R, et al. Serum albumin levels and inflammation[J]. Int J Biol Macromol, 2021, 184:857-862.
[5]	Kaplan M, Ates I, Akpinar MY, et al. Predictive value of C-reactive protein/albumin ratio in acute pancreatitis[J]. Hepatobiliary Pancreat Dis Int, 2017, 16(4):424-430.
[6]	Güneş H, Yurttutan S, Çobanuşağı M, et al. CRP/albumin ratio: A promising marker of gram-negative bacteremia in late-onset neonatal sepsis[J]. Turk Arch Pediatr, 2021, 56(1):32-36.
[7]	Chen YH, Wang L, Feng SY, et al. The relationship between C-reactive protein/albumin ratio and disease activity in patients with inflammatory bowel disease[J]. Gastroenterol Res Pract, 2020, 2020:3467419.
[8]	Yildirim T, Kiris T, Avci E, et al. Increased serum CRP-albumin ratio is independently associated with severity of carotid artery stenosis[J]. Angiology, 2020, 71(8):740-746.
[9]	Faria SS, Fernandes PC Jr, Silva MJ, et al. The neutrophil-to-lymphocyte ratio: A narrative review[J]. Ecancermedicalscience, 2016, 10:702.
[10]	孙雪婷，李可为，余刚.帕金森病免疫炎症机制的研究进展[J].中华神经科杂志，2019，52（8）：670-673.
[11]	Baran A, Bulut M, Kaya MC, et al. High-sensitivity C-reactive protein and high mobility group box-1 levels in Parkinson's disease[J]. Neurol Sci, 2019, 40(1):167-173.
[12]	Akıl E, Bulut A, Kaplan İ, et al. The increase of carcinoembryonic antigen (CEA), high-sensitivity C-reactive protein, and neutrophil/lymphocyte ratio in Parkinson's disease[J]. Neurol Sci, 2015, 36(3):423-428.
[13]	Memar MY, Alizadeh N, Varshochi M, et al. Immunologic biomarkers for diagnostic of early-onset neonatal sepsis[J]. J Matern Fetal Neonatal Med, 2019, 32(1):143-153.
[14]	Pathak A, Agrawal A. Evolution of C-reactive protein[J]. Front Immunol, 2019, 10:943.
[15]	Qiu X, Xiao Y, Wu J, et al. C-reactive protein and risk of Parkinson's disease: A systematic review and meta-analysis[J]. Front Neurol, 2019,10:384.
[16]	Andican G, Konukoglu D, Bozluolcay M, et al. Plasma oxidative and inflammatory markers in patients with idiopathic Parkinson's disease[J]. Acta Neurol Belg, 2012, 112(2):155-159.
[17]	Sawada H, Oeda T, Umemura A, et al. Baseline C-reactive protein levels and life prognosis in Parkinson's disease[J]. PLoS One, 2015, 10(7):e0134118.
[18]	Jin H, Gu HY, Mao CJ, et al. Association of inflammatory factors and aging in Parkinson's disease[J]. Neurosci Lett, 2020, 736:135259.
[19]	Wang L, Hu W, Wang J, et al. Impact of serum uric acid, albumin and their interaction on Parkinson's disease[J]. Neurol Sci, 2017,38(2):331-336.
[20]	Kakinen A, Javed I, Faridi A, et al. Serum albumin impedes the amyloid aggregation and hemolysis of human islet amyloid polypeptide and alpha synuclein[J]. Biochim Biophys Acta Biomembr, 2018, 1860(9):1803-1809.
[21]	Dong X, Nao J, Shi J, et al. Predictive value of routine peripheral blood biomarkers in Alzheimer's disease[J]. Front Aging Neurosci, 2019, 11:332.
[22]	Zenaro E, Pietronigro E, Della Bianca V, et al. Neutrophils promote Alzheimer's disease-like pathology and cognitive decline via LFA-1 integrin[J]. Nat Med, 2015, 21(8):880-886.
[23]	Choi SJ, Hong YH, Kim SM, et al. High neutrophil-to-lymphocyte ratio predicts short survival duration in amyotrophic lateral sclerosis[J]. Sci Rep, 2020, 10(1):428.
[24]	Ohtani R, Nirengi S, Nakamura M, al. High-density lipoprotein subclasses and mild cognitive impairment: Study of outcome and a Polipoproteins in Dementia (STOP-Dementia)1[J]. J Alzheimers Dis, 2018, 66(1):289-296.
[25]	Halazun HJ, Mergeche JL, Mallon KA, et al. Neutrophil-lymphocyte ratio as a predictor of cognitive dysfunction in carotid endarterectomy patients[J]. J Vasc Surg, 2014, 59(3):768-773.
[26]	Kara SP, Altunan B, Unal A. Investigation of the peripheral inflammation (neutrophil-lymphocyte ratio) in two neurodegenerative diseases of the central nervous system[J]. Neurol Sci, 2021, 31:1-9.
[27]	Sharma D, Spring KJ, Bhaskar SMM. Neutrophil-lymphocyte ratio in acute ischemic stroke: Immunopathology, management, and prognosis[J]. Acta Neurol Scand, 2021, 144(5):486-499.
[28]	Petrone AB, Eisenman RD, Steele KN, et al. Temporal dynamics of peripheral neutrophil and lymphocytes following acute ischemic stroke[J]. Neurol Sci, 2019, 40(9):1877-1885.

