Evidence-Based Medicine Research Group, Mashhad University of Medical Sciences, Mashhad, Iran.
Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Curr Rheumatol Rev. 2022;18(2):160-167. doi: 10.2174/1573397117666210921114431.
Neutrophil to lymphocyte ratio (NLR) is a marker for many inflammatory diseases. Ankylosing spondylitis (AS) is among these inflammatory diseases, and many studies have compared the NLR ratio between patients with AS and healthy controls.
This study aims to systematically review and analyze the available evidence about the significance of NLR values in AS.
Based on Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines, we searched Embase, Pubmed, ISI Web of Science, and Scopus databases from inception to August 2020 using ("Ankylosing spondyl* " OR "Bechterew Disease" OR "Rheumatoid Spondylitis") AND ((neutrophil* AND lymphocyte*) OR NLR) as key terms of the search strategy. Data selection and extraction were conducted separately by two authors. We appraised the included articles according to the Joanna Briggs checklist. Comprehensive Meta-analysis Version 2 was used for analysis and assessment of publication bias. I2 > 75% and p-value < 0.05 were considered significant.
In total, 182 studies resulted from a search in all databases. Duplicate removal, title, abstract, and full-text screening yielded 12 related studies, with 11 included in the meta-analysis. Quality assessment was satisfying in all studies. Pooled difference in NLR means value between patients and controls was 0.38 (95% CI: 0.24-0.52, p-value <0.0001). An I2 of 51% and a Cochran Q test p-value of <0.05 indicated moderate heterogeneity; thus, subgroup analysis had no indication. Publication bias was not significant (Funnel plot with an Egger's intercept of -0.07; p-value=0.95).
Significant higher amounts of NLR may be strongly indicative of underlying inflammation in AS.
中性粒细胞与淋巴细胞比值（NLR）是许多炎症性疾病的标志物。强直性脊柱炎（AS）就是其中一种炎症性疾病，许多研究比较了 AS 患者和健康对照者的 NLR 比值。
本研究旨在系统回顾和分析 NLR 值在 AS 中的意义的现有证据。
根据观察性研究的荟萃分析（MOOSE）指南，我们使用“强直性脊柱炎”或“Bechterew 病”或“类风湿性脊柱炎”和（中性粒细胞和淋巴细胞或 NLR）作为搜索策略的关键词，从建库开始至 2020 年 8 月在 Embase、Pubmed、ISI Web of Science 和 Scopus 数据库中进行检索。数据选择和提取由两位作者分别进行。我们根据 Joanna Briggs 清单对纳入的文章进行评估。综合 Meta 分析版本 2 用于分析和评估发表偏倚。I2>75%和 p 值<0.05 被认为具有统计学意义。
总共从所有数据库中搜索到 182 项研究。通过重复去除、标题、摘要和全文筛选，得到 12 项相关研究，其中 11 项纳入荟萃分析。所有研究的质量评估均令人满意。患者和对照组 NLR 均值差值为 0.38（95%CI：0.24-0.52，p 值<0.0001）。I2 为 51%，Cochran Q 检验 p 值<0.05，表明存在中度异质性；因此，亚组分析没有指示。发表偏倚不显著（漏斗图 Egger 截距为-0.07；p 值=0.95）。
AS 中 NLR 值明显升高可能强烈提示存在潜在炎症。
