Correlation between Neutrophil-to-Lymphocyte Ratio and Cerebral Edema in Children with Severe Diabetic Ketoacidosis
Diabetic ketoacidosis (DKA), a common onset modality of type 1 diabetes mellitus (T1DM), can lead, in rare instances, to the development of cerebral edema, which is the leading cause of mortality in T1DM. Aside from the identification of several demographic and clinical risk factors for cerebral ede...
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MDPI AG
2023-11-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/11/11/2976 |
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| author | Alexandra-Cristina Scutca Delia-Maria Nicoară Niculina Mang Iulius Jugănaru Giorgiana-Flavia Brad Otilia Mărginean |
| author_facet | Alexandra-Cristina Scutca Delia-Maria Nicoară Niculina Mang Iulius Jugănaru Giorgiana-Flavia Brad Otilia Mărginean |
| author_sort | Alexandra-Cristina Scutca |
| collection | DOAJ |
| description | Diabetic ketoacidosis (DKA), a common onset modality of type 1 diabetes mellitus (T1DM), can lead, in rare instances, to the development of cerebral edema, which is the leading cause of mortality in T1DM. Aside from the identification of several demographic and clinical risk factors for cerebral edema, attention has also been drawn to the possible link between systemic inflammation and neuroinflammation. This single-center retrospective study of 98 children with severe DKA aimed to investigate the possible relationship between neutrophil-to-lymphocyte ratio NLR) levels and the presence of cerebral edema. Patients were classified into three groups: alert (<i>n</i> = 28), subclinical cerebral edema (<i>n</i> = 59), and overt cerebral edema (<i>n</i> = 11). Lower blood pH and elevated NLR and blood urea were correlated with the presence of cerebral edema (<i>p</i> < 0.001). After a multivariable risk adjustment for possible confounding factors, such as age, pH, corrected sodium, and BUN, the NLR remained positively associated with cerebral edema (<i>p</i> = 0.045). As such, NLR may be an additional instrument to help practitioners target patients with a higher risk of severe cerebral edema. These patients would benefit from more rigorous neurologic surveillance, enabling the prompt identification of early signs of cerebral edema. |
| first_indexed | 2024-03-09T17:00:05Z |
| format | Article |
| id | doaj.art-d5b6806c20074992b1484a0ae6ddb48a |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-09T17:00:05Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-d5b6806c20074992b1484a0ae6ddb48a2023-11-24T14:31:00ZengMDPI AGBiomedicines2227-90592023-11-011111297610.3390/biomedicines11112976Correlation between Neutrophil-to-Lymphocyte Ratio and Cerebral Edema in Children with Severe Diabetic KetoacidosisAlexandra-Cristina Scutca0Delia-Maria Nicoară1Niculina Mang2Iulius Jugănaru3Giorgiana-Flavia Brad4Otilia Mărginean5Department XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, RomaniaDepartment XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, RomaniaDepartment XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, RomaniaDepartment XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, RomaniaDepartment XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, RomaniaDepartment XI Pediatrics, Discipline I Pediatrics, ‘Victor Babeş’ University of Medicine and Pharmacy of Timisoara, 300041 Timisoara, RomaniaDiabetic ketoacidosis (DKA), a common onset modality of type 1 diabetes mellitus (T1DM), can lead, in rare instances, to the development of cerebral edema, which is the leading cause of mortality in T1DM. Aside from the identification of several demographic and clinical risk factors for cerebral edema, attention has also been drawn to the possible link between systemic inflammation and neuroinflammation. This single-center retrospective study of 98 children with severe DKA aimed to investigate the possible relationship between neutrophil-to-lymphocyte ratio NLR) levels and the presence of cerebral edema. Patients were classified into three groups: alert (<i>n</i> = 28), subclinical cerebral edema (<i>n</i> = 59), and overt cerebral edema (<i>n</i> = 11). Lower blood pH and elevated NLR and blood urea were correlated with the presence of cerebral edema (<i>p</i> < 0.001). After a multivariable risk adjustment for possible confounding factors, such as age, pH, corrected sodium, and BUN, the NLR remained positively associated with cerebral edema (<i>p</i> = 0.045). As such, NLR may be an additional instrument to help practitioners target patients with a higher risk of severe cerebral edema. These patients would benefit from more rigorous neurologic surveillance, enabling the prompt identification of early signs of cerebral edema.https://www.mdpi.com/2227-9059/11/11/2976severe DKAcerebral edemaNLRinflammation |
| spellingShingle | Alexandra-Cristina Scutca Delia-Maria Nicoară Niculina Mang Iulius Jugănaru Giorgiana-Flavia Brad Otilia Mărginean Correlation between Neutrophil-to-Lymphocyte Ratio and Cerebral Edema in Children with Severe Diabetic Ketoacidosis Biomedicines severe DKA cerebral edema NLR inflammation |
| title | Correlation between Neutrophil-to-Lymphocyte Ratio and Cerebral Edema in Children with Severe Diabetic Ketoacidosis |
| title_full | Correlation between Neutrophil-to-Lymphocyte Ratio and Cerebral Edema in Children with Severe Diabetic Ketoacidosis |
| title_fullStr | Correlation between Neutrophil-to-Lymphocyte Ratio and Cerebral Edema in Children with Severe Diabetic Ketoacidosis |
| title_full_unstemmed | Correlation between Neutrophil-to-Lymphocyte Ratio and Cerebral Edema in Children with Severe Diabetic Ketoacidosis |
| title_short | Correlation between Neutrophil-to-Lymphocyte Ratio and Cerebral Edema in Children with Severe Diabetic Ketoacidosis |
| title_sort | correlation between neutrophil to lymphocyte ratio and cerebral edema in children with severe diabetic ketoacidosis |
| topic | severe DKA cerebral edema NLR inflammation |
| url | https://www.mdpi.com/2227-9059/11/11/2976 |
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