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Role of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and mean platelet volume (MPV) in assessing disease control in Asian patients with axial spondyloarthritis
Authors:Jun Jie Benjamin Seng  Yu Heng Kwan  Lian Leng Low  Julian Thumboo
Institution:1. Duke-NUS Medical School, Singapore;2. Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore;3. Department of Family Medicine, Singapore General Hospital, Singapore;4. ORCID Iconhttps://orcid.org/0000-0003-4228-2862;5. Department of Rheumatology and Immunology, Singapore General Hospital, Singapore;6. Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
Abstract:Introduction: C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) which are used for assessment of axial spondyloarthritis (AxSpA) related disease activity have poor specificity and sensitivity. Neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and mean platelet volume (MPV) have not been investigated as disease activity markers among Asian AxSpA patients.

Methodology: A retrospective, cross-sectional study was conducted in Singapore General Hospital from January 2013 to December 2015 to investigate the role of NLR, PLR and MPV as disease activity markers in AxSpA patients.

Results: The mean age of patients (n?=?122) was 37.0?±?12.5 years old and majority of them were male (n?=?93, 76.2%). No significant differences were found between patients with disease with regards to age, gender, ethnicity, HLAB-27 status, age at onset of diagnosis of AxSpA, duration of disease and comorbidities such as cardiac disease (p?>?0.05).

There were no significant differences in the ESR, NLR, PLR and MPV between the four disease activity groups (p?>?0.05). However, patients with very high disease activity had higher ESR and CRP compared to patients with inactive disease and moderate disease activity (p?Conclusion: NLR, PLR and MPV were not associated with disease activity in Asian AxSpA patients.
Keywords:Disease activity  biomarkers  ankylosing spondylitis  axial spondyloarthritis  inflammatory mediators
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