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Meta-Analysis
. 2021 Dec;12(1):286-295.
doi: 10.1080/21655979.2020.1865607.

Clinical relevance of neutrophil-to-lymphocyte ratio and mean platelet volume in pediatric Henoch-Schonlein Purpura: a meta-analysis

Bowen Li  1 , Qian Ren  2 , Jizu Ling  1 , Zhongbin Tao  1 , Xuemei Yang  1 , Yuning Li  1
Affiliations
Meta-Analysis

Clinical relevance of neutrophil-to-lymphocyte ratio and mean platelet volume in pediatric Henoch-Schonlein Purpura: a meta-analysis

Bowen Li et al. Bioengineered. 2021 Dec.

Abstract

The association of neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume (MPV) with the severe gastrointestinal (GI) involvement in pediatric Henoch-Schonlein Purpura (HSP) has been reported in many studies. However, the conclusions from the previous studies were controversial. Therefore, for the first time, we performed a meta-analysis to systematically evaluate the relationship of NLR and MPV to the severe GI involvements. We retrieved PubMed, EMBASE, Web of Science, and Chinese National Knowledge Infrastructure (CNKI) (up to October 2020) thoroughly to acquire eligible studies. The pooled standard mean difference (SMD) with 95% confidence interval (CI) was used to describe the correlation of NLR and MPV with the severe GI involvement. A total of 12 studies comprising 2168 patients with HSP were included in this meta-analysis. Our combined analysis showed that NLR in HSP patients with the severe GI involvement was significantly higher than that in those without the severe GI involvement (SMD = 1.37; 95% CI: 0.70-2.05; p < 0.01). In addition, a lower MPV was observed in children with severe GI involvement (SMD = -0.29; 95% CI: -0.56 - -0.01, p = 0.042). Our sensitivity analysis and publication bias evaluation indicated that our combined results were reliable. Taken together, our study suggested NLR and MPV may be used as biomarkers for predicting or diagnosing the severe GI involvement in children with HSP. Nevertheless, more homogeneous studies with a larger sample size are required to validate these findings.

Keywords: Henoch-Schonlein Purpura; MPV; NLR; gastrointestinal involvements.

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Conflict of interest statement

No, potential conflict of interest was reported by the authors.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Flow chart of literature search and selection
Figure 2.
Figure 2.
Meta-analysis of eight studies reporting the association between NLR and the GI involvement in HSP patients. SMD: standard mean difference; NLR: neutrophil-to-lymphocyte ratio; HSP: Henoch-Schonlein Purpura; GI: gastrointestinal
Figure 3.
Figure 3.
Meta-analysis of 10 studies reporting the association between MPV and the GI involvement in HSP patients. SMD: standard mean difference; MPV: mean platelet volume; HSP: Henoch-Schonlein Purpura; GI: gastrointestinal
Figure 4.
Figure 4.
Sensitivity analysis for NLR (a) and MPV (b). SMD: standard mean difference. NLR: neutrophil-to-lymphocyte ratio; MPV: mean platelet volume
Figure 5.
Figure 5.
Funnel plot describing the publication bias of MPV. SE: standard error. SMD: standard mean difference; MPV: mean platelet volume
See this image and copyright information in PMC

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