Department of Medicine, University of Cyprus Medical School, Nicosia, Cyprus.
Department of Medicine, University of Patras School of Health Sciences, Patras, Greece.
Rheumatol Int. 2023 Oct;43(10):1841-1848. doi: 10.1007/s00296-023-05381-8. Epub 2023 Jul 5.
The neutrophil-to-lymphocyte ratio (NLR) emerged as a potential biomarker in SLE, but its association with several outcomes remains unclear. We aimed to evaluate the relationship between NLR and SLE disease activity, damage, depression, and health-related quality of life. A cross-sectional study was conducted, including 134 patients with SLE who visited the Division of Rheumatology between November 2019 and June 2021. Demographics and clinical data including NLR, Safety of Estrogens in Lupus Erythematosus National Assessment-Systemic Lupus disease activity index (SELENA-SLEDAI), Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI), physician global assessment (PhGA), patient global assessment (PGA), patient health questionnaire (PHQ)-9, patient self-rated health, and lupus quality of life (LupusQoL) scores, were collected. Patients were stratified into two groups and compared using the NLR cut-off of 2.73, the 90th percentile value of healthy individuals. The analysis included t-test for continuous variables, χ-test for categorical variables, and logistic regression adjusting for age, sex, BMI, and glucocorticoid use. Among the 134 SLE patients, 47 (35%) had an NLR ≥ 2.73. The NLR ≥ 2.73 group had significantly higher rates of severe depression (PHQ ≥ 15), poor/fair self-rated health, and the presence of damage (SDI ≥ 1). These patients also scored significantly lower in LupusQoL domains (physical health, planning, and body image), and higher in SELENA-SLEDAI, PhGA, and PGA. Logistic regression confirmed that high NLR is associated with severe depression (PHQ ≥ 15) (OR:7.23, 2.03-25.74), poor/fair self-rated health (OR:2.77,1.29-5.96), high SELENA-SLEDAI score(≥ 4) (OR:2.22,1.03-4.78), high PhGA (≥ 2) (OR:3.76, 1.56-9.05), and presence of damage (SDI ≥ 1) (OR:2.67, 1.11-6.43). High NLR in SLE may indicate depression, worse quality of life, active disease, and the presence of damage.
中性粒细胞与淋巴细胞比值（NLR）作为系统性红斑狼疮（SLE）的潜在生物标志物而出现，但它与多种结局的关系仍不清楚。我们旨在评估 NLR 与 SLE 疾病活动、损伤、抑郁和健康相关生活质量之间的关系。进行了一项横断面研究，纳入了 2019 年 11 月至 2021 年 6 月间在风湿科就诊的 134 例 SLE 患者。收集了人口统计学和临床数据，包括 NLR、红斑狼疮活动评估-系统性红斑狼疮疾病活动指数（SELENA-SLEDAI）、系统性红斑狼疮国际合作临床/美国风湿病学会损伤指数（SDI）、医生总体评估（PhGA）、患者总体评估（PGA）、患者健康问卷（PHQ-9）、患者自评健康状况和狼疮生活质量（LupusQoL）评分。患者分为两组，使用健康个体 NLR 第 90 百分位数（2.73）作为 NLR 截断值进行比较。分析包括连续变量的 t 检验、分类变量的卡方检验和调整年龄、性别、BMI 和糖皮质激素使用的逻辑回归。在 134 例 SLE 患者中，47 例（35%）的 NLR≥2.73。NLR≥2.73 组严重抑郁（PHQ≥15）、自评健康状况差/差和存在损伤（SDI≥1）的发生率明显更高。这些患者的 LupusQoL 各领域评分（生理健康、计划和身体形象）也明显较低，SELENA-SLEDAI、PhGA 和 PGA 评分较高。逻辑回归证实，高 NLR 与严重抑郁（PHQ≥15）（OR：7.23，2.03-25.74）、自评健康状况差/差（OR：2.77，1.29-5.96）、SELENA-SLEDAI 评分较高（≥4）（OR：2.22，1.03-4.78）、PhGA 较高（≥2）（OR：3.76，1.56-9.05）和存在损伤（SDI≥1）（OR：2.67，1.11-6.43）相关。SLE 中的高 NLR 可能提示抑郁、生活质量较差、疾病活动度高和存在损伤。
