Detection Of The Predictive Value Of Hemocytometry Based On Peripheral Platelet-related Parameters And Adipocytokines In Febrile Seizures

Part I Acute Phase Serum Leptin,Adiponectin,Interleukin-6,and Visfatin Are Altered in Chinese Children With Febrile Seizures:A Cross-Sectional StudyObjective:To investigate the role of adipocytokines,such as leptin,adiponectin,IL-6 and visfatin in the pathogenesis of febrile seizures,and to study the changes of immune function in the body.Methods:This study included 55 patients with febrile seizure(FS),and matched with age and gender,42 children with febrile illness without seizures(febrile control,FC)and 48 healthy control group(HC).Serum levels of leptin,adiponectin,IL-6 and visfatin were measured by enzyme-linked immunosorbent assay(ELISA)method.Results:1.Serum Leptin and visfatin levels in FS group,FC group and Control group were significantly lower than those in HC group(P<0.05),but there was no significant difference between FS group and FC group(P>0.05).Serum levels of Adiponectin and IL-6 in FS group were significantly higher than those in FC group and HC group(P<0.05),but there was no significant difference between FC and HC groups(P>0.05).2.There was no significant difference between the simple FS group(SFS group)and the complex FS group(CFS group)in all the adipocytokines tests(P>0.05).3.There was no significant difference between the recurrent group and the non-recurrent group in all the adipocytokines tests(P>0.05).4.There was no correlation between leptin,adiponectin,visfatin,and IL-6 in the FS and FC groups.There was a weak negative correlation between leptin and adiponectin in the HC group.5.In the linear regression analysis,high serum adiponectin and IL-6 levels were significantly associated with the risk of febrileseizures among studied FS patients,but leptin and visfatin were not associated with FS.When binary logistic regression analysis was performed,the high serum adiponectin levels were the most significant risk factor associated with FS among studied children[odds ratio(OR):1.669;95%confidence interval(CI):1.388-2.007;P=0.000],and high serum IL-6 levels were also significantly associated with FS(OR:1.079;95%CI:1.022-1.139;P=0.006).6.The results of leptin,visfatin,and adiponectin in the group under 3-years-old were the same as the results of the whole group mentioned above.Serum IL-6 levels were significantly higher in children with FS compared to the HC group(P<0.01),but there was no difference between either the FS and FC groups or the FC and HC groups(P>0.05).The results for visfatin,adiponectin and IL-6 in the 3+year group were the same as those for the entire group described above.The leptin levels in the FC group were significantly lower than those in the HC group(P<0.01),but there was no difference between the FS group and the control group(P>0.05).7.The sensitivity and specificity of Adiponectin in predicting FS was 70.91%,92.22%,respectively,AUC=0.862,the best Cut-off value is 10.39;while the sensitivity and specificity of IL-6 was 83.64%and 57.78%,respectively,AUC=0.779 and the best Cut-off value is 5.27.Conclusions:1.Adiponectin and IL6 are related to the occurrence of febrile seizures,suggesting that Adiponectin and IL6 can be used as early assessment monitoring indicators and intervention targets of FS.Among them,the sensitivity of early diagnosis of IL-6 is higher,while the specificity of Adiponectin is higher.2.The diagnostic and prognostic value of peripheral blood adipokines(including leptin and visfatin)in children with FS remains to be validated by large-scale multicenter studies.Part II Study on the value of peripheral platelet-related parameters and other blood cells in the evaluation of febrile seizuresObjective:To evaluate the results of peripheral platelet-related parameters in children with and without febrile seizures in order to find widely used low-cost inflammatory response markers for predicting febrile seizures.Methods:This study included 79 patients with febrile seizure(FS),and matched with age and gender,82 children with febrile illness without seizures(febrile control,FC)and 81 healthy control group(HC).Retrospectively analyzed the results of CBCs in each group.Results:1.The results of CBCs compared among FS group,FC group and HC group:1)The platelet count and mean platelet volume(MPV)in FS group were significantly lower than those in FC group and HC group(P<0.05);and the platelet lymphocyte ratio(PLR)was significantly higher than that in HC group(P<0.05),but there was no significant difference between FS group and FC group(P>0.05);and there was no significant difference in platelet distribution width(PDW)between FS group and FC Group(P>0.05).2)The eosinophil count,Hemoglobin(HB),Mean corpuscular volume(MCV),mean erythrocyte Hemoglobin(MCH)and Hematocrit(HCT)in FS group were significantly lower than those in FC group and HC group(P<0.05).The WBC count,neutrophil count,neutrophil to lymphocyte ratio(NLR),monocyte count,C-reactive protein(CRP)in FS and FC groups were significantly higher than those in HC group(P<0.05),but there was no significant difference between FS group and FC Group(P>0.05).The proportion of eosinophils in FS and FC group was significantly lower than that in HC group(P<0.05),but there was no significant difference between FS group and FC group(P>0.05).The percentage of neutrophil count in FS group was significantly lower than that in FC group(P<0.05),the percentage and count of lymphocyte were higher than that of FC group(P<0.05).2.The counts of eosinophils,monocytes and platelets in CFS group were significantly lower than those in SFS group(P<0.05),while PDW in CFS group was larger than that in SFS group(P<0.05).There was no significant difference between the two groups in other clinical data and the results of laboratory examination(P>0.05).3.The red blood cell count,hemoglobin,platelet count and PLR in the recurrent group were lower than those in the non-recurrent group(P<0.05),while the lymphocyte count was higher than that in the non-recurrent group(P<0.05).There was no significant difference in other indexes(P>0.05).4.Comparison of febrile period after FS and one week after fever subsided:Thirty-seven of the 79 FS patients were followed up for one week after fever subsided,the WBC,neutrophil ratio and count,NLR,PLR,monocyte count,MCH,MCHC concentration were all lower than those in febrile period after FS,while the percentage and count of lymphocyte,the percentage and count of eosinophils and MCV were significantly higher than those in febrile period after FS(P<0.05).There was no significant difference in other indexes(P>0.05).5.The linear regression analysis showed that MCH,PLT,and MPV were strongly associated with the development of febrile seizures.When binary logistic regression analysis was performed,MPV was the most important protective factor associated with febrile seizures in the children studied.Conclusions:1.WBC,neutrophil,NLR,and CRP had no significant specificity in the occurrence of FS,and their role as inflammatory markers was more evident in FS patients.2.Iron deficiency may increase the risk of febrile seizures.3.Platelet count and MPV are closely related to the incidence of febrile seizures,especially platelet and PDW may be two simple and effective laboratory markers to distinguish different types of febrile seizures.Low PLR levels may be used to predict the risk of FS recurrence.