Correlation Of Peripheral Blood Inflammatory Indexes And Lipid Profile With Relapse Of Optic Neuromyelitis Optica Spectrum Disease

Objective: The clinical feature of neuromyelitis optica spectrum disease(NMOSD)is the high recurrence risk and progressive disability.This study explored the differences in peripheral blood inflammatory cells and lipids by comparing normal control and NMOSD primary and relapse groups to investigate the relationship between peripheral blood inflammatory cells and lipids and the relapse of NMOSD disease and their clinical significance to provide a new basis for the treatment and prevention of disease recurrence.Methods: Forty-four patients who visited our neurology department from August 2016 to November 2020 and were diagnosed with NMOSD,which divided into initial and recurrent groups.Including 22 cases in the initial group and 22 cases in the recurrent group,according to whether the disease was initial diagnosed or recurrent at the time of admission.Collection of clinical information such as gender,age,clinical features,duration of illness,Expanded Disability Status Scale(EDSS),imaging,visual evoked potentials,peripheral blood leukocytes,neutrophils,eosinophils,monocytes,lymphocytes and lipid profile,calculating neutrophils to lymphocytes ratio(NLR).In addition,30 cases of healthy subjects in the same area and of similar age were collected from our hospital during the same time period as normal controls.Clinical data and test results were compared between the three groups,and dichotomous logistic regression analysis was used to investigate the effect of test results on recurrence in NMOSD patients;in addition,the correlation between cholesterol(CHO)and EDSS scores was elaborated using bias correlation analysis corrected for sex.A subject operating characteristic curve(ROC)was used to analyze the optimal cut-off value of CHO for predicting relapse in NMOSD patients.Results:(1)Comparing the data of the three groups,neutrophils and CHO were higher in the NMOSD recurrence group than in the primary and normal groups,and there was a statistical difference(P < 0.05).In contrast,there was no statistical difference in neutrophils and CHO in the NMOSD primary group compared with controls(P > 0.05).There was a statistical difference in EDSS score and disease duration between patients in the NMOSD relapse group and the initial diagnosed group(P<0.05).There were no statistical differences in age,gender,and leukocytes,monocytes,eosinophils,lymphocytes,triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),apolipoprotein A1(APOA1),apolipoprotein B(APOB)(P>0.05)in all groups.(2)Binomial logistic regression analysis has showed that serum CHO levels was significantly associated with NMOSD relapses,which difference was statistically significant(P=0.031).Neutrophils and NLR were not found to be associated with NMOSD recurrence.(3)correlation analysis showed a positive correlation between CHO and EDSS(0R=0.375,P=0.037).(4)According to the ROC curve,CHO predicted relapse in NMOSD patients with a sensitivity of 68%,specificity of 73%,optimal cut-off value of 4.52,and area under the ROC curve(AUC)of0.700(95% CI: 0.542-0.859,P=0.023).Conclusions: High levels of serum CHO may be a risk factor for relapses in NMOSD patients and suggest a worse prognosis.In addition,elevated neutrophil levels of peripheral blood may not be associated with NMOSD relapses.