Prognostic role of neutrophil lymphocyte ratio and mean platelet volume in Bell’s palsy: Comparison of diabetic and non-diabetic patients

Abstract Objectives: A low Neutrophil Lymphocyte Ratio (NLR) has been shown to be associated with good prognosis in Bell’s Palsy (BP). However, the effect of chronic diseases that may affect the NLR, including Diabetes Mellitus (DM), has not been clarified in this context. This study aimed to evaluate the relationship between NLR and Mean Platelet Volume (MPV) in BP according to whether it is accompanied by DM, and their relationship with prognosis. Methods: A prospective observational study was conducted from May 2014 to May 2020 in a tertiary referral center, of all 79 consecutive participants diagnosed with BP in department of otolaryngology and 110 consecutive healthy participants admitted to the check-up unit. Patients diagnosed with BP were divided into two groups according to whether they were diagnosed with DM: diabetic BP patients (DM-BP, n = 33) and non-diabetic BP patients without any chronic disease (nonDM-BP, n = 46). Neutrophil (NEUT) and Lymphocyte (LYM) counts, and Mean Platelet Volume (MPV) were assessed from peripheral blood samples, and the NLR was calculated. Prognosis was evaluated using the House-Brackmann Score (HBS) six months after diagnosis. Results: The mean NLR was 2.85 ± 1.85 in BP patients and 1.69 ±0.65 in the control group. The mean NLR was significantly higher in BP patients than healthy controls (p < 0.001). The mean NLR was 2.58 ± 1.83 in the nonDM-BP group, 3.23 ± 1.83 in the DM-BP group, and 1.69 ± 0.65 in the control group. The NLR was significantly higher in the nonDM-BP and DM-BP groups than in the control group (p < 0.05). The recovery was 90% according to the HBS. The optimal cut-off value was 2.41 (p = 0.5). Conclusion: The NLR was increased in both diabetic and non-diabetic BP and had similar prognostic value in predicting the HBS before treatment in diabetic and non-diabetic patients with BP. MPV wasn’t significantly different in diabetic and non-diabetic BP patients compared with the normal population.

研究目的：低中性粒细胞与淋巴细胞比值（Neutrophil Lymphocyte Ratio）已被证实与贝尔麻痹（Bell’s Palsy）的良好预后相关。然而，可能影响该比值的慢性疾病（包括糖尿病（Diabetes Mellitus））在此类情境中的作用尚未明确。本研究旨在探讨伴或不伴糖尿病的贝尔麻痹患者中，中性粒细胞与淋巴细胞比值（NLR）与平均血小板体积（Mean Platelet Volume）的相关性，及其与预后的关联。方法：本研究为前瞻性观察性研究，于2014年5月至2020年5月在某三级转诊中心开展，纳入耳鼻咽喉科确诊的79例连续性贝尔麻痹患者，以及体检中心纳入的110例连续性健康对照者。根据是否合并糖尿病，将贝尔麻痹患者分为两组：合并糖尿病的贝尔麻痹患者（DM-BP组，n=33），以及无任何慢性疾病的非糖尿病贝尔麻痹患者（nonDM-BP组，n=46）。采集外周血样本检测中性粒细胞（Neutrophil）、淋巴细胞（Lymphocyte）计数及平均血小板体积（MPV），并计算NLR。于确诊后6个月采用House-Brackmann评分（House-Brackmann Score）评估患者预后。结果：贝尔麻痹患者的平均NLR为2.85±1.85，健康对照组为1.69±0.65。贝尔麻痹患者的平均NLR显著高于健康对照组（p<0.001）。nonDM-BP组的平均NLR为2.58±1.83，DM-BP组为3.23±1.83，健康对照组为1.69±0.65。nonDM-BP组与DM-BP组的NLR均显著高于健康对照组（p<0.05）。经House-Brackmann评分（HBS）评估，预后恢复率为90%。最佳截断值为2.41（p=0.5）。结论：无论是否合并糖尿病，贝尔麻痹患者的NLR均升高，且NLR在合并与未合并糖尿病的贝尔麻痹患者中，对治疗前House-Brackmann评分（HBS）的预测具有相似的预后价值。合并与未合并糖尿病的贝尔麻痹患者的MPV与正常人群相比，无显著差异。