Combination Of Neutrophil To Lymphocyte Ratio And Platelet To Lymphocyte Ratio As Diagnostic Biomarker For Rheumatoid Arthritis

Objective: The outstanding diagnostic role of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) attract more attention recently. The purpose of this study is to evaluate the diagnostic value of the NLR and PLR in Rheumatoid arthritis (RA) patients. Methods: NLR and PLR were compared between 125 RA patients (66 RA patients in disease active stage, 59 RA patients in non-active stage) and 126 healthy individuals; receiver operating characteristic curve (ROC curve) and the area under the ROC curve (AUC) were used to identify their associations with RA; Spearman correlation analysis was used to identify the correlations between NLR (PLR) and clinical characteristics of RA patients. Results: RA patients both in disease active stage and in non-active stage have high levels of NLR and PLR compared to healthy individuals, respectively (P<0.0001; P<0.0001). Results of ROC curve indicated that the combination of NLR and PLR as a panel revealed high diagnostic accuracy for discriminating active RA patients or non-active RA patients from healthy individuals, respectively (AUC, 0.880; 95% Confidence Interval [CI], 0.819-0.940; P< 0.0001; AUC, 0.839; 95% CI, 0.772-0.960; P< 0.0001). Moreover, the value of PLR and NLR showed positive correlations with erythrocyte sedimentation rate (ESR) (NLR, r=0.5048; P< 0.0001; PLR, r=0.3489; P=0.0012). Conclusion: Combination NLR and PLR in peripheral blood had a high diagnostic value to identify RA. Moreover, the value of NLR and PLR positively correlated with ESR can help us to estimate the severity of RA.