Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratios Correlation with Rheumatoid Arthritis Disease Activity

BACKGROUND: Rheumatoid arthritis (RA) disease is a well-known systemic autoimmune illness typified by symmetrical polyarticular arthritis. Monitoring disease activity is essential to manage RA effectively. In recent years, there was a growing use of various inflammatory biomarkers to assess disease...

Full description

Saved in:
Bibliographic Details
Main Authors: Noor Hasan Baiee, Zakaria M. Al-Ghazaly, Ammar Hatem Abdullateef
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Journal of Applied Hematology
Subjects:
Online Access:https://journals.lww.com/10.4103/joah.joah_1_25
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849731958079225856
author Noor Hasan Baiee
Zakaria M. Al-Ghazaly
Ammar Hatem Abdullateef
author_facet Noor Hasan Baiee
Zakaria M. Al-Ghazaly
Ammar Hatem Abdullateef
author_sort Noor Hasan Baiee
collection DOAJ
description BACKGROUND: Rheumatoid arthritis (RA) disease is a well-known systemic autoimmune illness typified by symmetrical polyarticular arthritis. Monitoring disease activity is essential to manage RA effectively. In recent years, there was a growing use of various inflammatory biomarkers to assess disease activity. Examples of newly developed markers that have drawn interest are neutrophil/lymphocyte ratio (NLR) and platelets/lymphocyte ratio (PLR) which may offer an affordable and cost-effective method in determining disease activity and directing therapy choices. OBJECTIVE: To explore possible correlation between NLR, PLR, and disease activity in RA patients. PATIENTS AND METHODS: This is a cross-sectional study involving 261 RA patients older than 16 years. All patients were interviewed, and physically examined, and their disease activity was assessed using Disease Activity Score-28 (DAS28) and Clinical Disease Activity Index (CDAI) scores. Blood samples were taken and tested for erythrocyte sedimentation rate (ESR) and complete blood count (CBC). NLR and PLR were calculated as a simple ratio between the neutrophil, lymphocyte, and platelet counts derived from CBC. Patients were divided according to DAS28 values into four categories: remission, mild, moderate, and severe. RESULTS: Significant positive correlations were showed between NLR and ESR (P < 0.001), DAS28 (P < 0.001), and CDAI (P = 0.0031). Patients with severe DAS28 scores showed higher NLR, and PLR compared to those with nonsevere (mild and moderate) scores with a statistically significant difference (P = 0.018) for NLR, (P = 0.014) for PLR. No significant correlation between PLR and both DAS28 and CDAI was found. CONCLUSION: A significant correlation was found between NLR and traditional markers of RA activity as ESR, DAS28, and CDAI. Patients with severe disease activity showed the highest levels of NLR and PLR compared with those of nonsevere disease.
format Article
id doaj-art-cd7bc719c4b44636ada6b4fdb0dbe46f
institution DOAJ
issn 1658-5127
2454-6976
language English
publishDate 2025-01-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Journal of Applied Hematology
spelling doaj-art-cd7bc719c4b44636ada6b4fdb0dbe46f2025-08-20T03:08:23ZengWolters Kluwer Medknow PublicationsJournal of Applied Hematology1658-51272454-69762025-01-01161505510.4103/joah.joah_1_25Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratios Correlation with Rheumatoid Arthritis Disease ActivityNoor Hasan BaieeZakaria M. Al-GhazalyAmmar Hatem AbdullateefBACKGROUND: Rheumatoid arthritis (RA) disease is a well-known systemic autoimmune illness typified by symmetrical polyarticular arthritis. Monitoring disease activity is essential to manage RA effectively. In recent years, there was a growing use of various inflammatory biomarkers to assess disease activity. Examples of newly developed markers that have drawn interest are neutrophil/lymphocyte ratio (NLR) and platelets/lymphocyte ratio (PLR) which may offer an affordable and cost-effective method in determining disease activity and directing therapy choices. OBJECTIVE: To explore possible correlation between NLR, PLR, and disease activity in RA patients. PATIENTS AND METHODS: This is a cross-sectional study involving 261 RA patients older than 16 years. All patients were interviewed, and physically examined, and their disease activity was assessed using Disease Activity Score-28 (DAS28) and Clinical Disease Activity Index (CDAI) scores. Blood samples were taken and tested for erythrocyte sedimentation rate (ESR) and complete blood count (CBC). NLR and PLR were calculated as a simple ratio between the neutrophil, lymphocyte, and platelet counts derived from CBC. Patients were divided according to DAS28 values into four categories: remission, mild, moderate, and severe. RESULTS: Significant positive correlations were showed between NLR and ESR (P < 0.001), DAS28 (P < 0.001), and CDAI (P = 0.0031). Patients with severe DAS28 scores showed higher NLR, and PLR compared to those with nonsevere (mild and moderate) scores with a statistically significant difference (P = 0.018) for NLR, (P = 0.014) for PLR. No significant correlation between PLR and both DAS28 and CDAI was found. CONCLUSION: A significant correlation was found between NLR and traditional markers of RA activity as ESR, DAS28, and CDAI. Patients with severe disease activity showed the highest levels of NLR and PLR compared with those of nonsevere disease.https://journals.lww.com/10.4103/joah.joah_1_25disease activity score-28neutrophil/lymphocyte ratioplatelets/lymphocyte ratiorheumatoid arthritis
spellingShingle Noor Hasan Baiee
Zakaria M. Al-Ghazaly
Ammar Hatem Abdullateef
Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratios Correlation with Rheumatoid Arthritis Disease Activity
Journal of Applied Hematology
disease activity score-28
neutrophil/lymphocyte ratio
platelets/lymphocyte ratio
rheumatoid arthritis
title Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratios Correlation with Rheumatoid Arthritis Disease Activity
title_full Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratios Correlation with Rheumatoid Arthritis Disease Activity
title_fullStr Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratios Correlation with Rheumatoid Arthritis Disease Activity
title_full_unstemmed Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratios Correlation with Rheumatoid Arthritis Disease Activity
title_short Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratios Correlation with Rheumatoid Arthritis Disease Activity
title_sort neutrophil to lymphocyte and platelet to lymphocyte ratios correlation with rheumatoid arthritis disease activity
topic disease activity score-28
neutrophil/lymphocyte ratio
platelets/lymphocyte ratio
rheumatoid arthritis
url https://journals.lww.com/10.4103/joah.joah_1_25
work_keys_str_mv AT noorhasanbaiee neutrophiltolymphocyteandplatelettolymphocyteratioscorrelationwithrheumatoidarthritisdiseaseactivity
AT zakariamalghazaly neutrophiltolymphocyteandplatelettolymphocyteratioscorrelationwithrheumatoidarthritisdiseaseactivity
AT ammarhatemabdullateef neutrophiltolymphocyteandplatelettolymphocyteratioscorrelationwithrheumatoidarthritisdiseaseactivity