Skip to main content

Advertisement

SpringerLink
Log in

Three new inflammatory markers C reactive protein to albumin ratio, neutrophil to lymphocyte ratio, and platelet to lymphocyte ratio correlated with relapsing polychondritis disease activity index

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Objective

The novel inflammatory markers C-reactive protein to albumin ratio (CAR), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) were associated with the disease activity of many autoimmune diseases. The aim of this study was to evaluate the association of these new inflammatory indexes with relapsing polychondritis disease activity index (RPDAI).

Methods

The data of relapsing polychondritis (RP) patients hospitalized between 2004 and 2020 at Peking Union Medical College Hospital were collected. One of the exclusive criteria was that RP patients overlapped with other diseases. Another was the RP patients with incomplete data. A total of 170 RP patients and 170 healthy controls (HCs) were included. The association of new inflammatory makers with RPDAI was assessed by Spearman’s correlation analysis.

Results

Compared to HCs, the CAR, NLR, and PLR were significantly higher in RP patients (both p < 0.001). The CAR, NLR, PLR, erythrocyte sedimentation rate and neutrophil counts in peripheral blood positively correlated with RPDAI. Blood albumin, lymphocyte count, hemoglobin (Hb) negatively correlated with RPDAI. The association of CAR, NLR, and PLR with RPDAI was demonstrated by Spearman’s correlation analysis.

Conclusion

The novel inflammatory markers CAR, NLR and PLR were associated with RPDAI.

Key Points

• This is the first research to explore the association of CAR, NLR, and PLR with disease activity in patients with RP

• CAR, NLR, and PLR are positively correlated with RPDAI

• CAR, NLR, and PLR might be the potential predictors of disease activity in RP

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

The readers can access the data supporting the conclusions of the study from the article.

References

  1. Chopra R, Chaudhary N, Kay J (2013) Relapsing polychondritis. Rheum Dis Clin North Am 39:263–276. https://doi.org/10.1016/j.rdc.2013.03.002

    Article  PubMed  Google Scholar 

  2. Hazra N, Dregan A, Charlton J, Gulliford MC, D’Cruz DP (2015) Incidence and mortality of relapsing polychondritis in the UK: a population-based cohort study. Rheumatology (Oxford) 54:2181–2187. https://doi.org/10.1093/rheumatology/kev240

    Article  Google Scholar 

  3. Rednic S, Damian L, Talarico R, Scire CA, Tobias A, Costedoat-Chalumeau N, Launay D, Mathian A, Mattews L, Ponte C, Toniati P, Bombardieri S, Frank C, Schneider M, Smith V, Cutolo M, Mosca M, Arnaud L (2018) Relapsing polychondritis: state of the art on clinical practice guidelines. RMD Open 4:e788. https://doi.org/10.1136/rmdopen-2018-000788

    Article  Google Scholar 

  4. Arnaud L, Devilliers H, Peng SL, Mathian A, Costedoat-Chalumeau N, Buckner J, Dagna L, Michet C, Sharma A, Cervera R, Haroche J, Papo T, D’Cruz D, Arlet P, Zwerina J, Belot A, Suzuki N, Harle JR, Moots R, Jayne D, Hachulla E, Marie I, Tanaka T, Lebovics R, Scott D, Kucharz EJ, Birchall M, Kong KO, Gorochov G, Amoura Z (2012) The Relapsing Polychondritis Disease Activity Index: development of a disease activity score for relapsing polychondritis. Autoimmun REV 12:204–209. https://doi.org/10.1016/j.autrev.2012.06.005

    Article  PubMed  Google Scholar 

  5. Yang WM, Zhang WH, Ying HQ, Xu YM, Zhang J, Min QH, Huang B, Lin J, Chen JJ, Wang XZ (2018) Two new inflammatory markers associated with disease activity score-28 in patients with rheumatoid arthritis: albumin to fibrinogen ratio and C-reactive protein to albumin ratio. Int Immunopharmacol 62:293–298. https://doi.org/10.1016/j.intimp.2018.07.007

    Article  CAS  PubMed  Google Scholar 

  6. Chen Q, Chen DY, Xu XZ, Liu YY, Yin TT, Li D (2019) Platelet/lymphocyte, lymphocyte/monocyte, and neutrophil/lymphocyte ratios as biomarkers in patients with rheumatoid arthritis and rheumatoid arthritis-associated interstitial lung disease. Med Sci Monit 25:6474–6481. https://doi.org/10.12659/MSM.916583

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Wu Y, Chen Y, Yang X, Chen L, Yang Y (2016) Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were associated with disease activity in patients with systemic lupus erythematosus. Int Immunopharmacol 36:94–99. https://doi.org/10.1016/j.intimp.2016.04.006

