Mercader-Salvans Júlia, García-González María, Quevedo-Abeledo Juan C, Quevedo-Rodríguez Adrián, Romo-Cordero Alejandro, Ojeda-Bruno Soledad, Gómez-Bernal Fuensanta, López-Mejías Raquel, Martín-González Candelaria, González-Gay Miguel Á, Ferraz-Amaro Iván
Division of Dermatology, Hospital Universitario de Canarias, 38320 Tenerife, Spain.
Division of Rheumatology, Hospital Universitario de Canarias, 38320 Tenerife, Spain.
Biomedicines. 2023 Oct 13;11(10):2782. doi: 10.3390/biomedicines11102782.
Complete blood count-derived ratios have been described as inflammatory biomarkers in several diseases. These hematological scores include the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammatory index ([SIRI]; neutrophils × monocytes/lymphocytes). Our aim was to study how these biomarkers are related to disease expression in a large and well-characterized series of patients with systemic lupus erythematosus (SLE). A total of 284 SLE patients and 181 age- and sex-matched healthy controls were recruited. The NLR, MLR, PLR, and SIRI were calculated, and activity (SLEDAI-2K), severity (Katz), and damage index (SLICC-DI) scores were assessed in patients with SLE. Multivariable linear regression analysis was performed to study whether these scores differ between patients and controls and how they are related to clinical and laboratory features of the disease. Crude cell counts of neutrophils, monocytes, lymphocytes, and platelets were lower in SLE patients compared to controls. Despite this, NLR, MLR, and PRL, but not SIRI, were higher in SLE patients than in controls after multivariable analysis. However, the relationship between the different scores and disease characteristics was limited. Only the Katz severity index revealed a significant positive relationship with SIRI, NLR, and MLR after adjustment for covariates. Similarly, alternative complement cascade activation and low C3 were significantly associated with higher NLR, MLR, and PLR. In conclusion, although cytopenias are a common feature of patients with SLE, hematologic composite scores are independently higher in this population compared to controls. However, the relationship of these scores with the characteristics of the disease is scarce, with the relationship with the complement system being the most consistent.
全血细胞计数衍生比值已被描述为多种疾病中的炎症生物标志物。这些血液学指标包括中性粒细胞与淋巴细胞比值（NLR）、单核细胞与淋巴细胞比值（MLR）、血小板与淋巴细胞比值（PLR）以及全身免疫炎症指数（[SIRI]；中性粒细胞×单核细胞/淋巴细胞）。我们的目的是研究这些生物标志物在一大组特征明确的系统性红斑狼疮（SLE）患者中与疾病表现的关系。共招募了284例SLE患者和181例年龄及性别匹配的健康对照。计算了NLR、MLR、PLR和SIRI，并对SLE患者的活动度（SLEDAI - 2K）、严重程度（Katz）和损伤指数（SLICC - DI）评分进行了评估。进行多变量线性回归分析以研究这些指标在患者和对照之间是否存在差异，以及它们与疾病的临床和实验室特征的关系。与对照组相比，SLE患者中性粒细胞、单核细胞、淋巴细胞和血小板的原始细胞计数较低。尽管如此，多变量分析后，SLE患者的NLR、MLR和PRL高于对照组，但SIRI并非如此。然而，不同指标与疾病特征之间的关系有限。调整协变量后，只有Katz严重程度指数与SIRI、NLR和MLR呈显著正相关。同样，替代补体级联激活和低C3与较高的NLR、MLR和PLR显著相关。总之，虽然血细胞减少是SLE患者的常见特征，但与对照组相比，该人群的血液学综合指标独立升高。然而，这些指标与疾病特征的关系较少，与补体系统的关系最为一致。
