Division of Rheumatology, Department of Medicine, University of the Philippines - Philippine General Hospital, Taft Avenue, Ermita, 1000, Manila, Philippines.
Division of Hematology, Department of Medicine, University of the Philippines - Philippine General Hospital, Manila, Philippines.
Rheumatol Int. 2020 Oct;40(10):1631-1637. doi: 10.1007/s00296-020-04685-3. Epub 2020 Aug 19.
Red cell distribution width (RDW) and neutrophil-lymphocyte ratio (NLR) are potential low-cost markers for detecting rheumatoid arthritis (RA) disease activity, but evidence on their accuracy for this purpose is conflicting. We aimed to determine the relationship between these and the Disease Activity Score of 28 joints (DAS-28) among Filipino RA patients, and to evaluate their ability to discriminate between patients with active RA and those in remission. This was a cross-sectional study done through a 7-year review of medical records of 134 adult patients with RA in a tertiary government hospital. Correlations were analyzed using Spearman analysis, and the receiver operating characteristic (ROC) curve was used to derive the sensitivity, specificity, and optimal cut-off values of RDW and NLR. Most patients were females with a mean disease duration of 7 years. Eighty-one percent (81%) had active disease using DAS-28 ESR. A weak positive correlation was found between NLR and DAS-28 and between NLR and ESR, but RDW did not correlate with either DAS-28 or ESR. The ROC analysis showed that in the differentiation of active RA and inactive RA, both RDW (area under the curve [AUC] 0.516, cut-off of ≥ 14.2% with 55.6% sensitivity and 42.3% specificity) and NLR (AUC 0.629, cut-off of ≥ 2.32 with 54.6% sensitivity and 76.9% specificity) had poor performance. NLR, but not RDW, was positively but weakly correlated with DAS-28 and ESR, making it a helpful marker of disease activity and inflammation in RA. Both NLR and RDW had low sensitivity and specificity for active RA and may not be useful in detecting disease activity.
红细胞分布宽度（RDW）和中性粒细胞与淋巴细胞比值（NLR）是检测类风湿关节炎（RA）疾病活动的潜在低成本标志物，但关于它们在这方面的准确性的证据存在争议。我们的目的是确定这些标志物与菲律宾 RA 患者的 28 个关节疾病活动评分（DAS-28）之间的关系，并评估它们区分活动期 RA 患者和缓解期患者的能力。这是一项横断面研究，通过对一家三级政府医院的 134 名成年 RA 患者的病历进行为期 7 年的回顾性分析。使用 Spearman 分析进行相关性分析，使用受试者工作特征（ROC）曲线得出 RDW 和 NLR 的灵敏度、特异性和最佳截断值。大多数患者为女性，平均病程为 7 年。81%（81%）的患者根据 DAS-28 ESR 确定为疾病活动期。NLR 与 DAS-28 之间以及 NLR 与 ESR 之间存在弱正相关，但 RDW 与 DAS-28 或 ESR 均无相关性。ROC 分析显示，在区分活动期 RA 和非活动期 RA 时，RDW（曲线下面积 [AUC] 0.516，截断值≥14.2%，灵敏度为 55.6%，特异性为 42.3%）和 NLR（AUC 0.629，截断值≥2.32，灵敏度为 54.6%，特异性为 76.9%）的性能均较差。NLR 与 DAS-28 和 ESR 呈正相关，但相关性较弱，表明其是 RA 疾病活动和炎症的有用标志物。NLR 和 RDW 对活动期 RA 的灵敏度和特异性均较低，可能无法用于检测疾病活动。
