Title:Neutrophil-lymphocyte, Lymphocyte-monocyte, and Platelet-lymphocyte Ratios: Non-invasive Biomarkers for Assessing Inflammatory Bowel Disease Activity
Volume: 19
Issue: 3
Author(s): Dhruvkumar M. Patel, Dhara K. Patel, Maitri M. Patel, Lalitkumar B. Patel, Ronak T. Shaikh, Neha T. Shaikh and Mukundkumar V. Patel*
Affiliation:
- Department of Medicine, Annaya College of
Medicine and Research, Gujarat University, Gujarat, India
Keywords:
Neutrophil-lymphocyte ratio, lymphocyte-monocyte ratio, platelet-lymphocyte ratio, inflammatory markers, inflammatory bowel disease, Crohn's disease, ulcerative colitis.
Abstract:
Background: Inflammatory bowel diseases (IBD) necessitate cost-effective biomarkers
for efficient management. This study aimed to explore the potential correlations of neutrophil-to--
lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio
(PLR) with IBD disease activity. Additionally, we assessed their associations with other inflammatory
markers.
Methods: We recruited 180 IBD patients with over 12 months of disease duration, categorized into
two groups: Group 1 (active IBD) with 113 cases and Group 2 (inactive IBD) with 67 cases,
alongside 200 group-matched healthy controls (Group 3). Hemogram, NLR, LMR, PLR, hs-CRP,
ESR, fecal calprotectin (FC), and relevant parameters were recorded.
Results: NLR and PLR were elevated, while LMR was decreased in active IBD patients compared
to those in remission. The cutoff values for active IBD were determined as NLR > 1.98, LMR <
3.01, and PLR > 147, exhibiting sensitivity of 92%, 88%, and 91%, and specificity of 93%, 87%,
and 89% respectively. Optimal cutoff values for IBD disease activity were CRP > 9.71, ESR > 24,
and FC > 176. Multivariate logistic regression identified NLR, LMR, and PLR as robust parameters
for discriminating IBD disease activity after adjusting for WBC, CRP, ESR, and FC markers
(p < 0.05). NLR and PLR exhibited proportional increases with IBD severity, while LMR lacked
such predictive capability.
Conclusion: NLR, PLR, and LMR emerge as simple, non-invasive, and cost-effective independent
markers of IBD disease activity, complementing traditional markers like CRP and ESR.
