NEUTROPHIL-TO-LYMPHOCYTE RATIO IN INFLAMMATORY BOWEL DISEASE – A MARKER OF DISEASE ACTIVITY

Jinsha K. A, Premkumar K, A. R Venkateswaran

Abstract


Introduction: The neutrophil-to-lymphocyte ratio (NLR) is a marker of subclinical inflammation already used to determine outcomes in coronary artery disease and some malignancies. However, it is not clear whether the NLR is a useful and simple indicator of clinical activity in inflammatory bowel disease.

Aim: The purpose of this study is to investigate the utility of neutrophil-to-lymphocyte ratio (NLR) as a simple and readily available predictor for clinical disease activity in inflammatory bowel disease (IBD).

Methodology: 104 (36 with Crohn’s Disease and 68 with Ulcerative colitis) and 48 healthy controls were included in the study. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) levels and complete blood count (CBC) were measured. The neutrophil and lymphocyte counts were recorded and NLR was calculated. The patients with active or inactive Ulcerative Colitis (UC) and Crohn’s Disease (CD) were classified according to the severity of the disease.

Results: The mean NLR values of active CD patients were significantly higher than those of inactive CD patients (5.68±1.62 vs 1.56±0.62, p 0.000). Mean NLR values of active UC patients were significantly higher than those of inactive UC patients (4.38±1.12 vs 1.4±0.12 0.45, p = 0.000).             The optimum NLR cut-off point for active CD was 2.9 with a sensitivity, specificity, PPV and NPV of 83%, 68%, 90%, and 78%, respectively (AUC – 0.780). NLR cut-off point for active UC was 2.72 with a sensitivity, specificity, PPV and NPV of 79%, 67%, 86%, and 62%, respectively (AUC – 0.730).

Conclusion: The NLR might be effective, readily available, and low-cost markers for assessing activity in inflammatory bowel disease patients.


Keywords


Neutrophil-to-lymphocyte ratio, NLR, C-reactive protein, CRP, Erythrocyte sedimentation rate, ESR, Inflammatory bowel disease, IBD

Full Text:

 Subscribers Only

Refbacks

  • There are currently no refbacks.