Romanian Journal of Rheumatology (Dec 2023)

Clinical significance of the lipid profile, neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in different rheumatic disease patients

  • Passant N. El-Husseiny,
  • Suzan S. Al-Adle,
  • Nahla N. Eesa,
  • Tamer A. Gheita

DOI
https://doi.org/10.37897/RJR.2023.4.8
Journal volume & issue
Vol. 32, no. 4
pp. 161 – 172

Abstract

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Objectives. To assess the lipid profile, neutrophil-lymphocyte ratio(NLR) and platelet-lymphocyte ratio(PLR) in different rheumatic diseases and to study their relation to disease activity and/or severity. Patients and methods. 257 patients (47 rheumatoid arthritis (RA), 100 systemic lupus erythematosus (SLE), 49 systemic sclerosis (SSc), 33 axial spondyloarthritis (axSpA) and 28 vasculitis (21with primary vasculitis and 7 with Behçet’s disease ‘BD’) and 70 controls were recruited. The disease activity and/or severity were assessed for each disease. The lipid profile was measured including: total cholesterol (TC), high-density lipoprotein (HDL),triglycerides (TG), low-density lipoprotein (LDL), very-low density lipoprotein (VLDL) and the LDL:HDL was calculated. The NLR and PLR were recorded. Results. In RA, NLR, PLR and HDL were significantly higher (p<0.0001, p=0.001, p=0.01). The disease activity score (DAS28) was significantly associated with dyslipidemia (p=0.02) and correlated inversely with NLR (r=-0.3, p=0.02). NLR and PLR correlated significantly with TG (p=0.02, p=0.03) respectively. In SLE, NLR, PLR and TG were significantly higher (p<0.0001, p<0.0001, p<0.001). The SLE disease activity index (SLEDAI) was significantly related to dyslipidemia (p=0.01) and NLR (p=0.005).PLR correlated inversely with the damage index (r=-0.2, p=0.01). SLEDAI correlated significantly with TG, (r=0.4, p<0.0001) and LDL: HDL (r=0.4, p<0.0001) and inversely with HDL(r=-0.4, p<0.0001). In SSc, NLR and PLR were significantly higher (p<0.0001, p=0.03). HDL correlated inversely with modified Rodnan skin score (mRss) (r=-0.3, p=0.04). In axSpA, NLR, PLR and lipid profile were similar to controls. In vasculitis, HDL was significantly higher (p=0.02) and TG correlated inversely with vasculitis damage index (VDI) (r=-0.5, p=0.03). In BD, PLR correlated significantly with the Arabic BD current activity form (Ar-BDCAF) (r=0.9, p=0.003). NLR correlated significantly with TC (r=0.4,p=0.03) and PLR inversely with TG(r=-0.5, p=0.04). NLR, PLR and ESR were valuable predictors of disease activity in RA, SLE, SSc and vasculitis. On comparing the different rheumatic diseases, NLR and TG were significantly higher in SLE (p<0.0001, p=0.002) and PLR in vasculitis (p=0.004). Conclusion. Dyslipidemia is frequently associated with the rheumatic diseases. NLR and PLR are feasible markers with a promising role in evaluation of their disease activities.

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