    Article  CAS  PubMed  Google Scholar 

  8. Qin B, Ma N, Tang Q, Wei T, Yang M, Fu H, Hu Z, Liang Y, Yang Z, Zhong R (2016) Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients. Mod Rheumatol 26:372–376. https://doi.org/10.3109/14397595.2015.1091136

    Article  PubMed  Google Scholar 

  9. Soliman WM, Sherif NM, Ghanima IM, El-Badawy MA (2020) Neutrophil to lymphocyte and platelet to lymphocyte ratios in systemic lupus erythematosus: Relation with disease activity and lupus nephritis. Reumatol Clin 16:255–261. https://doi.org/10.1016/j.reuma.2018.07.008

    Article  PubMed  Google Scholar 

  10. Lee YH, Song GG (2018) Neutrophil-to-lymphocyte ratio, mean platelet volume and platelet-to-lymphocyte ratio in Behcet’s disease and their correlation with disease activity: a meta-analysis. Int J Rheum Dis 21:2180–2187. https://doi.org/10.1111/1756-185X.13404

    Article  CAS  PubMed  Google Scholar 

  11. Dion J, Costedoat-Chalumeau N, Sene D, Cohen-Bittan J, Leroux G, Dion C, Frances C, Piette JC (2016) Relapsing polychondritis can be characterized by three different clinical phenotypes: analysis of a recent series of 142 patients. Arthritis Rheumatol 68:2992–3001. https://doi.org/10.1002/art.39790

    Article  PubMed  Google Scholar 

  12. Horvath A, Pall N, Molnar K, Kovats T, Surjan G, Vicsek T, Pollner P (2016) A nationwide study of the epidemiology of relapsing polychondritis. Clin Epidemiol 8:211–230. https://doi.org/10.2147/CLEP.S91439

    Article  PubMed  PubMed Central  Google Scholar 

  13. Pallo P, Levy-Neto M, Pereira R, Shinjo SK (2017) Relapsing polychondritis: prevalence of cardiovascular diseases and its risk factors, and general disease features according to gender. Rev Bras Reumatol Engl Ed 57:338–345. https://doi.org/10.1016/j.rbre.2017.02.003

    Article  PubMed  Google Scholar 

  14. McAdam LP, O’Hanlan MA, Bluestone R, Pearson CM (1976) Relapsing polychondritis: prospective study of 23 patients and a review of the literature. Medicine (Baltimore) 55:193–215

    Article  CAS  Google Scholar 

  15. Damiani JM, Levine HL (1979) Relapsing polychondritis—report of ten cases. Laryngoscope 89:929–946

    Article  CAS  Google Scholar 

  16. Bruegel M, Nagel D, Funk M, Fuhrmann P, Zander J, Teupser D (2015) Comparison of five automated hematology analyzers in a university hospital setting: Abbott Cell-Dyn Sapphire, Beckman Coulter DxH 800, Siemens Advia 2120i, Sysmex XE-5000, and Sysmex XN-2000. Clin Chem Lab Med 53:1057–1071. https://doi.org/10.1515/cclm-2014-0945

    Article  CAS  PubMed  Google Scholar 

  17. Schultze HE, Schwick G (1959) Quantitative immunological determination of blood proteins. Clin Chim Acta 4:15–25. https://doi.org/10.1016/0009-8981(59)90075-0

    Article  CAS  PubMed  Google Scholar 

  18. Doumas BT, Watson WA, Biggs HG (1971) Albumin standards and the measurement of serum albumin with bromcresol green. Clin Chim Acta 31:87–96. https://doi.org/10.1016/0009-8981(71)90365-2

    Article  CAS  PubMed  Google Scholar 

  19. (1993) ICSH recommendations for measurement of erythrocyte sedimentation rate. International Council for Standardization in Haematology (Expert Panel on Blood Rheology) J Clin Pathol 46:198–203. https://doi.org/10.1136/jcp.46.3.198

  20. Clauss A (1957) Rapid physiological coagulation method in determination of fibrinogen. Acta Haematol 17:237–246. https://doi.org/10.1159/000205234

    Article  CAS  PubMed  Google Scholar 

  21. Ferrada MA, Grayson PC, Banerjee S, Sikora KA, Colbert RA, Sinaii N, Katz JD (2018) Patient perception of disease-related symptoms and complications in relapsing polychondritis. Arthritis Care Res (Hoboken) 70:1124–1131. https://doi.org/10.1002/acr.23492

    Article  Google Scholar 

  22. Yayla ME, Ilgen U, Okatan IE, UsluYurteri E, Torgutalp M, Kelesoglu DA, Aydemir GE, Sezer S, Turgay TM, Kinikli G, Ates A (2020) Association of simple hematological parameters with disease manifestations, activity, and severity in patients with systemic sclerosis. Clin Rheumatol 39:77–83. https://doi.org/10.1007/s10067-019-04685-0

