Predictive Value of Neutrophil Lymphocyte Ratio in Assessing Severity Grades of Knee Osteoarthritis : Neutrophil-Lymphocyte Ratio (NLR) an Indicator in Knee Osteoarthritis

Muhammad Waqar Arif; Ghulam Abbas Khan Niazi; Ahsan Amer; Wasim Ali; Sehr Zara Amir; Faizan Badar

doi:10.54393/pjhs.v5i07.1396

Authors

Muhammad Waqar Arif Department of General Medicine, Pak Emirates Military Hospital, Rawalpindi, Pakistan
Ghulam Abbas Khan Niazi Department of Rheumatology, Pak Emirates Military Hospital, Rawalpindi, Pakistan
Ahsan Amer Department of General Medicine, Fauji Foundation Hospital, Rawalpindi, Pakistan
Wasim Ali Department of General Medicine, Pak Emirates Military Hospital, Rawalpindi, Pakistan
Sehr Zara Amir Department of General Medicine, Pak Emirates Military Hospital, Rawalpindi, Pakistan
Faizan Badar Department of General Medicine, Pak Emirates Military Hospital, Rawalpindi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i07.1396

Keywords:

Neutrophils, Knee Osteoarthritis, Severity, Biomarker

Abstract

Osteoarthritis is a disease with a significant inflammatory component. Neutrophil Lymphocyte Ratio (NLR) level is a marker to determine inflammation. Objective: To find the value of NLR ratio in assessing severity grades of knee osteoarthritis. Methods: Prospective Observational Study was carried out in Tertiary care hospital on 378 patients diagnosed both clinically and radio graphically with Knee osteoarthritis reported to tertiary care hospital were selected. Convenience sampling was performed. Patients were divided into, group A, B and C Mild, moderate and severe Knee osteoarthritis with 126 patients. Blood samples were taken from participants and total and differential leucocyte counts and neutrophil levels were determined. NLR value was determined in each group. Mean value was calculated. Results: Out of 378 patients, 172 (45.5%) were female and 206 (54.5%) were male. The mean value of NLR ratio in group A was found to be 2.96 ± 0.84. Mean value in group B was found to be 5.83 ± 1.52 and for grade 3 was found to be 8.86 ± 2.33. Conclusions: NLR value is a good indicator for assessing severity grades of Knee osteoarthritis.

References

Thijssen E, Van Caam A, Van Der Kraan PM. Obesity and osteoarthritis, more than just wear and tear: pivotal roles for inflamed adipose tissue and dyslipidaemia in obesity-induced osteoarthritis. Rheumatology. 2015 Apr; 54(4): 588-600. doi: 10.1093/rheumatology/keu464. DOI: https://doi.org/10.1093/rheumatology/keu464

Loeser RF, Collins JA, Diekman BO. Ageing and the pathogenesis of osteoarthritis. Nature Reviews Rheumatology. 2016 Jul; 12(7): 412-20. doi: 10.1038/nrrheum.2016.65. DOI: https://doi.org/10.1038/nrrheum.2016.65

Nelson AE. Osteoarthritis year in review 2017: clinical. Osteoarthritis and Cartilage. 2018 Mar; 26(3): 319-25. doi: 10.1016/j.joca.2017.11.014. DOI: https://doi.org/10.1016/j.joca.2017.11.014

SK D. Farooqi A. Osteoarthritis. Best Practice & Research Clinical Rheumatology. 2008 Aug; 22(4): 657-75. doi: 10.1016/j.berh.2008.07.002. DOI: https://doi.org/10.1016/j.berh.2008.07.002

Mobasheri A and Henrotin Y. Biomarkers of (osteo) arthritis. Biomarkers. 2015 Nov; 20(8): 513-8. doi: 10.3109/1354750X.2016.1140930. DOI: https://doi.org/10.3109/1354750X.2016.1140930

Wang Y, Teichtahl AJ, Cicuttini FM. Osteoarthritis year in review 2015: imaging. Osteoarthritis and Cartilage. 2016 Jan; 24(1): 49-57. doi: 10.1016/j.joca.2015.07.027. DOI: https://doi.org/10.1016/j.joca.2015.07.027

Bierma-Zeinstra S. Osteoarthritis. Lancet. 2019 Apr; 393(10182): 1745-59. doi: 10.1016/S0140-6736(19)30417-9. DOI: https://doi.org/10.1016/S0140-6736(19)30417-9

Nees TA, Rosshirt N, Zhang JA, Reiner T, Sorbi R, Tripel E et al. Synovial cytokines significantly correlate with osteoarthritis-related knee pain and disability: inflammatory mediators of potential clinical relevance. Journal of Clinical Medicine. 2019 Aug; 8(9): 1343. doi: 10.3390/jcm8091343. DOI: https://doi.org/10.3390/jcm8091343

