The Use of New Hematological Markers in the Diagnosis of Alopecia Areata
Keywords:
Alopecia areata, Monocyte lymphocyte ratio (MLR), ROC analysis, MarkerAbstract
Introduction: Alopecia areata (AA) is a non-cicatricial inflammatory and autoimmune hair loss disease. In recent studies, it has been reported that hematological parameters can be used as oxidative stress markers in the diagnosis of many inflammatory diseases due to their low cost and widespread use.
Objectives: In this study, it was aimed to reveal the significant cut-off points of hematological inflammatory markers in AA that can guide clinicians in clinical practice and determine how many times they increase the risk of disease.
Methods: The present study is retrospective case-control type. Seventy patients with AA and seventy healthy controls were included in the study. The hematological parameters in both groups were evaluated retrospectively.
Results: Hemoglobulin, monocyte, platelet, monocyte high-density lipoprotein cholesterol (HDL-C) ratio (MHR), monocyte lymphocyte ratio (MLR), platelet lymphocyte ratio (PLR) were high in patients with AA, while the number of lymphocytes was low. In ROC analysis, the optimal cut-off values for the diagnosis of AA were as follows: MLR 0.216, MHR 0.010, and PLR 111.715. In regression analysis, being above the following values of MLR 0.216, MHR 0.010, and PLR 111.715 increased the risk of developing AA by 6.3, 3.8, and 2.7 times, respectively.
Conclusions: It was seen that MHR and PLR, especially MLR, can significantly increase the risk of developing the disease in AA and can also be used as diagnostic markers.
References
Strazzulla LC, Wang EHC, Avila L, et al. Alopecia areata: Disease characteristics, clinical evaluation, and new perspectives on pathogenesis. J Am Acad Dermatol. 2018;78(1):1-12. DOI:10.1016/j.jaad.2017.04.1141. PMID: 29241771.
Pratt CH, King LE, Messenger AG, Christiano AM, Sundberg JP. Alopecia areata. Nat Rev Dis Primer. 2017;3:17011. DOI:10.1038/nrdp.2017.11. PMID: 28300084. PMCID: PMC5573125.
Safavi KH, Muller SA, Suman VJ, Moshell AN, Melton LJ. Incidence of alopecia areata in Olmsted County, Minnesota, 1975 through 1989. Mayo Clin Proc. 1995;70(7):628-633. DOI:10.4065/70.7.628. PMID: 7791384.
Darwin E, Hirt PA, Fertig R, Doliner B, Delcanto G, Jimenez JJ. Alopecia Areata: Review of Epidemiology, Clinical Features, Pathogenesis, and New Treatment Options. Int J Trichology. 2018;10(2):51-60. DOI:10.4103/ijt.ijt_99_17. PMID: 29769777. PMCID: PMC5939003.
Gilhar A, Etzioni A, Paus R. Alopecia areata. N Engl J Med. 2012;366(16):1515-1525. DOI:10.1056/NEJMra1103442. PMID: 22512484.
Simakou T, Butcher JP, Reid S, Henriquez FL. Alopecia areata: A multifactorial autoimmune condition. J Autoimmun. 2019;98:74-85. DOI: 10.1016/j.jaut.2018.12.001. PMID: 30558963.
Islam N, Leung PSC, Huntley AC, Gershwin ME. The autoimmune basis of alopecia areata: a comprehensive review. Autoimmun Rev. 2015;14(2):81-89. DOI: 10.1016/j.autrev.2014.10.014. PMID: 25315746.
Rashmi R, Rao KSJ, Basavaraj KH. A comprehensive review of biomarkers in psoriasis. Clin Exp Dermatol. 2009;34(6):658-663. DOI:10.1111/j.1365-2230.2009.03410.x. PMID: 19558584.
Asahina A, Kubo N, Umezawa Y, Honda H, Yanaba K, Nakagawa H. Neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and mean platelet volume in Japanese patients with psoriasis and psoriatic arthritis: Response to therapy with biologics. J Dermatol. 2017;44(10):1112-1121. DOI:10.1111/1346-8138.13875. PMID: 28493493.
Kridin K, Shihade W, Zelber-Sagi S. Mean Platelet Volume in Pemphigus Vulgaris. Angiology. 2018;69(4):303-307. DOI:10.1177/0003319717718329. KPMID: 28681645.
Pancar GS, Eyupoglu O. Red Cell Distribution Width and Mean Platelet Volume in Patients With Pityriasis Rosea. J Clin Med Res. 2016;8(6):445-448. DOI:10.14740/jocmr2535w. PMID: 27222672. PMCID: PMC4852777.
