the Diagnostic value of combined detection of serum NLR and CRP for migraine patients in attack stage: A prospective study

Running title: serum NLR and CRP for migraine patients

  • Yanluan Wan Department of Neurology, Ganyu District People's Hospital, Lianyungang, Jiangsu 222100, China
  • Guanglan Liu Department of Neurology, Ganyu District People's Hospital, Lianyungang, Jiangsu 222100, China
  • Chunfu Tao Department of Neurology, Ganyu District People's Hospital, Lianyungang, Jiangsu 222100, China
  • Xiujuan Yuan Department of Neurology, Ganyu District People's Hospital, Lianyungang, Jiangsu 222100, China
  • Haijian Zheng Department of Neurology, Ganyu District People's Hospital, Lianyungang, Jiangsu 222100, China
DOI: https://doi.org/10.5937/jomb0-57701
Keywords: Migraine in attack stage; serum CRP; NLR; combined detection; diagnostic value

Abstract


Objective: We attempted to clarify diagnostic value of combined detection of NLR and serum CRP for migraine patients in attack stage.

Methods: A total of 50 migraine patients in attack stage undergoing treatment in our hospital from June 2023 to June 2024 were chosen as observation group. Additionally, 50 healthy people undergoing physical examination in our hospital were chosen as control group. We adopted questionnaires to obtain the demography, medical history and disease situation of patients in detail. The patients and health examinees received blood routine examination in case of no medication within 3 h after admission. The absolute values of neutrophil (N) and lymphocyte (L) were obtained, followed by calculation of NLR. The serum CRP level received measurement through immune nephelometry. The diagnostic value of NLR and serum CRP for migraine received analysis through receiver operating characteristic curve (ROC).

Results: the serum CRP and NLR levels were significantly higher in the observation group compared with the control group, (P < 0.05).in the observation group, serum CRP and NLR levels in patients with migraine with aura were basically comparable to those in patients without migraine with aura, with no significant difference (P>0.05). Meanwhile, the differences in serum CPP and NLR levels between patients with frequent migraine attacks and patients with infrequent migraine attacks were not statistically significant (P>0.05) Serum CRP or NLR could be utilized for diagnosing migraine patients in attack stage, and diagnosis of migraine through serum CRP or NLR alone presented no difference (P = 0.633). There was statistical significance between combined detection and serum CRP or NLR alone.

Conclusion: Inflammatory biomarkers serum CRP and NLR presented a marked elevation in migraine patients in attack stage. The combination of serum CRP and NLR in diagnosing migraine attack has certain diagnostic value.

