Elevated Platelet-to-lymphocyte Ratio and Neutrophil-to-lymphocyte Ratio in Patients with Polymyositis/dermatomyositis: a Retrospective Study

Overview

Journal Clin Rheumatol

Publisher Springer

Specialty Rheumatology

Date 2023 Feb 13

PMID 36781682

Authors

Meiqi Li

Suyan Yan

Rongrong Dong

Weizhen Xiang

Zhenzhen Ma

Qingrui Yang

Affiliations

Soon will be listed here.

Abstract

Objectives: This study aimed to examine the diagnostic and prognostic value of the platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) in patients with polymyositis/dermatomyositis (PM/DM).

Method: Clinical data of 200 patients with PM/DM and 204 healthy controls were retrospectively reviewed. We examined whether the PLR and NLR were associated with PM/DM.

Results: The PLR and NLR were higher in patients with PM/DM than in controls (both P < 0.001). The PLR and NLR were higher in patients with DM than in those with PM (both P < 0.01). The PLR was higher in the anti-melanoma differentiation-associated protein-5 (anti-MDA5) PM/DM group than in the anti-MDA5 PM/DM group (P = 0.002). The NLR in non-survivors was higher than that in survivors (P = 0.01). The NLR was positively correlated with the occurrence of interstitial lung disease (ILD). The PLR and NLR were independent predictors of PM/DM, as well as risk factors (both P < 0.001). Moreover, the NLR had a predictive value for PM/DM-ILD and was closely related to mortality (P = 0.033, P = 0.003, respectively).

Conclusions: Patients with PM/DM have a higher NLR and PLR than healthy controls, especially in those with anti-MDA5. The PLR and NLR are independent risk factors for PM/DM and have some predictive value. The NLR is correlated with ILD and associated with an increased risk of mortality in patients with PM/DM. The NLR and PLR may be simple, economical, and accurate diagnostic and prognostic markers for patients with PM/DM. Key points • The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been studied in numerous inflammatory diseases as potential markers, but their clinical significance in polymyositis/dermatomyositis (PM/DM) remains unclear. • We examined the changes in the NLR and PLR between patients with PM/DM and healthy controls, as well as their association with mortality, interstitial lung disease, and anti-melanoma differentiation-associated protein-5. • Patients with PM/DM may benefit from using the NLR and PLR as simple, economical, and accurate diagnostic and prognostic markers.

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References

Lundberg I, Fujimoto M, Vencovsky J, Aggarwal R, Holmqvist M, Christopher-Stine L . Idiopathic inflammatory myopathies. Nat Rev Dis Primers. 2021; 7(1):86. DOI: 10.1038/s41572-021-00321-x. View

Gono T, Masui K, Nishina N, Kawaguchi Y, Kawakami A, Ikeda K . Risk Prediction Modeling Based on a Combination of Initial Serum Biomarker Levels in Polymyositis/Dermatomyositis-Associated Interstitial Lung Disease. Arthritis Rheumatol. 2020; 73(4):677-686. DOI: 10.1002/art.41566. View

Marie I . Morbidity and mortality in adult polymyositis and dermatomyositis. Curr Rheumatol Rep. 2012; 14(3):275-85. DOI: 10.1007/s11926-012-0249-3. View

Yang X, Hao Y, Zhang X, Geng Y, Ji L, Li G . Mortality of Chinese patients with polymyositis and dermatomyositis. Clin Rheumatol. 2020; 39(5):1569-1579. DOI: 10.1007/s10067-019-04910-w. View

Fathi M, Dastmalchi M, Rasmussen E, Lundberg I, Tornling G . Interstitial lung disease, a common manifestation of newly diagnosed polymyositis and dermatomyositis. Ann Rheum Dis. 2004; 63(3):297-301. PMC: 1754925. DOI: 10.1136/ard.2003.006122. View

Sato S, Hoshino K, Satoh T, Fujita T, Kawakami Y, Fujita T . RNA helicase encoded by melanoma differentiation-associated gene 5 is a major autoantigen in patients with clinically amyopathic dermatomyositis: Association with rapidly progressive interstitial lung disease. Arthritis Rheum. 2009; 60(7):2193-200. DOI: 10.1002/art.24621. View

