The monocyte-to-lymphocyte ratio: Sex-specific differences in the tuberculosis disease spectrum, diagnostic indices and defining normal ranges.

<h4>Background</h4>The monocyte-to-lymphocyte ratio (MLR) has been advocated as a biomarker in tuberculosis. Our objective was to evaluate its clinical value and associations.<h4>Methods</h4>Blood counts, inflammatory markers and clinical parameters were measured in patients...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Thomas S Buttle, Claire Y Hummerstone, Thippeswamy Billahalli, Richard J B Ward, Korina E Barnes, Natalie J Marshall, Viktoria C Spong, Graham H Bothamley
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/3633423d44a04ec497bff41c128099eb
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:3633423d44a04ec497bff41c128099eb
record_format	dspace
spelling	oai:doaj.org-article:3633423d44a04ec497bff41c128099eb2021-12-02T20:14:53ZThe monocyte-to-lymphocyte ratio: Sex-specific differences in the tuberculosis disease spectrum, diagnostic indices and defining normal ranges.1932-620310.1371/journal.pone.0247745https://doaj.org/article/3633423d44a04ec497bff41c128099eb2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0247745https://doaj.org/toc/1932-6203<h4>Background</h4>The monocyte-to-lymphocyte ratio (MLR) has been advocated as a biomarker in tuberculosis. Our objective was to evaluate its clinical value and associations.<h4>Methods</h4>Blood counts, inflammatory markers and clinical parameters were measured in patients with and those screened for tuberculosis. Complete blood counts (CBCs) from a multi-ethnic population aged 16 to 65 years were evaluated; a sub-group with normal hematological indices was used to define the range of MLRs.<h4>Results</h4>Multivariate analysis in proven tuberculosis (n = 264) indicated MLR associated with low serum albumin, high white cell counts and a positive culture; values were higher in sputum smear-positive pulmonary tuberculosis (S+PTB). Analysis in S+PTB (n = 296) showed higher MLRs in males and those with high neutrophil counts, low serum albumin and high C-reactive protein. The diagnostic value of MLRs was assessed by comparing notified patients with TB (n = 264) with denotified cases (n = 50), active case-finding in non-contacts (TB n = 111 and LTBI n = 373) and contacts of S+PTB (n = 149) with S+PTB found at screening (n = 75). Sensitivities and specificities ranged from 58.0-62.5% and 50.0-70.0% respectively for optimal cut-off values, defined by ROC curves. In CBCs obtained over one month, ratios correlated with neutrophil counts (ρ = 0.48, P<0.00001, n = 14,573; MLR = 0.45 at 8-8.9 x 109/L) and were higher in males than females (P<0.0001). The MLR range (mean ± 2SD) in those with normal hematological indices (n = 3921: females 0.122-0.474; males 0.136-0.505) paralleled LTBI MLRs. Ratios did not predict death (n = 29) nor response to treatment (n = 178 S+PTB with follow-up CBCs). Ratios were higher in males than female in the 16-45 years age group, where immune differences due to sex hormones are likely greatest.<h4>Conclusions</h4>Severe tuberculosis and male sex associated with high MLRs; the same variables likely affect the performance of other biomarkers. The ratio performed poorly as a clinical aid.Thomas S ButtleClaire Y HummerstoneThippeswamy BillahalliRichard J B WardKorina E BarnesNatalie J MarshallViktoria C SpongGraham H BothamleyPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0247745 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Thomas S Buttle Claire Y Hummerstone Thippeswamy Billahalli Richard J B Ward Korina E Barnes Natalie J Marshall Viktoria C Spong Graham H Bothamley The monocyte-to-lymphocyte ratio: Sex-specific differences in the tuberculosis disease spectrum, diagnostic indices and defining normal ranges.
description	<h4>Background</h4>The monocyte-to-lymphocyte ratio (MLR) has been advocated as a biomarker in tuberculosis. Our objective was to evaluate its clinical value and associations.<h4>Methods</h4>Blood counts, inflammatory markers and clinical parameters were measured in patients with and those screened for tuberculosis. Complete blood counts (CBCs) from a multi-ethnic population aged 16 to 65 years were evaluated; a sub-group with normal hematological indices was used to define the range of MLRs.