Phospholipase A2 and Systemic-Immune Inflammation Index as Early Predictors of Neurotoxicity Induced by Acute Glufosinate Ammonium Poisoning: A Population-Based Case-Control Analysis.

Objective: This study aimed to investigate the predictive value of the Systemic-Immune Inflammation Index (SII) and lipoprotein-associated phospholipase A2 (Lp-PLA2) in the early detection of glufosinate ammonium (GA) poisoning-induced neurotoxicity. Methods: A retrospective case-control analysis of patients with acute oral GA poisoning was conducted from January 2021 to August 2024. GA poisoning patients who developed neurotoxicity were identified as the case group. The control group was matched 1:2 with the case group on the year of age interval in GA patients without neurotoxicity. Univariate and multiple logistic regression analyses were performed to explore the independent risk of neurotoxicity induced by GA poisoning. Receiver operator characteristic (ROC) curve and area under the curve (AUC) were performed to evaluate the predictive value of SII, Lp-PLA2, and combination of both in GA poisoning patients associated with neurotoxicity. Results: A cohort of 82 patients experiencing neurotoxicity due to GA poisoning was identified, alongside a control group of 164 individuals who did not exhibit neurotoxic symptoms. The levels of SII and Lp-PLA2 were higher among the case group compared with the control group. After controlling for plasma GA concentration, lactate, neutrophil-to-lymphocyte ratio, and serum ammonia, the results of the multiple logistic regression analysis indicated that the case group was more likely to exhibit elevated levels of the SII (OR = 1.010, 95% CI: 1.004, 1.015, p < 0.001) and Lp-PLA2 (OR = 1.049, 95% CI: 1.032, 1.065, p < 0.001). Furthermore, the areas under the ROC curve of SII, Lp-PLA2, and combination of both were 0.781 (95% CI: 0.717, 0.845, p < 0.001), 0.880 (95% CI: 0.838, 0.923, p < 0.001), and 0.931 (95% CI: 0.901, 0.961, p < 0.001), respectively. Conclusions: The study concluded that SII, Lp-PLA2, and their combination could serve as predictive biomarkers for assessing the neurotoxicity associated with glufosinate ammonium poisoning.