THE RELATIONSHIP OF NEUTROPHIL LYMPHOCYTE RATIO WITH PROGNOSIS AND DISEASE ACTIVITY IN PATIENTS WITH RHEUMATOID ARTHRITIS

Abstract

Background: Rheumatoid arthritis (RA) is an autoimmune disease associated with systemic inflammation. Laboratory parameters such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and various disease evaluation indexes (such as DAS 28; HAQ, SF-36) are used as indicators of the severity of inflammatory activity. Neutrophil-to-lymphocyte ratio (NLR); It has attracted attention in recent years as a non-specific inflammatory marker. In our study, it was aimed to investigate the possible role of peripheral blood NLR, which is easy and inexpensive to measure, in demonstrating disease activity and prognosis in patients with RA. Materials and Methods: Forty-three patients who were diagnosed with RA according to the criteria of the American Rheumatology Association and who had not received prior specific treatment for RA were included in the study. Laboratory parameters such as ESR, CRP, and disease assessment indices (DAS 28; HAQ) were compared with the NLR at the time of diagnosis and at the time of enrollment after treatment. Results: There were no significant correlation found between the mean NLR and DAS 28, HAQ which provide information about the prognosis of the disease. When the relationship between NLR and ESR and CRP was examined in order to evaluate the relatonship between the disease activity and inflamation during the diagnosis instead of a composite index such as DAS 28, moderately weak relationship between NLR and CRP level was found (p=0.033, r=0,343) while the tendency between NLR and the average ESR was found to be also moderately weak (p=0.056, r=0.301). Conclusions: Moderate to weak correlation between mean NLR and mean CRP levels (p=0.033, r=0.343); between the mean ESR level, a moderate-weak correlation was found (p=0.056, r=0.301). The association with baseline CRP and the trend towards association with ESR suggest that NLR may be associated with inflammation. It was thought that the loss of this relationship during the study, that is, after the treatment, may be due to the fact that other factors such as medication affect this rate.