Neutrophil Lymphocyte Ratio as an Inflammatory Marker in Rheumatoid Arthritis

Abstract

Objective: To determine the role of Neutrophil Lymphocyte Ratio as an inflammatory marker in Rheumatoid Arthritis. Study Design: Cross-sectional analytical study. Place and Duration of Study: Rheumatology Department, National Hospital and Medical Center, Lahore Pakistan, from Mar to Sep 2021. Methodology: After approval from Institutional Ethical Review Board, 160 patients diagnosed with rheumatoid arthritis, aged 21-80 years, were enrolled. Demographic information and medical history were obtained and divided into two groups: Active disease (DAS-28 score>3.2) and LDA/remission (DAS-28 score<3.2). Clinical parameters of the DAS-28 score and CBC, including NLR, were assessed and recorded. Results: Out of 160 patients, there were 132(82.5%) females. The duration of disease was 8.4±6.8 years. Mean VAS score, tender joint count, swollen joint count, and DAS-28 score were 3.8±2.6, 4.2±4.1, 2.4±2.7 and 4.0±1.6 respectively. RA Factor was positive in 121(75.6%) and Anti-CCP antibody in 102(63.8%). Anaemia was found in 45(28.1%). Mean platelet and TLC were 357.1+99.3 ×109/L and 9.0+2.9 ×109/L respectively. On division into groups, the mean NLR in LDA/Remission-Group and Active Disease-Group were 2.5±1.4 and 3.9±2.1, respectively. High NLR was seen in 46 (57.5%) with Active Disease-Group compared with 13 (16.3%) in LDA/Remission-Group (p-value<0.001). Conclusion: High NLR was more common in active RA than LDA/remission, and NLR is useful in indicating disease activity.

Keywords

• Disease activity score (DAS) 28 score
• Neutrophil lymphocyte Ratio (NLR)
• Rheumatoid arthritis (RA)