Wang D, Bai N, Hu X, OuYang XW, Yao L, Tao Y et al. Preoperative inflammatory markers of NLR and PLR as indicators of poor prognosis in resectable HCC. PeerJ. 2019 Oct; 7: e7132. doi: 10.7717/peerj.7132. DOI: https://doi.org/10.7717/peerj.7132

Büyükavcı R, Aktürk S, Sağ S. Comparison of blood platelet distribution width and neutrophil-lymphocyte ratio in patients with different grades of knee osteoarthritis. Journal of Back and Musculoskeletal Rehabilitation. 2018 Jan; 31(6): 1035-9. doi: 10.3233/BMR-171028. DOI: https://doi.org/10.3233/BMR-171028

Fugaru Of, Șerbănescu Ms, Trăistaru Mr. The Role of Neutrophil to Lymphocyte Ratio in the Assessment and Rehabilitation of Knee Osteoarthritis Patients. Current Health Sciences Journal. 2023 Oct; 49(4): 546–54. doi:

Malik FB, Memon AG, Shah S, Latif D, Afzal MF, Memon SA. Prevalence Of Knee Osteoarthritis And Quality Of Life Among Middle Aged Adults Of Pakistan: soi: 21-2017/re-trjvol06iss01p280. The Rehabilitation Journal. 2022 Mar; 6(01): 280-3. doi: 10.52567/trj.v6i01.80. DOI: https://doi.org/10.52567/trj.v6i01.80

Kushwaha S, Kaushik R, Kakkar R, Kaushik RM. Red cell distribution width and neutrophil-lymphocyte ratio as inflammatory markers in patients with rheumatoid arthritis. Reumatologia. 2023 Mar; 61(1): 13. doi: 10.5114/reum/161286. DOI: https://doi.org/10.5114/reum/161286

Ioniţescu M, Vermeşan D, Haraguș H, Suciu O, Todor A, Dumitrașcu CV et al. Association of neutrophil to lymphocyte ratio with patient reported outcomes in knee osteoarthritis. Applied Sciences. 2020 Nov; 10(22): 8173. doi: 10.3390/app10228173. DOI: https://doi.org/10.3390/app10228173

Forget P, Khalifa C, Defour JP, Latinne D, Van Pel MC, De Kock M. What is the normal value of the neutrophil-to-lymphocyte ratio? BMC Research Notes. 2017 Dec; 10(1): 1-4. doi: 10.1186/s13104-016-2335-5. DOI: https://doi.org/10.1186/s13104-016-2335-5

Tasoglu Ö, Sahin A, Karatas G, Koyuncu E, Tasoglu I, Tecimel O et al. Blood mean platelet volume and platelet lymphocyte ratio as new predictors of hip osteoarthritis severity. Medicine. 2017 Feb; 96(6): e6073. doi: 10.1097/MD.0000000000006073. DOI: https://doi.org/10.1097/MD.0000000000006073

Raveendran D, Perry LA, Bucknill A, Liu Z. The Significance of Neutrophil Lymphocyte Ratio, Platelet Lymphocyte Ratio, and Red Cell Distribution Width in Osteoarthritis: A Systematic Review and Meta-Analysis. Journal of Orthopaedics for Physician Assistants. 2023 Oct; 11(4): e23. doi: 10.2106/JBJS.JOPA.23.00014. DOI: https://doi.org/10.2106/JBJS.JOPA.23.00014

Cai C, Zhang R, Xu X, Li G, Gou H. Diagnostic values of NLR and miR141 in patients with osteoarthritis and their association with severity of knee osteoarthritis. Experimental and Therapeutic Medicine. 2021 Jan; 21(1): 1. doi: 10.3892/etm.2020.9506. DOI: https://doi.org/10.3892/etm.2020.9506

Gundogdu G, Gundogdu K. A novel biomarker in patients with knee osteoarthritis: adropin. Clinical Rheuamatology. 2018 Aug; 37: 2179-86. doi: 10.1007/s10067-018-4052-z. DOI: https://doi.org/10.1007/s10067-018-4052-z

Taşoğlu Ö, Bölük H, Şahin Onat Ş, Taşoğlu İ, Özgirgin N. Is blood neutrophil-lymphocyte ratio an independent predictor of knee osteoarthritis severity? Clinical Rheumatology. 2016 Jun; 35: 1579-83. doi: 10.1007/s10067-016-3170-8. DOI: https://doi.org/10.1007/s10067-016-3170-8

Chandrashekara S, Mukhtar Ahmad M, Renuka P, Anupama KR, Renuka K. Characterization of neutrophil to lymphocyte ratio as a measure of inflammation in rheumatoid arthritis. International journal of rheumatic diseases. 2017 Oct; 20(10): 1457-67. doi: 10.1111/1756-185X.13157. DOI: https://doi.org/10.1111/1756-185X.13157