Neutrophil‐to‐C3 ratio and neutrophil‐to‐lymphocyte ratio were associated with disease activity in patients with systemic lupus erythematosus

Yu, Jianlin; Zeng, Tingting; Wu, Yang; Tian, Yongjian; Tan, Liming; Duan, Xinwang; Wu, Qiong; Li, Hua; Yu, Long

doi:10.1002/jcla.22633

Cited by 17 publications

(18 citation statements)

References 16 publications

(27 reference statements)

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“…26 The observations were in line with that noted by . 27 Yu et al, based on a retrospective study involving 194 SLE patients and 71 healthy controls, have reported a significant positive correlation of SLEDAI with NLR, and a statistically significantly higher NLR in subjects with severe disease activity (>9 SLEDAI score) than mild disease activity (≤9 SLEDAI score). The current study has shown a significant correlation between SLEDAI and NLR.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil-to-lymphocyte ratio in systemic lupus erythematosus is influenced by steroids and may not completely reflect the disease activity

Chandrashekara¹,

P²,

Anupama³

2020

IJRCI

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Objectives: Neutrophil-to-lymphocyte ratio (NLR) has emerged as an important parameter in inflammatory network and could pave the way for newer treatment strategies in systemic lupus erythematosus (SLE). The study evaluated NLR as a predictor of disease activity in SLE and attempted to relate the factors influencing the NLR. Methods: The study included 117 SLE patients fulfilling the systemic lupus international collaborating clinics/American College of Rheumatology (SLICC/ACR) criteria (2010). The subjects were classified into mild, moderate, and severe systemic lupus erythematosus disease activity index 2000 (SLEDAI 2K) groups and compared. NLR values were classified as ≤2, >2-4 and >4 groups and its relationship with study variables was evaluated by Notched box-and-Whisker plots, Spearman correlation and Mountain plot. ROC and multiple linear regression were used to verify discriminatory ability and factors influencing NLR respectively. Results: Approximately 24% (n=28) of patients each had mild and moderate SLEDAI disease activities, and 52.14% (n=61) had severe activity. Patients with severe disease activity were significantly younger (31.69±10.09 years) and were on more immunosuppressants/DMARDs. The patients in the >4 NLR group had significantly elevated total leucocyte count (TLC) 5560 (3360-11480) cells/mm 3 and CRP 4.46 (0.3-48.2) mg/L and more patients were on steroid therapy. The >2-4 NLR group had moderate inverse correlation with SLEDAI. NLR, ESR, CRP, and C3 did not show agreement with SLEDAI. The NLR was associated with CRP and steroid usage and could not discriminate disease severity. Conclusion: The relationship of the NLR with SLEDAI was not consistent. NLR was associated with CRP and steroid use. NLR as a marker of inflammation or as a predictor of SLE disease activity needs further investigation.

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Section: Discussionmentioning

confidence: 99%

Neutrophil-to-lymphocyte ratio in systemic lupus erythematosus is influenced by steroids and may not completely reflect the disease activity

Chandrashekara¹,

P²,

Anupama³

2020

IJRCI

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“…A growing body of evidence suggests that NLR may act as excellent indicator of inflammation status in various diseases, such as Crohn's disease (49), cancer (50,51), infection (52,53), and rheumatic diseases (54)(55)(56). Moreover, numerous studies also reported that NLR was closely related to inflammatory response and SLE disease activity (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). Consistent with these previous studies, in this meta-analysis, we further demonstrated a close correlation of NLR with disease activity and lupus nephritis in SLE patients.…”

Section: ' Discussionmentioning

confidence: 99%

“…During the full-text review process, four studies were further excluded for lacking the data of interest. Finally, 14 studies with 1,781 SLE patients and 1,330 healthy controls were included in this meta-analysis (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35).…”

Section: Study Selectionmentioning

confidence: 99%

“…Thirteen studies including 1,673 SLE patients and 1,330 healthy controls compared NLR between SLE patients and healthy controls (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). We performed the synthesized analysis of these studies using a random-effects model considering the significant heterogeneity across these studies (I 2 =96.5%, po0.001).…”

Section: Synthesized Analysismentioning

confidence: 99%

“…The synthesized result showed that NLR was significantly higher in SLE patients than in healthy controls (SMD=1.43; 95% CI, 0.98-1.88) ( Figure 2). Five studies of 697 patients compared NLR between patients with active SLE and those with inactive SLE (26,27,31,32,34). The synthesized analysis of the five studies was also performed using a random-effects model due to the significant heterogeneity (I 2 =97.0%, po0.001).…”