DeWane M, Waldman R, Lu J . Dermatomyositis: Clinical features and pathogenesis. J Am Acad Dermatol. 2019; 82(2):267-281. DOI: 10.1016/j.jaad.2019.06.1309. View

Chen Z, Cao M, Plana M, Liang J, Cai H, Kuwana M . Utility of anti-melanoma differentiation-associated gene 5 antibody measurement in identifying patients with dermatomyositis and a high risk for developing rapidly progressive interstitial lung disease: a review of the literature and a meta-analysis. Arthritis Care Res (Hoboken). 2013; 65(8):1316-24. DOI: 10.1002/acr.21985. View

Gono T, Kawaguchi Y, Satoh T, Kuwana M, Katsumata Y, Takagi K . Clinical manifestation and prognostic factor in anti-melanoma differentiation-associated gene 5 antibody-associated interstitial lung disease as a complication of dermatomyositis. Rheumatology (Oxford). 2010; 49(9):1713-9. DOI: 10.1093/rheumatology/keq149. View

10.

Koga T, Fujikawa K, Horai Y, Okada A, Kawashiri S, Iwamoto N . The diagnostic utility of anti-melanoma differentiation-associated gene 5 antibody testing for predicting the prognosis of Japanese patients with DM. Rheumatology (Oxford). 2012; 51(7):1278-84. DOI: 10.1093/rheumatology/ker518. View

11.

Li Y, Gao X, Li Y, Jia X, Zhang X, Xu Y . Predictors and Mortality of Rapidly Progressive Interstitial Lung Disease in Patients With Idiopathic Inflammatory Myopathy: A Series of 474 Patients. Front Med (Lausanne). 2020; 7:363. PMC: 7412929. DOI: 10.3389/fmed.2020.00363. View

12.

Li L, Xia Y, Chen C, Cheng P, Peng C . Neutrophil-lymphocyte ratio in systemic lupus erythematosus disease: a retrospective study. Int J Clin Exp Med. 2015; 8(7):11026-31. PMC: 4565283. View

13.

Chen Q, Chen D, Xu X, Liu Y, Yin T, Li D . 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. 2019; 25:6474-6481. PMC: 6733153. DOI: 10.12659/MSM.916583. View

14.

Shadmanfar S, Masoumi M, Davatchi F, Shahram F, Akhlaghi M, Faezi S . Correlation of clinical signs and symptoms of Behçet's disease with platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR). Immunol Res. 2021; 69(4):363-371. DOI: 10.1007/s12026-021-09194-4. View

15.

Wang H, Hu Y, Geng Y, Wu H, Chu Y, Liu R . The relationship between neutrophil to lymphocyte ratio and artery stiffness in subtypes of hypertension. J Clin Hypertens (Greenwich). 2017; 19(8):780-785. PMC: 8031274. DOI: 10.1111/jch.13002. View

16.

Haybar H, Pezeshki S, Saki N . Evaluation of complete blood count parameters in cardiovascular diseases: An early indicator of prognosis?. Exp Mol Pathol. 2019; 110:104267. DOI: 10.1016/j.yexmp.2019.104267. View

17.

Tas M, Yavuz A, Ak M, Ozcelik B . Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Discriminating Precancerous Pathologies from Cervical Cancer. J Oncol. 2019; 2019:2476082. PMC: 6735215. DOI: 10.1155/2019/2476082. View

18.

Kemal Y, Yucel I, Ekiz K, Demirag G, Yilmaz B, Teker F . Elevated serum neutrophil to lymphocyte and platelet to lymphocyte ratios could be useful in lung cancer diagnosis. Asian Pac J Cancer Prev. 2014; 15(6):2651-4. DOI: 10.7314/apjcp.2014.15.6.2651. View

19.

Lee S, Oh S, Kim S, Lee J, Kim M, Kim K . Prognostic significance of neutrophil lymphocyte ratio and platelet lymphocyte ratio in advanced gastric cancer patients treated with FOLFOX chemotherapy. BMC Cancer. 2013; 13:350. PMC: 3729814. DOI: 10.1186/1471-2407-13-350. View

20.

Liu X, Shen Y, Wang H, Ge Q, Fei A, Pan S . Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Patients with Sepsis: A Prospective Observational Study. Mediators Inflamm. 2016; 2016:8191254. PMC: 4823514. DOI: 10.1155/2016/8191254. View