Clinical utility of neutrophil to lymphocyte ratio (NLR) for epileptic seizures: A systematic review and meta-analysis

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery Pub Date : 2025-06-04 DOI:10.1016/j.clineuro.2025.108996

Tiemin Li , Da Wei , Huawei Zhang , Adilijiang Aihemaitiniyazi , Changqing Liu

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引用次数: 0

Abstract

Background

The neutrophil-to-lymphocyte ratio (NLR) is a commonly used biomarker for inflammation and is typically elevated in patients experiencing epileptic seizures making it a valuable diagnostic indicator in clinical practice. However, there is no consensus on the clinical utility of NLR in patients with epileptic seizures. Given this controversy, we conducted a meta-analysis to clarify the clinical utility of NLR for epileptic seizures. The meta-analysis has been registered in the PROSPERO database (registration number CRD42024550918).

Methods

We conducted a comprehensive literature search in the PubMed, Embase, Cochrane Library, and Web of Science databases, systematically reviewing the literature from January 1, 2000, to May 1, 2024, and determined the eligible studies. NLR values and corresponding sample sizes were extracted from each included study, and a random effects model was used for the meta-analysis. Sensitivity analysis was performed to investigate heterogeneity. Subgroup analysis was conducted to explore the sources of heterogeneity. Egger's test was also used in this meta-analysis to investigate publication bias.

Results

After a comprehensive literature search and screening, we included 16 studies in our meta-analysis. The pooled results indicate that NLR levels in the epileptic seizure group are significantly higher compared to the non-seizure group (random effects model, SMD 0.49, 95 % CI: 0.31, 0.67, P < 0.0001). Heterogeneity tests revealed significant heterogeneity (I² = 82 %). Sensitivity analysis results indicate that our findings are robust to the influence of individual studies. Subgroup analysis results suggest that the testing time of NLR and mean/median age are sources of heterogeneity. Egger's test shows no significant publication bias in this meta-analysis.

Conclusions

This is the first meta-analysis to demonstrate the potential clinical utility of NLR as a biomarker in patients with epileptic seizures.

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中性粒细胞与淋巴细胞比值（NLR）在癫痫发作中的临床应用：一项系统综述和荟萃分析

中性粒细胞与淋巴细胞比率（NLR）是一种常用的炎症生物标志物，在癫痫发作患者中通常升高，使其成为临床实践中有价值的诊断指标。然而，对于NLR在癫痫发作患者中的临床应用尚无共识。鉴于这一争议，我们进行了一项荟萃分析，以阐明NLR在癫痫发作中的临床应用。该meta分析已在PROSPERO数据库中注册（注册号CRD42024550918）。方法对PubMed、Embase、Cochrane Library和Web of Science数据库进行综合文献检索，系统回顾2000年1月1日至2024年5月1日的文献，确定符合条件的研究。从每个纳入的研究中提取NLR值和相应的样本量，并采用随机效应模型进行meta分析。对异质性进行敏感性分析。采用亚组分析探讨异质性的来源。在本荟萃分析中也使用了Egger检验来调查发表偏倚。经过全面的文献检索和筛选，我们在meta分析中纳入了16项研究。合并结果显示，癫痫发作组NLR水平明显高于非癫痫发作组（随机效应模型，SMD 0.49, 95 % CI: 0.31, 0.67, P <； 0.0001）。异质性检验显示显著异质性（I²= 82 %）。敏感性分析结果表明，我们的发现对个别研究的影响是稳健的。亚组分析结果显示NLR的检测时间和平均/中位年龄是异质性的来源。Egger检验显示，本荟萃分析没有显著的发表偏倚。这是首个证明NLR作为癫痫发作患者生物标志物的潜在临床应用的荟萃分析。

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

Clinical Neurology and Neurosurgery 医学-临床神经学

CiteScore

3.70

自引率

5.30%

发文量

358

审稿时长

46 days

期刊介绍： Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.