    Article  PubMed  Google Scholar 

  23. Seringec AN, Yildirim CG, Gogebakan H, Acipayam C (2019) The C-reactive protein/albumin ratio and complete blood count parameters as indicators of disease activity in patients with Takayasu arteritis. Med Sci Monit 25:1401–1409. https://doi.org/10.12659/MSM.912495

    Article  Google Scholar 

  24. Stabler T, Piette JC, Chevalier X, Marini-Portugal A, Kraus VB (2004) Serum cytokine profiles in relapsing polychondritis suggest monocyte/macrophage activation. Arthritis Rheum 50:3663–3667. https://doi.org/10.1002/art.20613

    Article  CAS  PubMed  Google Scholar 

  25. Wu Y, Potempa LA, El KD, Filep JG (2015) C-reactive protein and inflammation: conformational changes affect function. Biol Chem 396:1181–1197. https://doi.org/10.1515/hsz-2015-0149

    Article  CAS  PubMed  Google Scholar 

  26. Cronkite DA, Strutt TM (2018) The regulation of inflammation by innate and adaptive lymphocytes. J Immunol Res 2018:1467538. https://doi.org/10.1155/2018/1467538

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Couldwell G, Machlus KR (2019) Modulation of megakaryopoiesis and platelet production during inflammation. Thromb Res 179:114–120. https://doi.org/10.1016/j.thromres.2019.05.008

    Article  CAS  PubMed  Google Scholar 

  28. Don BR, Kaysen G (2004) Serum albumin: relationship to inflammation and nutrition. Semin Dial 17:432–437. https://doi.org/10.1111/j.0894-0959.2004.17603.x

    Article  PubMed  Google Scholar 

  29. Zeb A, Khurshid S, Bano S, Rasheed U, Zammurrad S, Khan MS, Aziz W, Tahir S (2019) The role of the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as markers of disease activity in Ankylosing Spondylitis. Cureus 11:e6025. https://doi.org/10.7759/cureus.6025

    Article  PubMed  PubMed Central  Google Scholar 

  30. Hu ZD, Sun Y, Guo J, Huang YL, Qin BD, Gao Q, Qin Q, Deng AM, Zhong RQ (2014) Red blood cell distribution width and neutrophil/lymphocyte ratio are positively correlated with disease activity in primary Sjogren’s syndrome. Clin Biochem 47:287–290. https://doi.org/10.1016/j.clinbiochem.2014.08.022

    Article  CAS  PubMed  Google Scholar 

  31. Jung JY, Lee E, Suh CH, Kim HA (2019) Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are associated with disease activity in polymyalgia rheumatica. J Clin Lab Anal 33:e23000. https://doi.org/10.1002/jcla.23000

    Article  PubMed  PubMed Central  Google Scholar 

  32. Yang W, Wang X, Zhang W, Ying H, Xu Y, Zhang J, Min Q, Chen J (2017) Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio are 2 new inflammatory markers associated with pulmonary involvement and disease activity in patients with dermatomyositis. Clin Chim Acta 465:11–16. https://doi.org/10.1016/j.cca.2016.12.007

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

This work was supported by the National Natural Science Foundation of China [grant number 81671614, the website: www.nsfc.gov.cn/]; Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(CIFMS)[grant number 2017-I2M-3–001]; and the National Key Research and Development Program of China (grant number No. 2016YFC0901500).

Author information

Author notes

  1. Xiaoyu Cao, Mengzhu Zhao and Huijuan Li contributed equally to the work

Authors and Affiliations

  1. Department of Rheumatology and Clinical Immunology, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital (PUMCH), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China

    Xiaoyu Cao, Mengzhu Zhao, Dong Xu, Mengtao Li, Xuan Zhang, Fengchun Zhang, Yong Hou & Xiaofeng Zeng

  2. Department of Rheumatology and Clinical Immunology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Xiaoyu Cao

  3. Department of Rheumatology and Clinical Immunology, Handan First Hospital, Hebei, China

    Huijuan Li

Authors
  1. Xiaoyu Cao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mengzhu Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Huijuan Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Dong Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mengtao Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Xuan Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Fengchun Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yong Hou
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Xiaofeng Zeng
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yong Hou.

Ethics declarations

Disclosures

None.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cao, X., Zhao, M., Li, H. et al. Three new inflammatory markers C reactive protein to albumin ratio, neutrophil to lymphocyte ratio, and platelet to lymphocyte ratio correlated with relapsing polychondritis disease activity index. Clin Rheumatol 40, 4685–4691 (2021). https://doi.org/10.1007/s10067-021-05827-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-021-05827-z

Keywords

Search

Navigation