Wang Jing, Su Jinyu, Yuan Yuan, Jin Xiaxia, Shen Bo, Lu Guoguang
Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Road, Linhai, Taizhou, Zhejiang Province, China.
Department of Pharmacy, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, 150 Ximen Road, Linhai, Taizhou, Zhejiang Province, China.
BMC Musculoskelet Disord. 2021 Jan 16;22(1):86. doi: 10.1186/s12891-021-03973-8.
Axial spondyloarthritis (axial SpA) is a chronic inflammatory disorder could lead to disability due to the failure of timely treatment. The role of lymphocyte-to-monocyte ratio (LMR) in axial SpA remains unclear. The aim of this study was to investigate the role of LMR in axial SpA diagnosis, disease activity classification and sacroiliitis staging.
Seventy-eight axial SpA patients [51males and 27 females; mean age 41.0 (29-52) years] and 78 healthy controls (HCs) [55males and 23 females; mean age 40 (30-53) years] were enrolled in this study. The diagnosis of axial SpA was performed according to the New York criteria or the Assessment of Spondyloarthritis international Society (ASAS) classification criteria, whereas the staging of sacroiliitis in axial SpA patients was determined by X-ray examination. Comparisons of LMR levels between groups were performed using t test. Pearson or Spearman correlation analysis were used to assess correlations between LMR and other indicators. Receiver operating characteristic (ROC) curves were used to determine the role of LMR in the diagnosis of axial SpA.
Higher neutrophil-to-lymphocyte ratio(NLR), red blood cell distribution width(RDW), platelet-to-lymphocyte ratio(PLR), mean platelet volume(MPV), erythrocyte sedimentation rate (ESR), and C-reactive protein(CRP) levels and lower red blood cell (RBC), hemoglobin (Hb), Hematocrit (Hct), LMR, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and albumin/globulin (A/G) levels were noted in axial SpA patients compared to HCs. Positive correlations were observed between LMR and RBC, Hb, Hct and A/G, whereas negative correlations were found between LMR and NLR, PLR, AST, and TBIL (P < 0.05). ROC curves showed that the area under the curve (AUC) for LMR in the diagnosis of ankylosing spondylitis was 0.803 (95% CI = 0.734-0.872) with a sensitivity and specificity of 62.8 and 87.2%, respectively, and the AUC (95% CI) for the combination of ESR, CRP and LMR was 0.975 (0.948-1.000) with a sensitivity and specificity of 94.9 and 97.4%, respectively. LMR levels were lower (P < 0.05) and significant differences in LMR values were observed among different stages (P < 0.05).
Our study suggested that LMR might be an important inflammatory marker to identify axial SpA and assess disease activity and X-ray stage of sacroiliitis.
轴性脊柱关节炎（axial SpA）是一种慢性炎症性疾病，若不及时治疗可能导致残疾。淋巴细胞与单核细胞比值（LMR）在轴性脊柱关节炎中的作用尚不清楚。本研究旨在探讨LMR在轴性脊柱关节炎诊断、疾病活动度分类和骶髂关节炎分期中的作用。
本研究纳入了78例轴性脊柱关节炎患者[51例男性和27例女性；平均年龄41.0（29 - 52）岁]和78例健康对照者（HCs）[55例男性和23例女性；平均年龄40（30 - 53）岁]。轴性脊柱关节炎的诊断依据纽约标准或国际脊柱关节炎评估协会（ASAS）分类标准，而轴性脊柱关节炎患者骶髂关节炎的分期通过X线检查确定。采用t检验比较组间LMR水平。使用Pearson或Spearman相关分析评估LMR与其他指标之间的相关性。采用受试者工作特征（ROC）曲线确定LMR在轴性脊柱关节炎诊断中的作用。
与健康对照者相比，轴性脊柱关节炎患者的中性粒细胞与淋巴细胞比值（NLR）、红细胞分布宽度（RDW）、血小板与淋巴细胞比值（PLR）、平均血小板体积（MPV）、红细胞沉降率（ESR）和C反应蛋白（CRP）水平较高，而红细胞（RBC）、血红蛋白（Hb）、血细胞比容（Hct）、LMR、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、总胆红素（TBIL）和白蛋白/球蛋白（A/G）水平较低。LMR与RBC、Hb、Hct和A/G呈正相关，而与NLR、PLR、AST和TBIL呈负相关（P < 0.05）。ROC曲线显示，LMR诊断强直性脊柱炎的曲线下面积（AUC）为0.803（95%CI = 0.734 - 0.872），敏感性和特异性分别为62.8%和87.2%，ESR、CRP和LMR联合检测的AUC（95%CI）为0.975（0.948 - 1.000），敏感性和特异性分别为94.9%和97.4%。LMR水平较低（P < 0.05），且在不同分期之间LMR值存在显著差异（P < 0.05）。
我们的研究表明，LMR可能是识别轴性脊柱关节炎以及评估疾病活动度和骶髂关节炎X线分期的重要炎症标志物。