组别	例数	男性	年龄（岁）	BMI（kg/m²）	吸烟	高血压	糖尿病	冠心病史	CRP（mg/L）
PD组	87	52（60.0）	70.7±8.3	23.26±2.41	22（25.3）	12（13.8）	13（14.9）	6（6.9）	5.06±3.43
对照组	60	38（63.3）	68.4±10.7	23.69±1.85	17（28.3）	10（16.7）	11（18.3）	6（10.0）	2.21±2.05
检验值		χ²=0.190	t=0.416	t=0.574	χ²=0.169	χ²=0.230	χ²=0.299	χ²=0.456	t=3.379
P值		>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	<0.01
组别	例数	受教育程度			白蛋白（g/L）	中性粒细胞（×10⁹/L）	淋巴细胞（×10⁹/L）	CAR	NLR
组别	例数	小学及以下	中学	大专及以上	白蛋白（g/L）	中性粒细胞（×10⁹/L）	淋巴细胞（×10⁹/L）	CAR	NLR
PD组	87	19（21.8）	42（48.3）	26（29.9）	34.62±5.01	3.37±1.12	1.32±0.86	0.18±0.12	2.97±0.94
对照组	60	15（25.0）	26（43.3）	19（31.7）	39.45±4.37	2.12±1.03	2.07±0.42	0.08±0.07	1.98±1.06
检验值		χ²=0.653			t=1.267	t=2.824	t=2.366	t=3.875	t=3.212
P值		>0.05			<0.01	<0.01	<0.01	<0.01	<0.01

组别	例数	男性	年龄（岁）	BMI（kg/m²）	吸烟	高血压	糖尿病	冠心病史	CRP（mg/L）
PD组	87	52（60.0）	70.7±8.3	23.26±2.41	22（25.3）	12（13.8）	13（14.9）	6（6.9）	5.06±3.43
对照组	60	38（63.3）	68.4±10.7	23.69±1.85	17（28.3）	10（16.7）	11（18.3）	6（10.0）	2.21±2.05
检验值		χ²=0.190	t=0.416	t=0.574	χ²=0.169	χ²=0.230	χ²=0.299	χ²=0.456	t=3.379
P值		>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	<0.01
组别	例数	受教育程度			白蛋白（g/L）	中性粒细胞（×10⁹/L）	淋巴细胞（×10⁹/L）	CAR	NLR
组别	例数	小学及以下	中学	大专及以上	白蛋白（g/L）	中性粒细胞（×10⁹/L）	淋巴细胞（×10⁹/L）	CAR	NLR
PD组	87	19（21.8）	42（48.3）	26（29.9）	34.62±5.01	3.37±1.12	1.32±0.86	0.18±0.12	2.97±0.94
对照组	60	15（25.0）	26（43.3）	19（31.7）	39.45±4.37	2.12±1.03	2.07±0.42	0.08±0.07	1.98±1.06
检验值		χ²=0.653			t=1.267	t=2.824	t=2.366	t=3.875	t=3.212
P值		>0.05			<0.01	<0.01	<0.01	<0.01	<0.01

Hoehn-Yahr分期	例数	CAR	NLR
早期	22	0.11±0.09	2.75±1.09
中期	36	0.17±0.07	2.91±0.75
晚期	29	0.24±0.07	3.16±0.84
F值		8.372	0.781
P值		<0.01	>0.05

Hoehn-Yahr分期	例数	CAR	NLR
早期	22	0.11±0.09	2.75±1.09
中期	36	0.17±0.07	2.91±0.75
晚期	29	0.24±0.07	3.16±0.84
F值		8.372	0.781
P值		<0.01	>0.05

组别	例数	CAR	NLR
伴认知功能障碍	54	0.23±0.09	3.13±0.59
不伴认知功能障碍	33	0.14±0.12	2.67±0.64
t值		2.376	1.615
P值		<0.01	<0.01

Please choose a citation manager

Content to export