Elif KILIÇ, Aylin REZVANİ, Aybala Erek TOPRAK, Hayriye ERMAN, Siddika Kesgin AYHAN, Emine POYRAZ, Nihal ÖZARAS

Romatoid Artritte Nötrofil/ Lenfosit ve Platelet/ Lenfosit Oranlarının Değerlendirilmesi

Amaç: Bu çalışmanın amacı, romatoid artrit (RA), hastalık aktivitesi ile hematolojik parametrelerden nötrofil-lenfosit oranı (NLO), platelet lenfosit oranı (PLO) ve eritrosit dağılım genişliği (RDW) arasındaki ilişkiyi incelemektir.Yöntemler: Yetmiş yedi romatoid artrit hastası ve 97 sağlıklı bireyden oluşmuş kontrol grubu bu retrospektif çalışmaya dâhil edildi. Kontrol grubuna sistemik ve kronik herhangi bir hastalığı olan kişiler dâhil edilmedi. Hastaların hastalık aktivite skorları (DAS 28) ve her iki grubun hematolojik parametreleri ve inflamasyon parametreleri istatistiksel olarak Student-t testi ve Spearman korelasyon testiyle karşılaştırıldı.Bulgular: Yaş ve cinsiyet açısından gruplar arasında fark yoktu. C-reaktif protein (CRP) ve eritrosit sedimentasyon hızı (ESH) seviyeleri RA hasta grubunda anlamlı olarak yüksekti (p

Evaluation of Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratios in Rheumatoid Arthritis

Objective: The purpose of this study is to investigate the relationship of disease activity with Neutrophil-Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) and red blood cell distribution width (RDW). Methods: Seventy seven RA patients and 97 healthy subjects were examined retrospectively. People with chronic and systemic diseases were excluded from control group of the study. The disease activity scores (DAS 28) of patient group, hematologic parameters and inflammation parameters of both groups were analyzed statistically using independent t-test and spearman correlation test.Results: Age and gender was not found different between groups. CRP and ESR levels were significantly higher in RA group (p

