Neutrophil-lymphocyte, platelet-lymphocyte and lymphocyte-monocyte ratios may not be useful markers to assess disease activity in rheumatoid arthritis: A STROBE-compliant article.

The associations among the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) and disease activity in rheumatoid arthritis remains unclear.To evaluate these indicators as potential markers of disease activity in patients with rheumatoid arthritis (RA).This cross-sectional study included 547 adult patients with RA. The patients were divided into two groups according to the disease activity score (DAS) system: remission and disease activity. Differences in the NLR, PLR and LMR of the two groups were assessed. Correlations were analyzed using Spearman analysis, and receiver operating characteristic (ROC) curves were used to identify the sensitivity, specificity, and optimal cutoff values to differentiate active RA patients from inactive RA patients.There was a statistically significant difference in the NLR (4.2 ± 3.2 vs 3.4 ± 2.4, P = .034) and PLR (222.3 ± 136.4 vs 176.9 ± 89.8, P = .006) between the two groups, but not for the LMR (3.0 ± 1.8 vs 3.4 ± 2.4, P = .115). In addition, the DAS28 and traditional inflammatory markers, including ESR and CRP, were weakly positively correlated with the NLR and PLR. Based on the ROC curves, the NLR (sensitivity 31.8%, specificity 77.8%) and PLR (sensitivity 57.3%, specificity 63.9%) were less valuable than the ESR (sensitivity 67.2%, specificity 91.7%) and CRP (sensitivity 76.2%, specificity 91.7%) for differentiating inactive RA patients from active RA patients due to low sensitivity and specificity and combining NLR or PLR also cannot significantly improved the diagnostic value of ESR and CRP.NLR, PLR and LMR may not be an useful independent diagnostic or complementary marker for disease activity in RA patients.

Lijuan W ，Yuting Z ，Chaoyang L ，Ju Y ... -  《-》

The value of the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as complementary diagnostic tools in the diagnosis of rheumatoid arthritis: A multicenter retrospective study.

The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have drawn attention in recent years as novel non-specific inflammatory markers; however, only a few studies have been conducted to investigate their value in RA. To investigate the value of the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) as complementary diagnostic tools in rheumatoid arthritis (RA). This study included 1009 patients with RA, 170 patients with other rheumatic diseases, and 245 healthy individuals from four medical centers. The patients' general data, including complete blood count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and rheumatoid factor (RF), were retrospectively analyzed, and the NLR and PLR were calculated. Potential effective indicators were screened by logistic regression analysis, and a receiver operating characteristic (ROC) curve was plotted to evaluate their diagnostic value for RA. (a) The NLR and PLR were significantly higher in the RA group than in the non-RA group and the control group (P < .05). (b) Spearman's Rho showed that the NLR was positively correlated with the PLR (r = .584, P < .05), RF (r = .167, P < .01), and CRP (r = .280, P < .01) but was not significantly correlated with ESR (r = .100, P > .05). The PLR was positively correlated with RF (r = .139, P < .01), CRP (r = .297, P < .01), and ESR (r = .262, P < .05). (c) Logistic analysis showed that RF, CRP, ESR, and the NLR had diagnostic value for RA. (d) For the NLR, the area under the curve (AUC) of the ROC curve was 0.831; at the cutoff value of 2.13, the diagnostic sensitivity, specificity, accuracy, and Youden index were 76.7%, 75.9%, 76.4%, and 0.5424, respectively. The NLR was less effective than CRP and RF but was superior to ESR in the diagnosis of RA. The NLR can thus be used as a complementary diagnostic indicator in the diagnosis of RA.

Jin Z ，Cai G ，Zhang P ，Li X ，Yao S ，Zhuang L ，Ren M ，Wang Q ，Yu X ... -  《-》

Relationship between neutrophil-lymphocyte, platelet-lymphocyte ratio and disease activity in rheumatoid arthritis treated with rituximab.

Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) may be used as indicators of inflammatory markers and disease activity due to inflammatory changes in neutrophils, platelets and lymphocytes. Our aim is to investigate the relationship between NLR, PLR ratio and disease activity in RA patients treated with rituximab. Thirty-eight patients (8 male, 30 female, mean age 56.8 ± 11.8 years) diagnosed with RA and 30 healthy controls were included in the study. Disease Activity Score of 28 joints - erythrocyte sedimentation rate (DAS28-ESR), lymphocyte, neutrophil, platelet counts, ESR, C-reactive protein (CRP), PLR, and NLR were evaluated before and after rituximab in RA patients. The relationship between all parameters was assessed by Pearson's correlation, Wilcoxon signed-rank, Mann-Whitney U and paired t tests. The levels of CRP, ESR, and DAS28-ESR decreased significantly at 6 months of rituximab treatment compared to pre-treatment. NLR and PLR ratios were higher in patients with RA than the control group. The median levels were 33.5 mm/hour, 5.7 mg/dL, and 3.7 respectively after 6 months of rituximab treatment. And, the levels were lower than baseline treatment. There was a significant correlation between the levels of DAS28-ESR and NLR, DAS28-ESR and PLR before and after treatment. The NLR and PLR were higher than healthy controls and correlated with DAS28-ESR in patients with RA. These parameters which are indicative of disease activity decrease with rituximab and correlate with disease activity at 6 months. The NLR and PLR may be useful indices to evaluate RA disease activity treated with rituximab.

Sargin G ，Senturk T ，Yavasoglu I ，Kose R ... -  《-》

Correlation between NLR, PLR, and LMR and Disease Activity, Efficacy Assessment in Rheumatoid Arthritis.

To analyze the value of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR) in the evaluation of disease activity and efficacy in patients with rheumatoid arthritis (RA). The clinical data of 132 newly diagnosed RA patients admitted to our hospital from November 2018 to January 2020 were retrospectively analyzed, and the NLR, PLR, and LMR were calculated. According to the 28-joint disease activity score (DAS28), all patients was divided into the remission group (n = 40) and the active group (n = 92). According to the curative effect of the active group, the patients were divided into the effective group (n = 61) and the ineffective group (n = 39). Logistic regression analysis of clinical data was to determine the influencing factors of RA disease activity. The receiver operating characteristic curve (ROC) was used to evaluate the predictive value of NLR, PLR, and LMR on disease activity and efficacy of RA. The number of cases of smoking history, the number of cases of drinking history, and NLR, PLR, CRP, and ESR levels of patients in the active group were higher than those of the remission group, and the LMR level was lower than that of the remission group; the differences were statistically significant (P < 0.05). The results of multivariate logistic regression analysis showed that NLR, PLR, LMR, CRP, and ESR were independent influencing factors of disease activity in RA patients (P < 0.05). The AUC of NLR, PLR, and LMR on the disease activity of RA patients was 0.872, 0.821, and 0.824, the sensitivity was 87.6%, 70.2%, and 69.3%, and the specificity was 75.6%, 76.8%, and 84.3%, respectively. The NLR and PLR values of the effective group were lower than those of the ineffective group, and the LMR values were higher than those of the ineffective group, and the differences were statistically significant (P < 0.05). The AUC of NLR, PLR, and LMR on the efficacy of RA patients was 0.756, 0.732, and 0.779, the sensitivity was 68.4%, 60.2%, and 67.9%, and the specificity was 83.2%, 86.4%, and 85.1%, respectively. NLR, PLR, and LMR are the independent factors that affect the disease activity of RA patients and can better evaluate the disease activity and efficacy of RA.

Li M ，Xie L 《-》

Platelet/Lymphocyte, Lymphocyte/Monocyte, and Neutrophil/Lymphocyte Ratios as Biomarkers in Patients with Rheumatoid Arthritis and Rheumatoid Arthritis-Associated Interstitial Lung Disease.

Chen Q ，Chen DY ，Xu XZ ，Liu YY ，Yin TT ，Li D ... -  《MEDICAL SCIENCE MONITOR》