Neutrophil-to-lymphocyte ratio mediates pulmonary consolidation through oxidative stress in children with <i>Mycoplasma pneumoniae</i> pneumonia

BACKGROUND: pneumonia (MPP) and explored the association between the neutrophil-to-lymphocyte ratio (NLR) and pulmonary consolidation through oxidative stress pathways. METHODS: = 40) groups. BALF oxidative stress biomarkers (malondialdehyde [MDA], superoxide dismutase [SOD], glutathione peroxidase [GSH-Px], and advanced oxidation protein products [AOPP]) and inflammatory markers were measured. Mediation analysis examined the NLR-MDA-consolidation pathway, and a Gaussian graphical model mapped the biomarker network. RESULTS: = 0.075; mediation proportion = 48.0%), though not reaching conventional significance. Network density increased by 72.5% in the consolidation group, with CRP and IL-6 as hub nodes in the non-consolidation group.NLR and BALF oxidative stress biomarkers, but not M. pneumoniae load, were associated with extra-pulmonary organ involvement. CONCLUSIONS: Children with MPP-associated consolidation exhibited oxidative-antioxidant imbalance in BALF. NLR may contribute to consolidation through lipid peroxidation These findings from a single-center retrospective study warrant validation in larger prospective multicenter cohorts.