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1. Scott DL, Wolfe F, Huizinga TW. Rheumatoid arthritis. Lancet 2010; 376: 1094-1108.
2. Choy EH, Panayi GS. Cytokine pathways and joint inflammation in rheumatoid arthritis. N Engl J Med 2001;344:907- 916.
3. Karimifar M, Salesi M, Farajzadegan Z. The association of anti-CCP1 antibodies with disease activity score 28 (DAS- 28) in rheumatoid arthritis. Adv Biomed Res 2012;1:30.
4. Kay J, Morgacheva O, Messing SP, et al. Clinical disease activity and acute phase reactant levels are discordant among patients with active rheumatoid arthritis: acute phase reactant levels contribute separately to predicting outcome at one year. Arthritis Res Ther 2014;16:R40.
5. Bowman SJ. Hematological manifestations of rheumatoid arthritis. Scand J Rheumatol 2002;31:251-259.
6. van Riel PL. The development of the disease activity score (DAS) and the disease activity score using 28 joint counts (DAS28). Clin Exp Rheumatol 2014;32:65-74.
7. Lippi G, Targher G, Montagnana M, et al. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med 2009;133:628-632.
8. Pichler M, Hutterer GC, Stoeckigt C, et al. Validation of the pre-treatment neutrophil-lymphocyte ratio as a prognostic factor in a large European cohort of renal cell carcinoma patients. Br J Cancer 2013;108:901-907.
9. Tamhane UU, Aneja S, Montgomery D, et al. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 2008;102:653-657.
10. de Jager CP, van Wijk PT, Mathoera RB, et al. Lymphocytopenia and neutrophil-lymphocyte count ratio predict bacteremia better than conventional infection markers in an emergency care unit. Crit Care 2010;14:192.
11. Templeton AJ, Ace O, McNamara MG, et al. Prognostic role of platelet to lymphocyte ratio in solid tumors: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev 2014;23:1204-1212.
12. Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis 1996;7:157-161.
13. Briggs C. Quality counts: new parameters in blood cell counting. Int J Lab Hematol 2009;31:277-297.
14. Colglazier CL, Sutej PG. Laboratory testing in the rheumatic diseases: a practical review. South Med J 2005;98:185- 191.
15. Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. N Engl J Med 1999;340:448- 454.
16. Kapci M, Turkdogan KA, Duman A, et.al. Biomarkers in the diagnosis of acute appendicitis. JCEI 2014;5:250-255.
17. Mantovani A, Cassatella MA, Costantini C, et.al. Neutrophils in the activation and regulation of innate and adaptive immunity. Nat Rev Immunol 2011;11:519-531.
18. McDonald B, Pittman K, Menezes GB, et al. Intravascular danger signals guide neutrophils to sites of sterile inflammation. Science 2010;330:362-366.
19. Boilard E, Blanco P, Nigrovic PA. Platelets: active players in the pathogenesis of arthritis and SLE. Nat Rev Rheumatol 2012;8:534-542.
20. Celikbilek M, Dogan S, Ozbakir O, et al. Neutrophil-lymphocyte ratio as a predictor of disease severity in ulcerative colitis. J Clin Lab Anal 2013;27:72-76.
21. Ozturk ZA, Kuyumcu ME, Yesil Y, et al. Is there a link between neutrophil-lymphocyte ratio and microvascular complications in geriatric diabetic patients? J Endocrinol Invest 2013;36:593-599.
22. Günbatar H, Ekin S, Sünnetçioğlu A, et.al. The relationship between neutrophil-to-lymphocyte ratio and plateletto-lymphocyte ratio in patients with obstructive sleep apnea syndrome. Dicle Med J 2015;42:289-293.
23. Hu ZD, Sun Y, Guo J, et al. Red blood cell distribution width and neutrophil/lymphocyte ratio are positively correlated with disease activity in primary Sjogren’s syndrome. CLB 2014;47:287-290.
24. Qin B, Ma N, Tang Q, et al. Neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients. Mod Rheumatol 2015:1; 5-8.
25. Feng JF, Huang Y, Chen QX. Preoperative platelet lymphocyte ratio (PLR) is superior to neutrophil lymphocyte ratio (NLR) as a predictive factor in patients with esophageal squamous cell carcinoma. World J Surg Oncol 2014; 12: 58.
26. Boilard E, Nigrovic PA, Larabee K, et al. Platelets amplify inflammation in arthritis via collagen-dependent microparticle production. Science 2010; 327: 580-583.
27. Uslu AU, Kucuk A, Sahin A, et al. Two new inflammatory markers associated with Disease Activity Score-28 in patients with rheumatoid arthritis: neutrophil-lymphocyte ratio and platelet-lymphocyte ratio. Int J Rheum Dis 2015;18:731-735.
28. Bath P, Algert C, Chapman N, et.al. Association of mean platelet volume with risk of stroke among 3134 individuals with history of cerebrovascular disease. Stroke 2004;35:622-626.
29. Kapsoritakis AN, Koukourakis MI, Sfiridaki A, et al. Mean platelet volume: a useful marker of inflammatory bowel disease activity. Am J Gastroenterol 2001;96:776-781.
30. Kisacik B, Tufan A, Kalyoncu U, et al. Mean platelet volume (MPV) as an inflammatory marker in ankylosing spondylitis and rheumatoid arthritis. Joint Bone Spine 2008;75:291-294.
31. Gasparyan AY, Sandoo A, Stavropoulos-Kalinoglou A, et al. Mean platelet volume in patients with rheumatoid arthritis: the effect of anti-TNF-alpha therapy. Rheumatol Int 2010;30:1125-1129.
32. Yazici S, Yazici M, Erer B, et al. The platelet indices in patients with rheumatoid arthritis: mean platelet volume reflects disease activity. Platelets 2010;21:122-125.
33. Evans TC, Jehle D. The red blood cell distribution width. J Emerg Med 1991;9:71-74.
34. Farkas N, Szabo A, Lorand V, et al. Clinical usefulness of measuring red blood cell distribution width in patients with systemic sclerosis. Rheumatology (Oxford) 2014; 53: 1439-1445.
35. Hu ZD, Chen Y, Zhang L, et al. Red blood cell distribution width is a potential index to assess the disease activity of systemic lupus erythematosus. Clin Chim Acta 2013; 425: 202-205.
36. Pascual-Figal DA, Bonaque JC, Redondo B, et al. Red blood cell distribution width predicts long-term outcome regardless of anaemia status in acute heart failure patients. Eur J Heart Fail 2009;11:840-846.
37. Hassan S, Antonelli M, Ballou S. Red cell distribution width: a measure of cardiovascular risk in rheumatoid arthritis patients? Clin Rheumatol 2015;34:1053-1057.
38. Rodriguez-Carrio J, Alperi-Lopez M, Lopez P, et al. Red cell distribution width is associated with cardiovascular risk and disease parameters in rheumatoid arthritis. Rheumatology (Oxford) 2015;54:641-646.