Turkmen D, Altunisik N, Sener S. Investigation of monocyte HDL ratio as an indicator of inflammation and complete blood count parameters in patients with acne vulgaris. Int J Clin Pract. 2020;74(12):e13639. DOI:10.1111/ijcp.13639. PMID: 32741037.
Kavak A, Baykal C, Ozarmağan G, Akar U. HLA in alopecia areata. Int J Dermatol. 2000;39(8):589-592. DOI:10.1046/j.1365-4362.2000.00921.x. PMID: 10971726.
Mirzoyev SA, Schrum AG, Davis MDP, Torgerson RR. Lifetime incidence risk of alopecia areata estimated at 2.1% by Rochester Epidemiology Project, 1990-2009. J Invest Dermatol. 2014;134(4):1141-1142. DOI:10.1038/jid.2013.464. PMID: 2420223. PMCID: PMC3961558.
Ozlu E, Karadag AS, Toprak AE, et al. Evaluation of Cardiovascular Risk Factors, Haematological and Biochemical Parameters, and Serum Endocan Levels in Patients with Lichen Planus. Dermatol Basel Switz. 2016;232(4):438-443. doi:10.1159/000447587 OPMID: 27508489.
Sirin MC, Korkmaz S, Erturan I, et al. Evaluation of monocyte to HDL cholesterol ratio and other inflammatory markers in patients with psoriasis. An Bras Dermatol. 2020;95(5):575-582. DOI:10.1016/j.abd.2020.02.008. PMID: 32711928. PMCID: PMC7562997.
Aktaş Karabay E, Demir D, Aksu Çerman A. Evaluation of monocyte to high-density lipoprotein ratio, lymphocytes, monocytes, and platelets in psoriasis. An Bras Dermatol. 2020;95(1):40-45. DOI:10.1016/j.abd.2019.05.002. PMID: 31889591. PMCID: PMC7058861.
Demirbaş A, Elmas ÖF, Atasoy M, Türsen Ü, Lotti T. Can monocyte to HDL cholesterol ratio and monocyte to lymphocyte ratio be markers for inflammation and oxidative stress in patients with vitiligo? A preliminary study. Arch Dermatol Res. 2021;313(6):491-498. DOI:10.1007/s00403-020-02129-3. PMID: 32816078.
İslamoğlu ZGK, Demirbaş A. Evaluation of complete blood cell and inflammatory parameters in patients with alopecia areata: Their association with disease severity. J Cosmet Dermatol. 2020;19(5):1239-1245. DOI:10.1111/jocd.13131. PMID: 31502748.
Ji H, Li Y, Fan Z, et al. Monocyte/lymphocyte ratio predicts the severity of coronary artery disease: a syntax score assessment. BMC Cardiovasc Disord. 2017;17(1):90. DOI:10.1186/s12872-017-0507-4. JPMID: 28359298. PMCID: PMC5374608.
Kang Y, Zhu X, Lin Z, et al. Compare the Diagnostic and Prognostic Value of MLR, NLR and PLR in CRC Patients. Clin Lab. 2021;67(9). DOI:10.7754/Clin.Lab.2021.201130. PMID: 34542964.
Yue S, Zhang J, Wu J, Teng W, Liu L, Chen L. Use of the Monocyte-to-Lymphocyte Ratio to Predict Diabetic Retinopathy. Int J Environ Res Public Health. 2015;12(8):10009-10019. DOI:10.3390/ijerph120810009. PMID: 26308022. PMCID: PMC4555325.
Zawada AM, Rogacev KS, Rotter B, et al. SuperSAGE evidence for CD14++CD16+ monocytes as a third monocyte subset. Blood. 2011;118(12):e50-61. DOI:10.1182/blood-2011-01-326827. PMID: 21803849.
Yayla ME, İlgen U, Okatan İE, et al. Association of simple hematological parameters with disease manifestations, activity, and severity in patients with systemic sclerosis. Clin Rheumatol. 2020;39(1):77-83. DOI:10.1007/s10067-019-04685-0. PMID: 31317426.
Cosansu NC, Dikicier BS, Yaldiz M, Solak B. Is There Any Association Between the Monocyte/Lymphocyte Ratio and the Presence and Severity of the Disease in Patients with Psoriasis? Sak Tıp Derg. 2020;10(3):430-436. DOI: 10.31832/smj.719980.
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