Taşoğlu Özlem, Bölük Hüma, Şahin Onat Şule, Taşoğlu İrfan, Özgirgin Neşe
Department of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Education and Research Hospital, Sıhhıye, Ankara, Turkey.
Department of Cardiovascular Surgery, Ankara Yüksek İhtisas Education and Research Hospital, Ankara, Turkey.
Clin Rheumatol. 2016 Jun;35(6):1579-83. doi: 10.1007/s10067-016-3170-8. Epub 2016 Jan 16.
Knee osteoarthritis (OA) is one of the most common forms of joint disease, affecting an increasing number of people worldwide. Latest data suggests that inflammation plays a critical role in the pathogenesis of OA. There are a number of inflammatory markers like cytokins and cartilage degradation products that can be used as indicators in OA. Blood neutrophil-lymphocyte ratio (NLR) is a simple non-invasive and cost-effective marker of inflammation in various systemic diseases, but it has not been investigated in OA yet. The aim of the present study was to compare blood NLR levels in patients with severe - Kellgren and Lawrence (KL) grade 4 - knee OA and mild to moderate - KL grades 1-3 - knee OA. A total of 176 patients with knee OA were included in this cross-sectional study. KL grading was done according to the two-view (antero-posterior and lateral) plain radiography of both knees. Demographic characteristics, blood neutrophil, lymphocyte and platelet counts, erythrocyte sedimentation rate, and C-reactive protein were recorded. Blood NLR levels were calculated. In the severe knee OA group, blood NLR levels were found to be elevated as compared to the mild to moderate knee OA group. A blood NLR of ≥2.1 was taken as the cutoff based upon the receiver operating characteristics (roc). In the roc curve analysis, blood NLR ≥ 2.1 had 50 % sensitivity and 77 % specificity in predicting severe knee OA. In multivariate analysis, age and blood NLR ≥ 2.1 emerged as independent predictors of severe knee OA. The results of the present study, for the first time in the literature, suggests blood NLR as a novel and promising inflammatory marker indicating the severity of knee OA.
膝骨关节炎（OA）是最常见的关节疾病形式之一，全球受其影响的人数日益增加。最新数据表明，炎症在OA的发病机制中起关键作用。有许多炎症标志物，如细胞因子和软骨降解产物，可作为OA的指标。血液中性粒细胞与淋巴细胞比值（NLR）是各种全身性疾病中一种简单、无创且经济有效的炎症标志物，但尚未在OA中进行研究。本研究的目的是比较重度——凯尔格伦和劳伦斯（KL）4级——膝OA患者与轻度至中度——KL 1 - 3级——膝OA患者的血液NLR水平。本横断面研究共纳入176例膝OA患者。根据双膝的前后位和侧位平片进行KL分级。记录人口统计学特征、血液中性粒细胞、淋巴细胞和血小板计数、红细胞沉降率和C反应蛋白。计算血液NLR水平。与轻度至中度膝OA组相比，重度膝OA组的血液NLR水平升高。根据受试者工作特征（roc）曲线，将血液NLR≥2.1作为临界值。在roc曲线分析中，血液NLR≥2.1在预测重度膝OA时具有50%的敏感性和77%的特异性。在多变量分析中，年龄和血液NLR≥2.1是重度膝OA的独立预测因素。本研究结果在文献中首次表明，血液NLR是一种新型且有前景的炎症标志物，可指示膝OA的严重程度。