References

1. Jat, M.I., et al., Prevalence of Migraine among patients of Depressive Disorder. Pak J Med Sci, 2018. 34(4): p. 964-967.
2. Ghavami, Y., et al., Migraine features in patients with Meniere's disease. Laryngoscope, 2016. 126(1): p. 163-8.
3. Czapińska-Ciepiela, E., Treatment of migraine in a patient with epilepsy. Wiad Lek, 2018. 71(9): p. 1793-1802.
4. Karikari, T.K., et al., Commentary: Global, regional, and national burden of neurological disorders during 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Front Neurol, 2018. 9: p. 201.
5. Hu, L., et al., Different Chinese patent medicine therapies for migraine: A protocol for systematic review and network meta-analysis. Medicine (Baltimore), 2021. 100(2): p. e24179.
6. Cameron, C., et al., Triptans in the Acute Treatment of Migraine: A Systematic Review and Network Meta-Analysis. Headache, 2015. 55 Suppl 4: p. 221-35.
7. Edvinsson, L., The Trigeminovascular Pathway: Role of CGRP and CGRP Receptors in Migraine. Headache, 2017. 57 Suppl 2: p. 47-55.
8. Abd Al-Kareem, T.A., S.A. Hassan, and S.M. Abdalhadi, Polycystic Ovary Syndrome: pathogenesis, management, and treatment with metals and organic compounds. Cell Mol Biomed Rep, 2024. 4(1): p. 54-64.
9. Li, W. and Y. Wang, The progress and development trends on stress granules in the world and China during the past 35 years. Cell Mol Biomed Rep, 2024. 4(1): p. 17-29.
10. Albeizanee, S., et al., Pathophysiological aspects of antioxidant glutathione system components during covid-19 infection; a patient-based survey and clinical relevance. Cell Mol Biomed Rep, 2025. 5(2): p. 103-112.
11. El-Seedy, A. and V. Ladeveze, CFTR complex alleles and phenotypic variability in cystic fibrosis disease: CFTR complex alleles. Cellular and Molecular Biology, 2024. 70(8): p. 244-260.
12. Panconesi, A., M.L. Bartolozzi, and L. Guidi, Migraine pain: reflections against vasodilatation. J Headache Pain, 2009. 10(5): p. 317-25.
13. Ramachandran, R., Neurogenic inflammation and its role in migraine. Semin Immunopathol, 2018. 40(3): p. 301-314.
14. Nehring, S.M., A. Goyal, and B.C. Patel, C Reactive Protein, in StatPearls. 2022, StatPearls Publishing
Copyright © 2022, StatPearls Publishing LLC.: Treasure Island (FL).
15. Zhang, Y., et al., C-Reactive Protein Levels Predict Responses to PD-1 Inhibitors in Hepatocellular Carcinoma Patients. Front Immunol, 2022. 13: p. 808101.
16. VanDevanter, D.R., et al., C-reactive protein (CRP) as a biomarker of pulmonary exacerbation presentation and treatment response. J Cyst Fibros, 2022. 21(4): p. 588-593.
17. Wang, Y., et al., Correlation between Changes in Serum RBP4, hs-CRP, and IL-27 Levels and Rosuvastatin in the Treatment of Coronary Heart Disease. J Healthc Eng, 2021. 2021: p. 8476592.
18. Quaglia, L.A., et al., C-reactive protein is independently associated with coronary atherosclerosis burden among octogenarians. Aging Clin Exp Res, 2014. 26(1): p. 19-23.
19. McKechnie, D.G., et al., Inflammatory markers and incident heart failure in older men: the role of NT-proBNP. Biomark Med, 2021. 15(6): p. 413-425.
20. Butler, C.C., et al., C-Reactive Protein Testing to Guide Antibiotic Prescribing for COPD Exacerbations. N Engl J Med, 2019. 381(2): p. 111-120.
21. Windgassen, E.B., et al., C-reactive protein and high-sensitivity C-reactive protein: an update for clinicians. Postgrad Med, 2011. 123(1): p. 114-9.
22. Vanmolkot, F.H. and J.N. de Hoon, Increased C-reactive protein in young adult patients with migraine. Cephalalgia, 2007. 27(7): p. 843-6.
23. Ahsen, A., et al., As a new inflammatory marker for familial Mediterranean fever: neutrophil-to-lymphocyte ratio. Inflammation, 2013. 36(6): p. 1357-62.
24. Borkum, J.M., Brain Energy Deficit as a Source of Oxidative Stress in Migraine: A Molecular Basis for Migraine Susceptibility. Neurochem Res, 2021. 46(8): p. 1913-1932.
25. Canpolat, U., et al., Role of preablation neutrophil/lymphocyte ratio on outcomes of cryoballoon-based atrial fibrillation ablation. Am J Cardiol, 2013. 112(4): p. 513-9.
26. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia, 2018. 38(1): p. 1-211.
27. Buture, A., et al., Current Understanding on Pain Mechanism in Migraine and Cluster Headache. Anesth Pain Med, 2016. 6(3): p. e35190.
28. Sanders, C.L., A. Ponte, and F. Kueppers, The Effects of Inflammation on Alpha 1 Antitrypsin Levels in a National Screening Cohort. Copd, 2018. 15(1): p. 10-16.
29. He, L., C. Fan, and G. Li, The relationship between serum C-reactive protein and senile hypertension. BMC Cardiovasc Disord, 2022. 22(1): p. 500.
30. Tanik, N., et al., Retinol-binding protein-4 and hs-CRP levels in patients with migraine. Neurol Sci, 2015. 36(10): p. 1823-7.
31. García-Ortega, D.Y., et al., Neutrophil/lymphocyte ratio is associated with survival in synovial sarcoma. Surg Oncol, 2018. 27(3): p. 551-555.
32. Imtiaz, F., et al., Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population. Int Arch Med, 2012. 5(1): p. 2.
33. Karabulut, K.U., et al., The change of neutrophils/lymphocytes ratio in migraine attacks: A case-controlled study. Ann Med Surg (Lond), 2016. 10: p. 52-6.
34. Bakirci, E.M., et al., The role of the nonspecific inflammatory markers in determining the anatomic extent of venous thromboembolism. Clin Appl Thromb Hemost, 2015. 21(2): p. 181-5.
Published
2025/07/07
Issue
Ahead of print
Section
Original paper

Copyright (c) 2025 Yanluan Wan, Guanglan Liu, Chunfu Tao, Xiujuan Yuan, Haijian Zheng

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

The published articles will be distributed under the Creative Commons Attribution 4.0 International License (CC BY). It is allowed to copy and redistribute the material in any medium or format, and remix, transform, and build upon it for any purpose, even commercially, as long as appropriate credit is given to the original author(s), a link to the license is provided and it is indicated if changes were made. Users are required to provide full bibliographic description of the original publication (authors, article title, journal title, volume, issue, pages), as well as its DOI code. In electronic publishing, users are also required to link the content with both the original article published in Journal of Medical Biochemistry and the licence used.

Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.