The association between the lymphocyte-monocyte ratio and disease activity in rheumatoid arthritis
The association between the lymphocyte-monocyte ratio and disease activity in rheumatoid arthritis
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DOI：
10.1007/s10067-017-3815-2
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发表时间：
2017-12-01
影响因子：
3.4
通讯作者：
Li, Jun
中科院分区：
文献类型：
--
作者：
Du, Juping;Chen, Shuaishuai;Li, Jun
淋巴细胞-单核细胞比率（LMR）是用于预测疾病发展、进展和存活的全身炎症标志物。最近，一项全基因组关联研究确定了ITGA 4和HLA-DRB 1中影响LMR水平的遗传变异，并被广泛认为是包括类风湿性关节炎（RA）在内的自身免疫性疾病的易感基因。然而，LMR在RA患者中的作用仍不清楚。采用二元logistic回归分析比较66例RA患者、163例骨关节炎（OA）患者和131例健康对照（HC）的LMR水平和其他实验室数据。使用斯皮尔曼秩检验测量LMR与疾病活动度和其他炎症标志物之间的相关性。ROC曲线分析评估了LMR对RA的诊断准确性。RA患者的LMR和淋巴细胞计数显著低于HC组/OA患者，而单核细胞计数显著高于HC组/OA患者（p < 0.01）。LMR降低与疾病活动性增加相关（p = 0.012）。此外，DAS 28和传统炎症标志物，包括ESR，CRP，RDW，PLR和NLR，以及免疫相关因子，如C4，伊加和IgM，与LMR呈负相关，而血红蛋白和白蛋白与LMR呈正相关。ROC曲线显示LMR曲线下面积为0.705（95%CI = 0.630-0.781）。其特异性和敏感性分别为82.82%和45.45%。本研究表明，LMR是一种重要的炎症标志物，可用于识别RA患者的疾病活动性和区分RA与OA患者。
The lymphocyte-monocyte ratio (LMR) is a systemic inflammatory marker for prediction of disease development, progress, and survival. Recently, a genome-wide association study identified genetic variations in ITGA4 and HLA-DRB1 that affect the LMR levels and were widely believed to be susceptibility genes for autoimmune diseases, including rheumatoid arthritis (RA). However, the role of LMR in RA patients remains unclear. The LMR level and other laboratory data of 66 RA patients, 163 osteoarthritis (OA) patients, and 131 healthy controls (HC) were compared using binary logistic regression. The correlations between LMR and disease activity and other inflammatory markers were measured using the Spearman rank test. ROC curve analyses assessed the diagnostic accuracy of LMR in RA. The LMR and lymphocyte count were significantly lower in RA patients, whereas the monocyte count was significantly higher relative to the HC group/OA patients (p < 0.01). A decreased LMR has been associated with increased disease activity (p = 0.012). In addition, the DAS28 and traditional inflammatory markers, including ESR, CRP, RDW, PLR, and NLR, and immune-related factors, such as C4, IgA, and IgM, were inversely correlated with LMR, while hemoglobin and albumin were positively correlated with LMR. The ROC curve showed that the area under the curve of LMR was 0.705 (95%CI = 0.630-0.781). The corresponding specificity and sensitivity were 82.82 and 45.45%, respectively. The present study shows that the LMR is an important inflammatory marker which could be used to identify disease activity in RA patients and to distinguish RA from OA patients.