Section: Synthesized Analysismentioning

confidence: 99%

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Relationship between Neutrophil-to-Lymphocyte Ratio and Systemic Lupus Erythematosus: A Meta-analysis

Wang¹,

Wang²,

Jia³

et al. 2020

Clinics

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Systemic lupus erythematosus (SLE) is a chronic systematic autoimmune disease. Current methods of diagnosing SLE or evaluating its activity are complex and expensive. Numerous studies have suggested that neutrophil-tolymphocyte ratio (NLR) is closely correlated with the presence of SLE and its activity, suggesting that it may serve as a diagnostic and monitoring indicator for SLE. Therefore, we performed a meta-analysis to systematically assess the association between NLR and SLE. We performed a literature search until 12 April 2019 in the PubMed, Web of Science, and China National Knowledge Infrastructure databases. Cross-sectional studies comparing the NLR of SLE patients versus those of healthy controls, of active versus inactive SLE patients, and of SLE patients with versus without lupus nephritis were considered for inclusion. Mean intergroup NLR differences were estimated using standardized mean differences and their 95% confidence intervals. Study quality was assessed using the Agency for Healthcare Research and Quality instrument for cross-sectional studies. Fourteen studies with 1,781 SLE patients and 1,330 healthy controls were included in this meta-analysis. The pooled results showed that the NLR was significantly higher in SLE patients than in healthy controls, in active SLE patients than in inactive SLE patients, and in SLE patients with lupus nephritis than in those without lupus nephritis. NLR may be an indicator for monitoring disease activity and reflecting renal involvement in SLE patients. Nevertheless, more high-quality studies are warranted to further validate our findings.

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Serum amyloid A‐to‐albumin ratio as a potential biomarker to predict the activity, severity, and poor prognosis of systemic lupus erythematosus

Zhao

Zhang

Feng

et al. 2022

Clinical Laboratory Analysis

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Objectives: To evaluate the predictive value of serum amyloid A-to-albumin ratio (SAR) for active systemic lupus erythematosus (SLE), severe active SLE, and poor prognosis of SLE. Methods:One hundred and eighty-six patients with SLE undergoing treatment in our hospital were selected. The demographic characteristics, clinical data, and disease prognosis of all patients were collected and analyzed.Results: There were significant differences in SLEDAI, total glyceride (TG), serum amyloid A (SAA), SAR, urinary microalbumin-to-creatinine ratio (ACR), erythrocyte sedimentation rate (ESR), albumin (ALB), complement 3 (C3), anti-dsDNA, anti-Sm positive rate, and anti-dsDNA positive rate between active SLE and stable SLE patients. TG, SAR, C3, ACR, and positive anti-dsDNA were independent influencing factors of active SLE, and the odds ratio (OR) values were 2.342, 10.921, 0.832, 1.451, and 2.476, respectively. The area under curves (AUCs) of SAA, ALB, and SAR for predicting active SLE and severe active SLE were 0.743, 0.724, 0.787, 0.711, 0.686, and 0.733, respectively. The AUC of SAR for predicting the poor prognosis of active SLE was 0.719.High SAR, high ACR, low C3, and positive anti-dsDNA were high risk factors for poor prognosis. Kaplan-Meier (K-M) survival analysis showed that patients with high SAR, high ACR, low C3, and positive anti-dsDNA had shorter continuous remission time than that with low SAR, low ACR, high C3, and negative anti-dsDNA. Conclusion:SAR had high predictive value for active SLE, severe active SLE, and poor prognosis of SLE. High SAR may be a potential marker for predicting the activity and prognosis of Chinese patients with SLE.

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Neutrophil‐to‐C3 ratio and neutrophil‐to‐lymphocyte ratio were associated with disease activity in patients with systemic lupus erythematosus

Abstract: NC R and NLR are two useful inflammatory markers for evaluating disease activity in patients with SLE.

Cited by 17 publications

References 16 publications

Neutrophil-to-lymphocyte ratio in systemic lupus erythematosus is influenced by steroids and may not completely reflect the disease activity

Neutrophil-to-lymphocyte ratio in systemic lupus erythematosus is influenced by steroids and may not completely reflect the disease activity

Relationship between Neutrophil-to-Lymphocyte Ratio and Systemic Lupus Erythematosus: A Meta-analysis

Serum amyloid A‐to‐albumin ratio as a potential biomarker to predict the activity, severity, and poor prognosis of systemic lupus erythematosus

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