Neutrophil/lymphocyte and platelet/lymphocyte ratios as potential markers of disease activity in patients with Ankylosing spondylitis: a case-control study

Abstract

Background: The neutrophil/ lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) have the potential to be inflammatory markers that reflect the activity of many inflammatory diseases. The aim of this study was to evaluate the NLR and PLR as potential markers of disease activity in patients with ankylosing spondylitis. Methods: The study involved 132 patients with ankylosing spondylitis and 81 healthy controls matched in terms of age and gender. Their sociodemographic data, disease activity scores using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), erythrocyte sedimentation rate (ESR), and white blood cell, neutrophil, lymphocyte and platelet counts were recorded. The patients with ankylosing spondylitis were further divided according to their BASDAI scores into patients with inactive disease (BASDAI < 4) and patients with active disease (BASDAI ≥4). The correlations between the NLR, PLR and disease activity were analysed. Results: There was a statistically significant difference in the NLR and PLR between the active and inactive ankylosing spondylitis patients (2.31 ± 1.23 vs. 1.77 ± 0.73, p = 0.002), (142.04 ± 70.98 vs. 119.24 ± 32.49, p < 0.001, respectively). However, there was no significant difference in both the NLR and PLR between the healthy control group and ankylosing spondylitis patients (p > 0.05). In addition, the PLR was significantly higher in both the active and inactive groups compared to those in the healthy control group (142.04 ± 70.98 vs. 99.32 ± 33.97, p = 0.014), (119.24 ± 32.49 vs. 99.32 ± 33.97, p = 0.019). The BASDAI scores were positively correlated with the PLR (r = 0.219, p = 0.012) and the NLR, but they were not statistically significant with the later (r = 0.170, p = 0.051). Based on the ROC curve, the best NLR cutoff value for predicting severe disease activity in ankylosing spondylitis patients was 1.66, with a sensitivity of 61.8% and a specificity of 50.6%, whereas the best PLR cutoff value was 95.9, with a sensitivity of 70.9% and a specificity of 55.5%. Conclusion: The PLR may be used as a useful marker in the assessment and monitoring of disease activity in AS together with acute phase reactants such as the ESR.

Mediterranean Personalized Diet Combined with Physical Activity Therapy for the Prevention of Cardiovascular Diseases in Italian Women

“…Furthermore, AIP is a predictive indicator for the coronary artery disease in postmenopausal women [65] and it is a strong marker to predict the risk of atherosclerosis and coronary heart disease [40]. For what concerns the inflammation milieu, both NLR and PLR have the potential to be inflammatory markers that reflect the activity of many inflammatory diseases [66]. Obese subjects undergo a chronic inflammatory condition due to the adipose tissue dysfunction of immune-related activities, involving a transient infiltration of neutrophils within the abdominal fat and their binding to adipocytes.…”

Associations of Platelet Count with Inflammation and Response to Anti-TNF-α Therapy in Patients with Ankylosing Spondylitis

“…Fifteen studies were further excluded for the lack of usable data, and two additional studies were identified though an updated literature search on September 2, 2020 (Supplementary Figure S1). Therefore, 14 published observational studies were finally included (Kisacik et al, 2008;Wang et al, 2008;Yazici et al, 2010;Nalbant et al, 2011;Orum et al, 2012;Boyraz et al, 2014;Bozan et al, 2016;Sezgin et al, 2017;Huang et al, 2018;Tang et al, 2018;Enginar and Kacar, 2019;Al-Osami et al, 2020;Liu et al, 2020;Zhuang et al, 2020). Supplementary Table S2 showed the main characteristics of those observational studies included in the meta-analysis.…”

Platelet-to-Lymphocyte Ratio as an Independent Factor Was Associated With the Severity of Ankylosing Spondylitis

“…In recent years, routine blood parameters were reported as markers of systemic inflammation associated with the diagnosis and prognosis of numerous malignancies and chronic inflammatory diseases (7,8). A previous study constructed a novel nomogram for the diagnosis of osteoarticular TB by incorporating MLR, ESR and BMI (9).…”