<h4>Results</h4>Multivariate analysis in proven tuberculosis (n = 264) indicated MLR associated with low serum albumin, high white cell counts and a positive culture; values were higher in sputum smear-positive pulmonary tuberculosis (S+PTB). Analysis in S+PTB (n = 296) showed higher MLRs in males and those with high neutrophil counts, low serum albumin and high C-reactive protein. The diagnostic value of MLRs was assessed by comparing notified patients with TB (n = 264) with denotified cases (n = 50), active case-finding in non-contacts (TB n = 111 and LTBI n = 373) and contacts of S+PTB (n = 149) with S+PTB found at screening (n = 75). Sensitivities and specificities ranged from 58.0-62.5% and 50.0-70.0% respectively for optimal cut-off values, defined by ROC curves. In CBCs obtained over one month, ratios correlated with neutrophil counts (ρ = 0.48, P<0.00001, n = 14,573; MLR = 0.45 at 8-8.9 x 109/L) and were higher in males than females (P<0.0001). The MLR range (mean ± 2SD) in those with normal hematological indices (n = 3921: females 0.122-0.474; males 0.136-0.505) paralleled LTBI MLRs. Ratios did not predict death (n = 29) nor response to treatment (n = 178 S+PTB with follow-up CBCs). Ratios were higher in males than female in the 16-45 years age group, where immune differences due to sex hormones are likely greatest.<h4>Conclusions</h4>Severe tuberculosis and male sex associated with high MLRs; the same variables likely affect the performance of other biomarkers. The ratio performed poorly as a clinical aid.
format	article
author	Thomas S Buttle Claire Y Hummerstone Thippeswamy Billahalli Richard J B Ward Korina E Barnes Natalie J Marshall Viktoria C Spong Graham H Bothamley
author_facet	Thomas S Buttle Claire Y Hummerstone Thippeswamy Billahalli Richard J B Ward Korina E Barnes Natalie J Marshall Viktoria C Spong Graham H Bothamley
author_sort	Thomas S Buttle
title	The monocyte-to-lymphocyte ratio: Sex-specific differences in the tuberculosis disease spectrum, diagnostic indices and defining normal ranges.
title_short	The monocyte-to-lymphocyte ratio: Sex-specific differences in the tuberculosis disease spectrum, diagnostic indices and defining normal ranges.
title_full	The monocyte-to-lymphocyte ratio: Sex-specific differences in the tuberculosis disease spectrum, diagnostic indices and defining normal ranges.
title_fullStr	The monocyte-to-lymphocyte ratio: Sex-specific differences in the tuberculosis disease spectrum, diagnostic indices and defining normal ranges.
title_full_unstemmed	The monocyte-to-lymphocyte ratio: Sex-specific differences in the tuberculosis disease spectrum, diagnostic indices and defining normal ranges.
title_sort	monocyte-to-lymphocyte ratio: sex-specific differences in the tuberculosis disease spectrum, diagnostic indices and defining normal ranges.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/3633423d44a04ec497bff41c128099eb
work_keys_str_mv	AT thomassbuttle themonocytetolymphocyteratiosexspecificdifferencesinthetuberculosisdiseasespectrumdiagnosticindicesanddefiningnormalranges AT claireyhummerstone themonocytetolymphocyteratiosexspecificdifferencesinthetuberculosisdiseasespectrumdiagnosticindicesanddefiningnormalranges AT thippeswamybillahalli themonocytetolymphocyteratiosexspecificdifferencesinthetuberculosisdiseasespectrumdiagnosticindicesanddefiningnormalranges AT richardjbward themonocytetolymphocyteratiosexspecificdifferencesinthetuberculosisdiseasespectrumdiagnosticindicesanddefiningnormalranges AT korinaebarnes themonocytetolymphocyteratiosexspecificdifferencesinthetuberculosisdiseasespectrumdiagnosticindicesanddefiningnormalranges AT nataliejmarshall themonocytetolymphocyteratiosexspecificdifferencesinthetuberculosisdiseasespectrumdiagnosticindicesanddefiningnormalranges AT viktoriacspong themonocytetolymphocyteratiosexspecificdifferencesinthetuberculosisdiseasespectrumdiagnosticindicesanddefiningnormalranges AT grahamhbothamley themonocytetolymphocyteratiosexspecificdifferencesinthetuberculosisdiseasespectrumdiagnosticindicesanddefiningnormalranges AT thomassbuttle monocytetolymphocyteratiosexspecificdifferencesinthetuberculosisdiseasespectrumdiagnosticindicesanddefiningnormalranges AT claireyhummerstone monocytetolymphocyteratiosexspecificdifferencesinthetuberculosisdiseasespectrumdiagnosticindicesanddefiningnormalranges AT thippeswamybillahalli monocytetolymphocyteratiosexspecificdifferencesinthetuberculosisdiseasespectrumdiagnosticindicesanddefiningnormalranges AT richardjbward monocytetolymphocyteratiosexspecificdifferencesinthetuberculosisdiseasespectrumdiagnosticindicesanddefiningnormalranges AT korinaebarnes monocytetolymphocyteratiosexspecificdifferencesinthetuberculosisdiseasespectrumdiagnosticindicesanddefiningnormalranges AT nataliejmarshall monocytetolymphocyteratiosexspecificdifferencesinthetuberculosisdiseasespectrumdiagnosticindicesanddefiningnormalranges AT viktoriacspong monocytetolymphocyteratiosexspecificdifferencesinthetuberculosisdiseasespectrumdiagnosticindicesanddefiningnormalranges AT grahamhbothamley monocytetolymphocyteratiosexspecificdifferencesinthetuberculosisdiseasespectrumdiagnosticindicesanddefiningnormalranges
_version_	1718374636846055424

The monocyte-to-lymphocyte ratio: Sex-specific differences in the tuberculosis disease spectrum, diagnostic indices and defining normal ranges.

Ejemplares similares