The correlation of both neutrophil/lymphocyte and platelet/lymphocyte ratios with disease activity in ankylosing spondylitis patients

Abstract

Background
Ankylosing spondylitis (AS) is a chronic autoimmune disease that causes inflammation, disability, and reduced quality of life. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are emerging as cost-effective and reliable biomarkers for evaluating inflammation, disease activity, and therapeutic response in ankylosing spondylitis. The objective of this study was to investigate the relationship between NLR and PLR with disease activity in individuals with ankylosing spondylitis.


Results
The mean age was 41.17 ± 9.03 years for the case group and 41.8 ± 7.52 years for the control group. AS patients had a mean disease duration of 11.17 ± 4.73 years. AS patients had significantly lower hemoglobin (P = 0.007) and lymphocyte counts (P = 0.012) but higher platelet counts (P < 0.0001), NLR (P = 0.010), and PLR (P < 0.0001) compared to controls. Most patients showed severe disease activity, with mean BASDAI and ASDAS scores of 4.2 ± 0.63 and 2.8 ± 0.39, respectively. Significant correlations were found between BASDAI scores and lymphocyte count (r = − 0.707, P < 0.0001), NLR (r = 0.546, P = 0.002), PLR (r = 0.808, P < 0.0001), ESR (r = 0.362, P = 0.049), and CRP (r = 0.671, P < 0.0001) levels. The PLR ratio (> 113.5) was a better diagnostic marker than NLR (> 1.6), with a higher area under the curve (AUC) of 0.841, along with higher sensitivity, specificity, and predictive values.


Conclusions
PLR, alongside acute-phase reactants, may serve as a valuable marker for inflammation. Further research on these biomarkers could enhance the understanding and management of disease progression.