The effect and correlation of smoking with platelet indices, neutrophil lymphocyte ratio and platelet lymphocyte ratio

Pujani, Mukta; Chauhan, Varsha; Singh, Kanika; Rastogi, Samarth; Agarwal, Charu; Gera, Kamal

doi:10.1016/j.htct.2020.07.006

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Hematology, Transfusion and Cell Therapy

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Original article • Hematol., Transfus. Cell Ther. 43 (04) • 2021 • https://doi.org/10.1016/j.htct.2020.07.006 copy

The effect and correlation of smoking with platelet indices, neutrophil lymphocyte ratio and platelet lymphocyte ratio

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Introduction:

Smoking is associated with the occurrence and progression of cardiovascular diseases, inflammatory disorders and malignancies.

Objective:

To study the platelet indices, neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) in smokers and their correlation with smoking pack-years.

Method:

A total of 110 smokers and 110 non-smokers were included. The smokers were grouped into three groups: mild (<5 pack-years), moderate (5-10 pack-years) and heavy (>10 pack-years). The platelet count, plateletcrit (PCT), mean platelet volume (MPV) and platelet distribution width (PDW) were noted. The NLR and PLR were calculated and the statistical analysis was made using the Student’s T-test, Analysis of Variance (ANOVA) and Spearman’s correlation coefficient.

Results:

The platelet count, PCT and PDW were significantly higher with mean values: 218.56 ± 121.31 vs 203.23 ± 80.35 (p-value = 0.038), 0.27 ± 0.10 vs 0.26 ± 0.10 (p-value = 0.041) and 12.54 ± 1.45 vs 11.99 ± 1.70 (p-value = 0.001) in smokers and non-smokers, respectively. The PLR differed significantly with mean values: 119.40 ± 84.81 in smokers and 181.99 ± 313.09 in non-smokers, with a p-value of 0.045. A significant positive correlation was found between pack-years of smoking and platelet count and PLR with the Pearson correlation coefficient of 0.250 and 0.198 and p-values, 0.008 and 0.037, respectively. The Platelet Count, PCT, MPV and PDW varied significantly between mild, moderate and heavy smoker groups, with p-values of 0.045, 0.010, 0.015 and 0.017, respectively.

Conclusion:

The platelet indices and inflammatory markers NLR and PLR are derived from routine blood investigations, which are easily available and inexpensive. The monitoring of platelet indices, along with the PLR, can be used as early predictors of morbidity in smokers.

Keywords:
NLR; PLR; Mean platelet volume; Platelet distribution width; Plateletcrit

	Smokers (n = 110)	Non-smokers (n = 110)	p-Value
Age	47.42 ± 13.45	49.21 ± 15.29	0.357
Gender			0.808
Males	101	97
Females	9	13

Parameter	Smokers (n = 110)	Non-smokers (n = 110)	p-Value
Platelet count (10³/uL)	218.56 ± 121.31	203.23 ± 80.35	0.038^* * p < .05).
MPV (fL)	17.79 ± 4.20	16.48 ± 4.33	0.367
PCT (%)	0.27 ± 0.10	0.26 ± 0.10	0.041^* * p < .05).
PDW (fL)	12.54 ± 1.45	11.99 ± 1.70	0.001^* * p < .05).
(NLR) (%)	2.61 ± 1.99	2.48 ± 2.30	0.526
(PLR)(%)	119.40 ± 84.81	181.99 ± 313.09	0.045^* * p < .05).

Parameter	Mild smokers (<5 pack-years)	Moderate smokers (5-10 pack-years)	Heavy smokers (>10 pack-years)	p-Value
	N = 60	N = 11	N = 39
Platelet count (10³/uL)	205.82 ± 74.94	188.58 ± 73.79	264.41 ± 190.78	0.045^* * p < .05).
PCT (%)	0.27 ± 0.06	0.23 ± 0.10	0.33 ± 0.16	0.010^* * p < .05).
MPV (fL)	10.85 ± 1.73	12.08 ± 1.51	12.42 ± 1.55	0.017^* * p < .05).
PDW (fL)	14.09 ± 4.12	16.11 ± 3.79	17.49 ± 4.21	0.015^* * p < .05).
NLR (%)	2.47 ± 2.14	3.54 ± 4.13	2.78 ± 1.37	0.226
PLR (%)	108.69 ± 54.54	105.10 ± 83.49	139.39 ± 114.32	0.19

Parameter	Correlation coefficient ‘r’	p-Value
Platelet count (10³/uL)	0.250^* * p < .05).	0.008^* * p < .05).
PCT (%)	0.015	0.891
MPV (fL)	0.050	0.643
PDW (fL)	0.074	0.500
Neutrophil lymphocyte ratio (NLR) (%)	0.064	0.179
Platelet lymphocyte ratio (PLR) (%)	0.198	0.037^* * p < .05).

Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular (ABHH) R. Dr. Diogo de Faria, 775 cj 133, 04037-002, São Paulo / SP - Brasil - São Paulo - SP - Brazil
E-mail: htct@abhh.org.br

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[1] *Corresponding author at: Department of Pathology, ESIC Medical College, Faridabad, Haryana, India. E-mail address: kanikasingh263@gmail.com (K. Singh).