Diagnostic significance of neutrophil-lymphocyte ratio (NLR) in dogs with chronic enteropathy: A meta-analytical study

This meta-analysis aimed to determine the diagnostic significance of the neutrophil-to-lymphocyte ratio (NLR) in dogs with chronic enteropathy (CE). This meta-analysis was constructed according to the PRISMA statement guidelines. The Web of Science, Sage, EBESCO, Ovid, Scopus, and Google Scholar databases were searched. Standardized mean difference (SMD) and odds ratio (OR) were calculated. Heterogenicity and publication bias were evaluated in this study. Five studies were found to be eligible for the assessment of the diagnostic significance of the NLR in dogs with CE. In total, 570 dogs (263 with CE and 307 healthy controls) were included in this study. NLR increased significantly in dogs with CE in comparison with healthy controls in fixed effect model (SMD 2.738; 95% CI: 1.96-3.8; P < 0.001). Hedges' G test indicated that there is significant evidence of diagnostic value of NLR in dogs with CE, where the pooled effect was 0.55 at fixed effect model. Moreover, the odds ratio (OR) reflects the significant diagnostic value of the NLR in dogs with CE. At fixed effects, the results indicated no significant evidence of heterogeneity (Cochran's Q Statistic :6.351, I2: 37.01 %). The variability of the true effect sizes represented by tau statistics indicated a very low level of heterogeneity (0.089). Publication bias analysis indicated no significant publication bias among the studies (Egger's test; Begg and Mazumdar rank correlation). The present meta-analysis implies that the NLR could be a reliable diagnostic biomarker for dogs with chronic enteropathy.