Association between the immune-inflammation index and the severity and clinical outcomes of patients with inflammatory bowel disease: a systematic review and meta-analysis.

IF 2.5 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Peiji Li, Yilin Wu, Wei Xiong, Jiahui Cao, Mengyun Chen, Zhaowei Yuan, Wenxin Guo, Bing Yang
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引用次数: 0

Abstract

Background: Existing studies have explored the association between immune-inflammatory indices and inflammatory bowel disease (IBD), but there is a lack of comprehensive evidence. This meta-analysis and systematic review seeks to synthesize the data of available clinical research and offer the latest and comprehensive evidence-based conclusions regarding whether these immune-inflammatory indices can effectively predict the severity, activity, and prognosis of IBD.

Methods: Seven databases were comprehensively retrieved from their establishment to March 23, 2025. The combined results were described through standardized mean differences (SMD) or odds ratios (OR) with 95% confidence intervals (CI). Review Manager 5.4 and STATA 15.0 were leveraged for data analysis.

Results: Our analysis included 35 studies involving 5,870 patients. The aggregated data revealed that the neutrophil-to-lymphocyte ratio (NLR) (OR = 1.18, 95% CI:1.04 to 1.34; P = 0.001) (SMD = 1.01, 95%CI = 0.73 to 1.29, P < 0.001), platelet-to-lymphocyte ratio (PLR) (SMD = 0.60, 95%CI = 0.46 to 0.74, P < 0.001), neutrophil-to-platelet ratio (NPR) (OR = 1.20, 95% CI:1.08 to 1.32, P < 0.001), and C-reactive protein to albumin ratio (CRP/ALB) (OR = 1.50, 95% CI:1.38 to 1.65, P < 0.001) were potentially linked to disease activity in IBD patients. PLR (SMD = 1.08, 95%CI = 0.60 to 1.55, P < 0.001) showed potential associations with disease severity in IBD patients. Additionally, NLR (SMD = 0.43, 95%CI = 0.15 to 0.70, P = 0.002) and eosinophil-to-lymphocyte ratio (ELR) (SMD = 0.63, 95%CI = 0.26 to 1.00, P < 0.001) had potential associations with endoscopic response in IBD patients. Moreover, NLR was potentially associated with disease relapse(OR = 1.35, 95% CI:1.09 to 1.68; P = 0.006) and steroid responsiveness (SMD = 0.50, 95%CI = 0.15 to 0.85, P = 0.005).

Conclusion: NLR, PLR, NPR, and CRP/ALB are potential predictors of disease activity in IBD patients. PLR shows the potential to predict disease severity, while NLR and ELR are potential indicators of endoscopic response. Furthermore, NLR is also a potential predictor of relapse and steroid responsiveness. Currently, there is insufficient evidence to support an association between NLR and the severity of IBD, whereas lymphocyte-to-monocyte ratio (LMR) appears to be associated with both the severity and activity of IBD and PLR and eosinophil*neutrophil-to-lymphocytes ratio (ENLR) are associated with endoscopic response in IBD.

Prospero registration: CRD 42024609659.

免疫炎症指数与炎症性肠病患者的严重程度和临床结局之间的关系:一项系统综述和荟萃分析
背景:已有研究探讨了免疫炎症指数与炎症性肠病(IBD)之间的关系,但缺乏全面的证据。本荟萃分析和系统综述旨在综合现有临床研究数据,并就这些免疫炎症指标是否能有效预测IBD的严重程度、活动性和预后提供最新、全面的循证结论。方法:综合检索自建库至2025年03月23日的7个数据库。综合结果通过标准化平均差异(SMD)或95%置信区间(CI)的优势比(or)进行描述。利用Review Manager 5.4和STATA 15.0进行数据分析。结果:我们的分析包括35项研究,涉及5870例患者。汇总数据显示,中性粒细胞与淋巴细胞比值(NLR) (OR = 1.18, 95% CI:1.04 ~ 1.34;P = 0.001) (SMD = 1.01, 95%CI = 0.73 ~ 1.29)。结论:NLR、PLR、NPR和CRP/ALB是IBD患者疾病活动性的潜在预测因子。PLR显示了预测疾病严重程度的潜力,而NLR和ELR是内镜反应的潜在指标。此外,NLR也是复发和类固醇反应性的潜在预测因子。目前,没有足够的证据支持NLR与IBD严重程度之间的关联,而淋巴细胞与单核细胞的比值(LMR)似乎与IBD和PLR的严重程度和活动性相关,嗜酸性粒细胞*中性粒细胞与淋巴细胞的比值(ENLR)与IBD的内镜反应相关。普洛斯彼罗注册:CRD 42024609659。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Gastroenterology
BMC Gastroenterology 医学-胃肠肝病学
CiteScore
4.20
自引率
0.00%
发文量
465
审稿时长
6 months
期刊介绍: BMC Gastroenterology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of gastrointestinal and hepatobiliary disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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