The Neutrophil/lymphocyte and platelet/lymphocyte ratio and correlation with acute phase reactants and disease activity in patients with rheumatoid arthritis

Abstract

ABSTRACT

Introduction. The neutrophil/lymphocyte ratio (NLR) and the platelet/lymphocyte ratio (PLR) are well-recognized sensitive measures of inflammation in several diseases. The objectives of this study were to correlate the NLR and PLR with ESR, CRP and disease activity as measured with the DAS-28 CRP and to determine the cut-off points of the NLR and PLR indicative of remission, mild, moderate and severe activity.

Patients and Methods.  This is a retrospective study in which we included adult patients with diagnosis of RA. The correlation of NLR and PLR with ESR, CRP and the DAS-28 CRP was evaluated with the Pearson's test. Cut-off values of the NLR and PLR to discriminate disease activity (remission, low, moderate and high disease activity) were analyzed with ROC curves using the DAS-28 CRP as the gold standard.

Results. We included 151 measurements corresponding to 55 patients. The NLR had a weak correlation with ESR (r= 0.065), CRP (r= 0.23) and DAS-28 CRP (r= 0.18). The PLR had a weak correlation with ESR (r= 0.22), moderate with CRP (r= 0.38) and weak with the DAS-28 CRP (r= 0.20). The areas under curve of the NLR to discriminate remission, low, moderate and severe disease activity were 0.61, 0.61, 0.58 and 0.35, respectively, and for the PLR were 0.55, 0.55, 0.45 and 0.24, respectively.

Conclusion. In this study, we found a weak to moderate correlation of the RNL and RPL with acute phase reactants and disease activity. Likewise, the discriminative capacity of RNL and RPL was low to establish the disease activity status in this patient sample. Therefore, these indicators would not be suitable to address disease activity in patients with RA.