Abstract：
BACKGROUND: Systemic inflammation (SI) is linked to chronic kidney disease (CKD) progression and multiple complications. Data regarding SI biomarkers in pediatric patients are scarce. This case-control and cross-sectional study investigates the correlation of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), total iron binding capacity (TIBC) and serum albumin to serum interleukin-6 (IL-6).
METHODS: NLR and PLR were measured in 53 patients (median age: 12.9 years), including 17 on dialysis and 36 with a median glomerular filtration rate of 39 ml/min/1.73m2, and in 25 age and sex-matched healthy controls. Iron profile, serum albumin and IL-6 were measured in the patient group. IL-6 levels > 3rd quartile were classified as high.
RESULTS: Patients presented higher NLR and PLR and particularly those on dialysis (p < 0.001 and p = 0.001). We observed a significant correlation between natural logarithm (ln) of IL-6 (lnIL-6) and NLR (rs = 0.344, p = 0.014), serum albumin (rs = -0.350, p = 0.011) and TIBC (rs = -0.345, p = 0.012) after adjustment for CKD stage, while the correlation between lnIL-6 and PLR was not significant (rs = 0.206, p = 0.151). Combination of NLR, serum albumin and TIBC predicted high IL-6 (13 patients) with an AUC of 0.771 (95% CI 0.608-0.943). Pairing of NLR ≥ 1.7 and TIBC ≤ 300 μg/dL exhibited the highest sensitivity (76.9%), while incorporating serum albumin ≤ 3.8 g/dL along with them achieved the highest specificity (95%) for detecting high IL-6 levels.
CONCLUSIONS: Both NLR and PLR levels increase in CKD, especially in patients on chronic dialysis. NLR, rather than PLR, along with TIBC and serum albumin, are associated with IL-6 in pediatric CKD.
METHODS: NLR and PLR were measured in 53 patients (median age: 12.9 years), including 17 on dialysis and 36 with a median glomerular filtration rate of 39 ml/min/1.73m2, and in 25 age and sex-matched healthy controls. Iron profile, serum albumin and IL-6 were measured in the patient group. IL-6 levels > 3rd quartile were classified as high.
RESULTS: Patients presented higher NLR and PLR and particularly those on dialysis (p < 0.001 and p = 0.001). We observed a significant correlation between natural logarithm (ln) of IL-6 (lnIL-6) and NLR (rs = 0.344, p = 0.014), serum albumin (rs = -0.350, p = 0.011) and TIBC (rs = -0.345, p = 0.012) after adjustment for CKD stage, while the correlation between lnIL-6 and PLR was not significant (rs = 0.206, p = 0.151). Combination of NLR, serum albumin and TIBC predicted high IL-6 (13 patients) with an AUC of 0.771 (95% CI 0.608-0.943). Pairing of NLR ≥ 1.7 and TIBC ≤ 300 μg/dL exhibited the highest sensitivity (76.9%), while incorporating serum albumin ≤ 3.8 g/dL along with them achieved the highest specificity (95%) for detecting high IL-6 levels.
CONCLUSIONS: Both NLR and PLR levels increase in CKD, especially in patients on chronic dialysis. NLR, rather than PLR, along with TIBC and serum albumin, are associated with IL-6 in pediatric CKD.
摘要：
背景：全身炎症（SI）与慢性肾脏病（CKD）进展和多种并发症有关。关于儿科患者SI生物标志物的数据很少。这项病例对照和横断面研究调查了中性粒细胞-淋巴细胞比率（NLR）的相关性，血小板-淋巴细胞比率（PLR），总铁结合能力（TIBC）和血清白蛋白对血清白细胞介素-6（IL-6）。
方法：对53例患者（中位年龄：12.9岁）的NLR和PLR进行了测量，其中包括17例透析患者和36例肾小球滤过率中位数为39ml/min/1.73m2，以及25例年龄和性别匹配的健康对照。铁轮廓，在患者组中测量血清白蛋白和IL-6。IL-6水平>第3四分位数被分类为高。
结果：患者表现出较高的NLR和PLR，尤其是透析患者（p<0.001和p=0.001）。我们观察到IL-6的自然对数（ln）（lnIL-6）和NLR（rs=0.344，p=0.014）之间的显着相关性，血清白蛋白（rs=-0.350，p=0.011）和TIBC（rs=-0.345，p=0.012）在调整CKD分期后，lnIL-6与PLR之间的相关性不显着（rs=0.206，p=0.151）。NLR的组合，血清白蛋白和TIBC预测高IL-6（13例），AUC为0.771（95％CI0.608-0.943）。NLR≥1.7和TIBC≤300μg/dL的配对表现出最高的灵敏度(76.9%),同时掺入血清白蛋白≤3.8g/dL时，检测高IL-6水平的特异性最高（95％）。
结论：CKD患者NLR和PLR水平均升高，尤其是慢性透析患者。NLR,而不是PLR，连同TIBC和血清白蛋白,在小儿CKD中与IL-6相关。
方法：对53例患者（中位年龄：12.9岁）的NLR和PLR进行了测量，其中包括17例透析患者和36例肾小球滤过率中位数为39ml/min/1.73m2，以及25例年龄和性别匹配的健康对照。铁轮廓，在患者组中测量血清白蛋白和IL-6。IL-6水平>第3四分位数被分类为高。
结果：患者表现出较高的NLR和PLR，尤其是透析患者（p<0.001和p=0.001）。我们观察到IL-6的自然对数（ln）（lnIL-6）和NLR（rs=0.344，p=0.014）之间的显着相关性，血清白蛋白（rs=-0.350，p=0.011）和TIBC（rs=-0.345，p=0.012）在调整CKD分期后，lnIL-6与PLR之间的相关性不显着（rs=0.206，p=0.151）。NLR的组合，血清白蛋白和TIBC预测高IL-6（13例），AUC为0.771（95％CI0.608-0.943）。NLR≥1.7和TIBC≤300μg/dL的配对表现出最高的灵敏度(76.9%),同时掺入血清白蛋白≤3.8g/dL时，检测高IL-6水平的特异性最高（95％）。
结论：CKD患者NLR和PLR水平均升高，尤其是慢性透析患者。NLR,而不是PLR，连同TIBC和血清白蛋白,在小儿CKD中与IL-6相关。
