Characterization of neutrophil-to-lymphocyte ratio as a measure of inflammation in rheumatoid arthritis

Autor: K.R. Anupama, P Renuka, K. Renuka, Masoodi Mukhtar Ahmad, S Chandrashekara
Rok vydání: 2017
Předmět:
Male
Neutrophils
Health Status
Likelihood ratios in diagnostic testing
Gastroenterology
Arthritis
Rheumatoid
0302 clinical medicine
Surveys and Questionnaires
Lymphocytes
Child
Aged
80 and over
medicine.diagnostic_test
Complete blood count
Middle Aged
C-Reactive Protein
030220 oncology & carcinogenesis
Rheumatoid arthritis
Erythrocyte sedimentation rate
Area Under Curve
Female
medicine.symptom
Inflammation Mediators
musculoskeletal diseases
Adult
medicine.medical_specialty
Adolescent
Visual analogue scale
Subgroup analysis
Inflammation
Blood Sedimentation
03 medical and health sciences
Young Adult
Rheumatology
Predictive Value of Tests
Internal medicine
medicine
Humans
Lymphocyte Count
Neutrophil to lymphocyte ratio
Aged
030203 arthritis & rheumatology
business.industry
Interleukin-6
fungi
Reproducibility of Results
medicine.disease
Cross-Sectional Studies
ROC Curve
Immunology
Joints
business
Biomarkers
Zdroj: International journal of rheumatic diseases. 20(10)
ISSN: 1756-185X
Popis: Objectives The neutrophil to lymphocyte ratio (NLR) is one of the well-recognized sensitive measures of inflammation. This cross-sectional observational study was aimed at characterizing the relationship of NLR with the inflammatory markers erythrocyte sedimentation rate (ESR), C-reative protein (CRP), Disease Activity Score of 28 joints (DAS28)-CRP(3), joint counts and quality measures of rheumatoid arthritis (RA). Materials and Methods Patients with RA were recruited in two phases. The following were assessed for all patients: joint count, pain by visual analogue scale (VAS), complete blood count, ESR, CRP and quality index assessment using the Short Form health survey (SF-36) questionnaire. A subgroup analysis was also performed to evaluate the association between NLR and cytokines. Results Four hundred and eighty-nine subjects were recruited. Distribution of NLR values corresponded with DAS28-CRP(3) rather than CRP and ESR. A significant difference in VAS, swollen joint counts (SJC-28), inflammatory parameters and general health outcome measures was observed among the NLR groups. A weak correlation was observed between NLR and RA disease measures. It had least bias at lower ranges with DAS28-CRP(3) than CRP and ESR. The NLR cut-off value of 1.4 classified the patients in deep remission with 90% specificity, 24% sensitivity, likelihood ratio positive (LR+) 2.46 and likelihood ratio negative (LR−) 0.84. CRP was a significant baseline predictor of NLR. A significant influence of interleukin-6 on CRP was noted. Conclusion In contrast to the traditional markers, NLR may serve as a less expensive and effective measure of inflammation in RA. Its efficacy is comparable to that of CRP and it is not impacted by the cytokines influencing CRP and ESR.
Databáze: OpenAIRE
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