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Abstract
Background and aims Systemic Lupus Erythematosus (SLE) is a complex autoimmune disease characterised by enhanced apoptosis in conjunction with high levels of autoantibodies and deregulated cytokine productions. It contributes to immune dysfunction, tissue inflammation, and organ damage. Neutrophil to Lymphocyte ratio (NLR) is a promising marker in SLE, but its relationships with SLE’s disease activity in Indonesian population has not been evaluated.
To investigate the correlation between NLR and SLE disease activity.
Methods A cross sectional study with consecutive sampling technique was conducted with 70 Indonesian SLE patients in Dr. Soetomo Hospital Surabaya at May 2016-July 2016. Peripheral blood count was evaluated during assessment with flowcytometry technique and disease activity was evaluated with Systemic Lupus Activity Measure (SLAM) score. Data analysis was done with Spearman’s correlation rank test and ROC curve using SPSS v22.0.
Results There were 19 patients with SLAM score <7 (group 1) and 51 patients with SLAM score ≥7 (group 2). We found that lymphocyte count and NLR was statistically significant between groups [1.58 (0.66–2.73) vs 0.95 (0.14–3.49); p<0.01; 2.873 (0.14–9.29) vs 4.51 (0.57–25.85), p<0.01]. Positive correlation was observed between NLR and SLAM score (r=0.249, p<0.038) with Spearman’s correlation test. Analysis with ROC curve revealed the cut-off value of NLR was 3.17 (AUC 0.684, p<0.02, 95% CI 0.55–0.813, sensitivity 69%, specificity 58%).
Basic characteristics of the study.
Bivariate analysis between several parameters and SLAM score.
ROC curve of NLR with activity in SLE patients.
Conclusions NLR is correlated to disease activity and a promising tool for assessing disease activity in Indonesian SLE patients.