title: The Association Between Neutrophil/Lymphocyte Ratio and Disease Activity in Rheumatoid Arthritis and Ankylosing Spondylitis.
abstract: BACKGROUND
  Elevated neutrophil count is associated with poor prognosis and increased mortality in many conditions. Neutrophil to lymphocyte ratio (NLR) has emerged as a marker of inflammation in neoplastic and cardiovascular disorders. Herein, we investigated utility of this simple tool in rheumatoid arthritis (RA) and ankylosing spondylitis (AS).
  
  
  METHODS
  The study consisted of 136 RA and 140 AS patients, along with 117 healthy control subjects. RA and AS activities were determined with Disease Activity Score (DAS) and Bath Ankylosing Spondylitis Disease Activity indices (BASDAI), respectively. The association between NLR and disease activity was analyzed.
  
  
  RESULTS
  Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and neutrophil counts were significantly higher in RA and AS patients compared to healthy controls. Similarly, NLR was higher compared to control subjects, both in RA (2.53 ± 1.4 vs. 2.16 ± 1.0, P = 0.019) and AS (2.43 ± 1.4 vs. 2.16 ± 1.0, P = 0.077). NLR correlated well with ESR and CRP, both in RA and AS. Moreover, NLR increased across worsening DAS28 activity groups (2.1 ± 1.0 in patients with remission, 2.5 ± 1.0 in low-moderate, 3.8 ± 2.5 in high disease activity). However, no association was found between NLR and BASDAI.
  
  
  CONCLUSIONS
  NLR is a cheap and readily available marker for the assessment of disease activity in RA.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Gazi University Hospital, Ankara, Turkey. mercanridvan@hotmail.com.
authors.forename: Ridvan
authors.initials: R
authors.lastname: Mercan
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Gazi University Hospital, Ankara, Turkey.
authors.forename: Berivan
authors.initials: B
authors.lastname: Bitik
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Gazi University Hospital, Ankara, Turkey.
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Tufan
authors.affiliation: Department of Internal Medicine, Gazi University Hospital, Ankara, Turkey.
authors.forename: Utku Burak
authors.initials: UB
authors.lastname: Bozbulut
authors.affiliation: Department of Internal Medicine, Gazi University Hospital, Ankara, Turkey.
authors.forename: Nuh
authors.initials: N
authors.lastname: Atas
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Gazi University Hospital, Ankara, Turkey.
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Ozturk
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Gazi University Hospital, Ankara, Turkey.
authors.forename: Seminur
authors.initials: S
authors.lastname: Haznedaroglu
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Gazi University Hospital, Ankara, Turkey.
authors.forename: Berna
authors.initials: B
authors.lastname: Goker
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000097:blood*; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology*; D013167:Spondylitis, Ankylosing / Q000097:blood*; D018709:Statistics, Nonparametric; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein
keywords: ankylosing spondylitis; disease activity, neutrophil; neutrophil to lymphocyte ratio; rheumatoid arthritis