Elevated neutrophil-lymphocyte ratio in patients with euthyroid chronic autoimmune thyreotidis

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Abstract

Objective. The neutrophil-lymphocyte ratio (NLR), determined from peripheral blood, is accepted as an available and practical indicator of the systemic inflammation. In this study, we aimed to determine whether the NLR was higher in euthyroid chronic autoimmune thyreotidis (CAT) patients compared to a healthy control group.

Methods. A total of 112 patients were enrolled in this study, including 59 patients with euthyroid CAT on any form of therapy and 53 healthy controls. Th e CAT patients were similar in age to the healthy control group (mean 33.9±12.8 years versus 30.2±12.4 years, p=0.10). Measurements were available for the white blood cells (WBC), neutrophils, lymphocytes, platelets, C-reactive protein (CRP), thyroid peroxidase immune antibody (anti-TPO), and anti-thyroglobulin immune antibody (anti-TG). The NLR and platelet-lymphocyte ratio (PLR) were calculated. Differences between the CAT and control groups were tested using the student’s t-test and the correlations were determined using Pearson’s correlation coefficients.

Results. There were no differences between the CAT and control groups for WBCs (7.9±0.3 and 7.4±0.2, respectively; p=0.1) or neutrophils (5.5±0.3 and 5.4±1.1; p=0.9), but lymphocytes were higher in the CAT group (3.1±0.5 vs. 2.04±0.1; p=0.05) as was the NLR (4.0±0.7 vs. 2.0±0.1; p=0.01). Th e NLR was positively correlated with CRP (r=0.6, p<0.001), anti-TPO (r=0.3, p<0.001), anti-TG (r=0.3, p=0.006), WBCs (r=0.4, p<0.001), and the PLR (r=0.73, p<0.001). The PLR was also higher in the CAT than the control group (p=0.02).

Conclusions. In this study, we found that NLR values were higher in euthyroid CAT patients than in a healthy control group and that NLR correlated with autoantibodies used to diagnose the disease.

Ahsen A, Ulu MS, Yuksel S, Demir K, Uysal M, Erdogan M, Acarturk G. As a new inflammatory marker for familial Mediterranean fever: neutrophil-to-lymphocyte ratio. Inflammation 36, 1357-1362, 2013.

Ansar W, Ghosh S. C-reactive protein and the biology of disease. Immunol Res 56, 131-142, 2013.

Bhat T, Teli S, Rijal J, Bhat H, Raza M, Khoueiry G, Meghani M, Akhtar M, Costantino T. Neutrophil to lymphocyte ratio and cardiovascular diseases: a review. Expert Rev Cardiovasc Th er 11, 55-59, 2013.

Boilard E, Nigrovic PA, Larabee K, Watts GF, Coblyn JS, Weinblatt ME, Massarotti EM, Remold-O’Donnell E, Farndale RW, Ware J, Lee DM. Platelets amplify inflammation in arthritis via collagen-dependent microparticle production. Science 327, 580-583, 2010.

Celikbilek M, Dogan S, Ozbakır O, Zararsız G, Kucuk H, Gursoy S, Yurci A, Guven K, Yucesoy M. Neutrophil lymphocyte ratio as a predictor of disease severity in ulcerative colitis. J Clin Lab Anal 27, 72-76, 2013.

Cho JS, Park MH, Ryu YJ, Yoon YH. The neutrophil to lymphocyte ratio can discriminate anaplastic thyroid cancer against poorly or well differentiated cancer. Ann Surg Treat Res 88, 187-192, 2015.

Choi JL, Li S, Han JY. Platelet function tests: a review of progresses in clinical application. Biomed Res Int 456569, 2014.

Deng Q, He B, Liu X, Yue J, Ying H, Pan Y, Sun H, Chen J, Wang F, Gao T, Zhang L, Wang S. Prognostic value of preoperative inflammatory response biomarkers in gastric cancer patients and the construction of a predictive model. J Transl Med 13, 66, 2015.

Feng JF, Huang Y, Chen QX. Preoperative platelet lymphocyte ratio (PLR) is superior to neutrophil lymphocyte ratio (NLR) as a predictive factor in patients with esophageal squamous cell carcinoma. World J Surg Oncol 12, 58, 2014.

Guthrie GJ, Charles KA, Roxburgh CS, Horgan PG, McMillan DC, Clarke SJ. The systemic inflammation-based neutrophil-lymphocyte ratio: experience in patients with cancer. Crit Rev Oncol Hematol 88, 218-230, 2013.

