Work

The neutrophil-to-lymphocyte ratio as a surrogate marker for disease activity in systemic lupus erythematosus: a correlation study using the SLE-DAS

Year: 2025

Type: article

Abstract: Background: The neutrophil-to-lymphocyte ratio (NLR) is a potential surrogate marker for disease activity in many rheumatic diseases. Objective: To study the correlation between NLR and disease activity of systemic lupus erythematosus (SLE) using the SLE disease activity score (SLE-DAS). Design: Retrospective, cross-sectional. Methods: Consecutive adult patients who fulfilled the American College of Rheumatology (ACR) or Systemic Lupus International Collaboration Clinic (SLICC) criteria for SLE were recruited between March 2023 and February 2024. SLE activity was assessed by physicians’ global assessment (PGA), SLE-DAS, and SLE disease activity index-2000 (SLEDAI-2K). The calculated NLR was correlated with disease activity indices and serological parameters (anti-dsDNA, C3/4) by Spearman’s rank correlation. Patients were stratified into SLE-DAS remission, mild, and moderate/severe disease activity, and a comparison of the NLR was performed among these subgroups by one-way ANOVA. Results: A total of 420 SLE patients were studied (93.1% women, age 31.6 ± 13.1 years, SLE duration 15.7 ± 8.1 years). Moderate/severe, mild disease activity and SLE-DAS remission were present in 70 (16.7%), 65 (15.5%), and 285 (67.9%) patients, respectively. SLE-DAS correlated significantly with SLEDAI-2K (rho 0.90; p < 0.001) and PGA (rho 0.60; p < 0.001). The mean NLR of all patients was 3.54 ± 4.0 and NLR correlated significantly with SLE-DAS (rho 0.17; p < 0.001). The NLR was significantly higher in patients with active disease in the SLE-DAS renal domain than those in remission (5.17 ± 7.11 vs 3.22 ± 3.19; p = 0.03). The NLR in patients with moderate/severe SLE-DAS activity (5.25 ± 6.89) was significantly higher than those with mild activity (3.12 ± 2.26; p < 0.01) or remission (3.22 ± 3.19; p < 0.01). ROC analysis showed that an NLR cut-off of 3.11 showed a sensitivity of 55.6% and specificity of 68.7% in detecting moderate/severe SLE-DAS activity (area under the curve 0.67 (0.6–0.7); p < 0.001). Conclusion: The NLR is a convenient marker that correlates significantly with disease activity in SLE.

Source: Therapeutic Advances in Musculoskeletal Disease

DOI: 10.1177/1759720x251347272

Authors: Mandy Ming Yan Wong, Fung Lam, Chi Chiu Mok

Institutions: Tuen Mun Hospital, Pok Oi Hospital

Language: English

Topic: Systemic Lupus Erythematosus Research

Subfield: Rheumatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,650