Hematological Markers Associated withRheumatoid Arthritis among Yemeni Patients inSana’a City: A Case- Control Study
Background: Rheumatoid arthritis (RA) is characterized by chronic inflammation and immune dysregulation affecting the hematopoietic system through multiple factors. Various inflammatory hematological markers, such as the neutrophil-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic immune response index (SIRI), represent systemic inflammation and balance of the immune response.
Objective: This case-control study aimed to evaluate and compare the clinical utility of these novel, inflammatory ratios among Yemeni patients with rheumatoid arthritis.
Methods: 200 participants were enrolled in our study, including 100 cases with RA and 100 healthy controls. Peripheral blood samples were obtained from each participant for CBC and serological tests. The NLR, LMR, PLR, NMR, SIRI, and SII were calculated. A receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic value of RA.
Results: NLR, PLR, NMR, SIRI, and SII were significantly elevated in patients with rheumatoid arthritis, whereas LMR was significantly reduced compared with healthy controls (p < 0.05). Spearman’s rho showed that the NLR (r = .242, P = 0.015; r = 0.224, P = 0.025), PLR (r = 0.425, P < .001; r = 0.360, P < 0.001), and SII (r = 0.298, P = 0.003; r = 0.303, P = 0.002) were positively correlated with both ESR and anti-CCP, while NMR (r = 0.243, P =
0.015) was only positively correlated with ESR. The AUC for SIRI equals to 0.658, NLR (AUC = 0.647), SII (AUC = 0.617), and PLR (AUC = 0.614) are statistically significant but modest discriminative power between patients with RA and healthy controls.
Conclusions: NLR, PLR, SIRI, and SII were significantly higher in RA patients than in control participants while LMR was significantly lower in RA patients. NLR, PLR, and SII were positively correlated with both ESR and anti-CCP, while NMR was only positively correlated with ESR. Therefore, these may be used as complementary diagnostic indicators in the diagnosis of RA, as they are simple, inexpensive, and objective markers. Further studies with larger sample sizes and extended follow-ups are warranted.
المقاييس
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