Diagnostic value of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and mean thrombocyte volume in irritable bowel syndrome-constipation according to Rome IV criteria

Aim: Structural and biochemical reagents that could help diagnose irritable bowel syndrome (IBS) are still lacking. Moreover, useof certain diagnosis criteria in the diagnosis of the disease decreases the need for making over-diagnostic tests in order to ruleout other diseases. Rome IV criteria include new parameters for the diagnosis of IBS. Our objective in this study is to research thediagnostic value of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and mean platelet volume (MPV) count inIBS-Constipation (IBS-C).Material and Methods: Data of the cases among patients who applied to general surgery polyclinics of Ordu University MedicalFaculty who were diagnosed with IBS and have Rome IV IBS-C diagnosis criteria. Healthy volunteers were selected from adulthealthy patients who applied to general surgery policlinics of our hospital for general health check purposes. The age, sex, WBC(white blood cell), NLR, PLR, MPV values of the cases were analyzed.Results:Average age of IBS-C group was 39.47±9.97 (min 19-max 57). Average age of the control group was 40.16±11.50 (min 18-max 59). Out of 78 IBS-C group patients, 48 (61.5%) were women and 30 (38.5%) were men. Of 82 patients 54 (65.9%) were women,28 (%34.1) were men. Average age of the patients was 39.83±10.75 (min 18-max 59). A significant result was obtained for NLR whencontrol group was compared with IBS-C group (p=0.01). No significant difference was determined between two groups for MPV, PLR(p>0.05). Cut-off value of NLR was calculated as 1.895, and the sensitivity in IBS diagnosis was calculated as 51.3%, and the specificitywas calculated as 59.8%.Conclusion: We have determined significant results with NLR, which is an inflammatory reagent, in IBS-C according to Rome IV Criteria.However, NLR has low sensitivity and specificity for IBS-C diagnosis from the other causes of constipation. We are of the opinion thatinflammatory reagents such as NLR, PLR, MPV are not useful in the diagnosis of this disease. We consider that our study will shed alight on future studies with larger research populations.

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1. Longstreth GF, Thompson WG, Chey WD, et al. Functional bowel disorders. Gastroenterology 2006;130:1480-91.
2. Lacy BE, Patel NK. Rome criteria and a diagnostic approach to irritable bowel syndrome. J Clin Med 2017;6:99.
3. Quigley E. Current concepts of the irritable bowel syndrome. Scand J Gastroenterol Suppl 2003;237:1-8.
4. Schmulson MJ, Drossman DA. what is new in rome IV. J neurogastroenterol motil 2017;23:151-63.
5. Imtiaz F, Shafique K, Mirza SS, et al. Neutrophil iymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population. Int Arch Med 2012;5:2.
6. Celikbilek M, Dogan S, Ozbakır O, et al. Neutrophil-lymphocyte ratio as a predictor of disease severity in ulcerative colitis. J Clin Lab Anal 2013;27:72-6.
7. Proctor MJ, Morrison DS, Talwar D, et al. A comparison of inflammation-based prognostic scores in patients with cancer. A Glasgow Inflammation Outcome Study. Eur J Cancer 2011;47:2633-41.
8. Briggs C. Quality counts: new parameters in blood cell counting. Int J Lab Hematol 2009;31:277-97.
9. Spiller RC. Irritable bowel syndrome: gender, infection, lifestyle or what else? Dig Dis 2011;29:215-21.
10. Occhipinti K, Smith JW. Irritable bowel syndrome: a review and update. Clin Colon Rectal Surg 2012;25:46-52.
11. El-Salhy M. Irritable bowel syndrome: diagnosis and pathogenesis. World J Gastroenterol 2012;18:5151-63.
12. Jung H, Kim YH, Park JY, et al. Estimating the burden of irritable bowel syndrome: analysis of a nationwide Korean database. J Neurogastroenterol Motil 2014;20:242-52.
13. Lovell RM, Ford AC. Global prevalence of and risk factors for irritable bowel syndrome: a meta-analysis. Clin Gastroenterol Hepatol 2012;10:712-21.
14. Ghoshal UC, Abraham P, Bhatt C, et al. Epidemiological and clinical profile of irritable bowel syndrome in India; report of the Indian Society of Gastroenterology Task Force. Indian J Gastroenterol 2008;27:22-8.
15. Shah SS, Bhatia SJ, Mistry FP. Epidemiology of dyspepsia in Mumbai. Indian J Gastroenterol 2001;20:103-6.
16. Kwan AC, Hu WH, Chan YK, et al. Prevalence of irritable bowel syndrome in Hong Kong. J Gastroenterol Hepatol 2002;17:1180-6.
17. Drossman DA, Camilleri M, Mayer EA, et al. AGA technical review on irritable bowel syndrome. Gastroenterology 2002;123:2108-31.
18. Hungin AP, Chang L, Locke GR, et al. Irritable bowel syndrome in the United States: prevalence, symptom patterns and impact. Aliment Pharmacol Ther 2005;21:1365-75.
19. Wilkins T, Pepitone C, Alex B, et al. Diagnosis and management of IBS in adults. Am Fam Physician 2012;86:419-26.
20. Whitehead WE, Palsson OS, Simren M. Irritable bowel syndrome: what do the new Rome IV diagnostic guidelines mean for patient management? Expert Rev Gastroenterol Hepatol 2017;11:281-3.
21. Bai T, Xia J, Jiang Y, et al. Comparison of the rome IV and rome III criteria for IBS diagnosis: A cross-sectional survey. J Gastroenterol Hepatol 2017;32:1018-25.
22. Unal M, Kucuk A, Urun Unal G, et al. Mean platelet volume, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in psoriasis. TurkDerm 2015;49:112-6.
23. Yavuzcan A, Caglar M, Ustun Y, et al. Evaluation of mean platelet volume, neutrophil/lymphocyte ratio and platelet/ lymphocyte ratio in advanced stage endometriosis with endometrioma. J Turk Ger Gynecol Assoc 2013;14:210-5.
24. Guclu M, Agan AF. Relationship of peripheral blood neutrophil to lymphocyte ratio and irritable bowel syndrome. Turk J Med Sci 2017;47:1067-71.