Many conditions may affect mean platelet volume and neutrophil to lymphocyte ratio

Dear Editor,

We read with great interest the article “Mean platelet volume and neutrophil to lymphocyte ratio in patients with tinnitus: a case-control study” by Yıldız et al.¹ We would like to make some comment on this study.

Mean platelet volume (MPV) measurement technique is not specified in this study. It is known that variables such as anticoagulant use and the time between blood collection and measurement significantly affect MPV measurements.² Many factors such as age, gender, diabetes, obesity, hypertension, metabolic syndrome and even the use of some antihypertensives affect the MPV.³ The existence of these conditions would certainly confuse the results and they should have been excluded from the study population.

Neutrophil to lymphocyte ratio (NLR) has been investigated in the pathogenesis and prognosis of many diseases, and many studies in the literature have found valuable results. Studies have shown that many factors such as hypertension, diabetes mellitus, metabolic syndrome, acute coronary syndromes, abnormal thyroid function tests, kidney or liver dysfunction, known malignancy, systemic infection, and drug use that may affect hematological parameters affect the NLR value.^4,5 For these reasons, it would have been better if the authors had mentioned these factors in the method section.

Consequently, NLR and MPV can be affected by many factors. The routine clinical use of these parameters may not yet be appropriate.

References

• ¹
  Yildiz S, Karaca H, Toros SZ. Mean platelet volume and neutrophil to lymphocyte ratio in patients with tinnitus: a case-control study. Braz J Otorhinolaryngol. 2020, http://dx.doi.org/10.1016/j.bjorl.2020.05.006
  » http://dx.doi.org/10.1016/j.bjorl.2020.05.006
• ²
  Noris P, Melazzini F, Balduini CL. New roles for mean platelet volume measurement in the clinical practice?. Platelets. 2016;27:607-12.
• ³
  Beyan C, Beyan E. Were the measurements standardized sufficiently in published studies about mean platelet volume?. Blood Coagul Fibrinolysis. 2017;28:234-6.
• ⁴
  Bedel C, Selvi F. Association of platelet to lymphocyte and neutrophil to lymphocyte ratios with in-hospital mortality in patients with type A acute aortic dissection. Braz J Cardiovasc Surg. 2020;34:694-8.
• ⁵
  Angkananard T, Anothaisintawee T, McEvoy M, Attia J, Thakkinstian A. Neutrophil lymphocyte ratio and cardiovascular disease risk: a systematic review and meta-analysis. Biomed Res Int. 2018;2018:2703518.

Publication Dates

• Publication in this collection
  15 Mar 2021
• Date of issue
  Jan-Feb 2021