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The role of platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in the diagnosis and severity of inflammatory bowel disease in children

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Abstract

Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are simple and inexpensive inflammatory biomarkers that reflect systemic inflammation based on complete blood count values. In this study, we investigate the role of these biomarkers in the diagnosis and severity of pediatric inflammatory bowel disease (IBD). We analyzed 73 pediatric patients with IBD with a retrospective study design who underwent measurement of fecal calprotectin (FC) and endoscopy and 67 age- and sex-matched healthy controls. NLR and PLR were compared between the patients and healthy controls. We also plotted the ROC diagrams separately for markers to obtain the optimal point and a suitable cutoff point. We enrolled 73 pediatric patients less than 18 years of age with IBD, 40 subjects with UC and 33 with CD and 67 healthy subjects as control group with median age of 9.00 ± 4.61 in all subjects. Furthermore, the mean score of PCDAI or PUCAI in the all subjects was 19.26 ± 16.31. In the ROC curve, the optimal cutoff value for NLR and PLR for detecting IBD was 2.04 (sensitivity 82.1%; specificity 82.9%) and 103 (sensitivity 67.9%; specificity 71.4%). Also, the optimal cutoff values for NLR and PLR for differentiating IBD severity (remission vs. active disease) were 2.94 (sensitivity 77.8%; specificity 50.0%) and 157 (sensitivity 88.9%; specificity 54.5%), respectively.

Conclusion: Our findings indicate the role of easy and non-invasive markers such as NLR and PLR in order to diagnose the disease in the initial examinations as well as the severity of the disease.

What is Known:

• NLR and PLR are simple and inexpensive inflammatory biomarkers that reflect systemic inflammation based on complete blood count values.

What is New:

• In this study, we investigate the role of these biomarkers in the diagnosis and severity of pediatric IBD.

• Our findings indicate the role of NLR and PLR in order to diagnose the disease in the initial examinations as well as the severity of the disease.

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Acknowledgements

This study is taken from the Genetic registry program in chronic inflammatory bowel disease (IBD) in children at Tehran University of Medical Sciences (IR.TUMS.MEDICINE.REC.1400.951). We are thankful to Dr Pejman Rohani, head of the infant cholestasis registry at Tehran University of Medical Sciences.

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Author notes

  1. Arefeh Zahmatkesh and Mohammad Hassan Sohouli have contributed equally to this work.

Authors and Affiliations

  1. School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Arefeh Zahmatkesh

  2. Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Mohammad Hassan Sohouli

  3. Department of Internal Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Seyed Mahmoud Eshagh Hosseini

  4. Pediatric Gastroenterology and Hepatology Research Center, Pediatrics Centre of Excellence, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran

    Mohammad Hassan Sohouli & Pejman Rohani

  5. Pediatrics Gastroenterology, Department of Pediatrics, School of Medicine Childrens Medical Center, Tehran University of Medical Sciences, Tehran, Iran

    Mohammad Hassan Sohouli & Pejman Rohani

Authors
  1. Arefeh Zahmatkesh
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  2. Mohammad Hassan Sohouli
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  3. Seyed Mahmoud Eshagh Hosseini
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  4. Pejman Rohani
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Contributions

Mh.S and P.R contributed in conception, design, and statistical analysis. MH.S, A.Z, SM.EH, and P.R contributed in data collection and manuscript drafting. MH.S and P.R supervised the study. All authors approved the final version of the manuscript.

Corresponding authors

Correspondence to Mohammad Hassan Sohouli or Pejman Rohani.

Ethics declarations

Ethics approval and consent to participate

This study was approved by the research council and ethics committee of Tehran University of Medical Sciences, Tehran, Iran. We confirm that all methods were carried out in accordance with relevant guidelines and regulations. Also, we are confirming that informed consent was obtained from a parent and/or legal guardians of the participants (control as well as patients).

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Not applicable.

Competing interests

The authors declare no competing interests.

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Communicated by Peter de Winter

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Zahmatkesh, A., Sohouli, M.H., Hosseini, S.M.E. et al. The role of platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in the diagnosis and severity of inflammatory bowel disease in children. Eur J Pediatr 182, 4263–4270 (2023). https://doi.org/10.1007/s00431-023-05110-0

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