Association of Neutrophil to Lymphocyte Ratio with Patient Reported Outcomes in Knee Osteoarthritis

Abstract

Background: Determining the association of neutrophil to lymphocyte ratio (NLR) and clinical disease severity in patients with mild and advanced stage knee osteoarthritis (OA).Method: We analyzed clinical scores and routine hematology panels of 111 subjects with symptomatic knee degeneration: mild OA (66) who underwent knee arthroscopy and advanced OA (45) who had total replacement. Results: Compared to the advanced OA group, the mild OA group was younger (54/67), had fewer females (1.75/5.43), and better scores: Euroqol EQ5D Index (0.50/0.25), VAS (visual analog scale) (65/44); International knee documentation committee subjective knee evaluation form—IKDC (31.6/20.24); Knee disability and osteoarthritis outcome score for joint replacement—KOOSJR (15.5/18.3); and better Kellgren–Lawrence stage (1.3/3.8). Patients with advanced disease had higher NLRs compared to mild OA group and controls: 2.82 versus 1.99 (p = 0.004) and 1.98 (p = 0.002). In the multiple regression model, NLR was only influenced by age (p < 0.001). In the subgroup analysis, for the early OA cases, NLR was significantly dependent to VAS (p = 0.006), IKDC (p = 0.001) and KOOSJR (p < 0.001). Conclusion: NLR was not associated with symptomatic knee OA, as determined by commonly used patient reported outcomes. However, for patients with mild degenerative modifications, EQ5D, VAS, and IKDC were independent predictors of NLR.

An Evaluation of the Uric Acid and Hematological Parameters in Patients with Nodal Hand Osteoarthritis

“…Shi et al reported that PLR could show in ammation in knee OA (12). In another study, no relationship was determined between NLR and symptomatic knee OA (13).…”

“…This is more evident in patients with erosive hand OA (8). There are few studies related to the parameters of uric acid (9, 10), neutrophil-lymphocyte ratio (NLR) and thrombocyte-lymphocyte ratio (PLR) in OA, and these studies have been conducted more on patients with knee OA (11)(12)(13).…”

Evaluation of the uric acid and hematological parameters in patients with nodal hand osteoarthritis

“…This is more evident in patients with erosive hand OA [8]. There are few studies related to the parameters of uric acid [9,10], neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in OA, and these studies have been conducted more on patients with knee OA [11][12][13].…”

Hubungan Derajat Penyakit Osteoartritis Lutut dengan Neutrophil Lymphocyte Ratio pada Pasien di RSU Al Fauzan Jakarta Periode 2019-2021

“…Padahal salah satu pemeran penting dalam patogenesis OA adalah inflamasi. 11 Proses inflamasi tersebut ditandai dengan adanya peningkatan sitokin inflamasi seperti TNF-α, dan IL-1β yang dapat menyebabkan terjadinya degradasi tulang rawan sendi dan penurunan sintesis Hyaluronic Acid (HA) akibat adanya peningkatan Reactive Oxygen Spesies (ROS), sehingga akan muncul gejala kaku dan nyeri pada sendi karena fungsi HA sendiri sebagai lubrikan dan salah satu faktor regenerasi tulang rawan sendi. 3,12 Selain itu, adanya mediator inflamasi juga akan meningkatkan aktivitas neutrophil yang menetap, dan secara bersamaan akan terjadi penurunan kadar limfosit.…”

“…3,12 Selain itu, adanya mediator inflamasi juga akan meningkatkan aktivitas neutrophil yang menetap, dan secara bersamaan akan terjadi penurunan kadar limfosit. 11,13 Sehingga, ketika dilakukan pemeriksaan NLR akan didapatkan nilai yang meningkat pada keadaan inflamasi. Oleh karena itu, peneliti tertarik melakukan penelitian ini dengan tujuan untuk mengetahui hubungan antara derajat penyakit osteoartritis lutut dengan Neutrophil Lymphocyte Ratio (NLR) di RSU Al Fauzan Jakarta Periode 2019-2021.…”