Italiano JE Jr, Mairuhu AT, Flaumenhaft R. Clinical relevance of microparticles from platelets and megakaryocytes. Curr Opin Hematol 17, 578-84, 2010.

Jaillon S, Galdiero MR, Del Prete D, Cassatella MA, Garlanda C, Mantovani A. Neutrophils in innate and adaptive immunity. Semin Immunopathol 35, 377-94, 2013.

Kaplan MJ. Role of neutrophils in systemic autoimmune diseases. Arthritis Res Ther 15, 219-228, 2013.

Kaya A, Kurt M, Tanboga HI, Isik T, Gunaydin ZY, Kaya Y, Topcu S, Sevimli S. Relation of neutrophil to lymphocyte ratio with the presence and severity of stable coronary artery disease. Clin Appl Th romb Hemost 20, 473-477, 2014.

Kemal Y, Yucel I, Ekiz K, Demirag G, Yilmaz B, Teker F, Ozdemir M. Elevated serum neutrophil to lymphocyte and platelet to lymphocyte ratios could be useful in lung cancer diagnosis. Asian Pac J Cancer Prev 15, 2651-2654, 2014.

Moodley D, Mody GM, Chuturgoon AA. Initiation but no execution - modulation of peripheral blood lymphocyte apoptosis in rheumatoid arthritis - a potential role for heat shock protein 70. J Infl amm (Lond) 8, 30, 2011.

Poplawska-Kita A, Kosciuszko-Zdrodowska M, Siewko K, Telejko B, Hryniewicka J, Milewski R, Abdelrazek SS, Szelachowska M, Gorska M. High serum Ig G4 concentrations in patients with Hashimoto’s Th yroiditis. Int J Endocrinol 2015, 706843, 2015.

Rao NL, Shetty S, Upadhyaya K, Prasad RM, Lobo EC, Kedilaya HP, Prasad G. Salivary C-Reactive Protein in Hashimoto’s Th yroiditis and Subacute Th yroiditis. Int J Inflam 2010, 514659, 2010.

Rifaioglu EN, Sen BB, Ekiz O, Dogramaci AC. Neutrophil to lymphocyte ratio in Behcet’s disease as a marker of disease activity. Acta Dermatovenerol APA 23, 65-67, 2014.

Rowe IF, Deans AC. Serum C-reactive protein measurement in pyoderma gangrenosum. Dermatologica 173, 216-219, 1986.

Sahin S, Sarikaya S, Alcelik A, Erdem A, Tasliyurt T, Akyol L, Altunkas F, Aktas G, Karaman K. Neutrophils to lymphocyte ratio is a useful predictor of atrial fi brillation in patients with diabetes mellitus. Acta Medica Mediterranea 29, 847-851, 2013.

Sen BB, Rifaioglu EN, Ekiz O, Inan MU, Sen T, Sen N. Neutrophil to lymphocyte ratio as a measure of systemic infl ammation in psoriasis. Cutan Ocul Toxicol 33, 223-227, 2014.

Semple JW, Freedman J. Platelets and innate immunity. Cell Mol Life Sci 67, 499-511, 2010.

Sprague DL, Elzey BD, Crist SA, Waldschmidt TJ, Jensen RJ, Ratliff TL. Platelet-mediated modulation of adaptive immunity: unique delivery of CD154 signal by platelet-derived membrane vesicles. Blood 111, 5028-5036, 2008.

Turner D, Mack DR, Hyams J, LeLeiko N, Otley A, Markowitz J, Kasirer Y, Muise A, Seow CH, Silverberg MS, Crandall W, Griffiths AM. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) or both? A systematic evaluation in pediatric ulcerative colitis. J Crohns Colitis 5, 423-429, 2011.

Uslu AU, Kucuk A, Sahin A, Ugan Y, Yilmaz R, Gungor T, Bagdaci S, Kucuksen S. Two new inflammatory markers associated with Disease Activity Score-28 in patients with rheumatoid arthritis: neutrophil-lymphocyte ratio and platelet-lymphocyte ratio. Int J Rheum Dis 18, 731-735, 2015.

Wang J, Arase H. Regulation of immune responses by neutrophils. Ann N Y Acad Sci 1319, 66-81, 2014.

Yao Y, Simard AR, Shi FD, Hao J. IL-10-producing lymphocytes in inflammatory disease. Int Rev Immunol 32, 324-336, 2013

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