Evaluation of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, mean platelet volume, and C-reactive protein in patients with psoriasis vulgaris
Öz
Objective: Recent reports indicate that neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR),
mean platelet volume (MPV), and C-reactive protein (CRP) are key markers of systemic inflammation. These markers
have also been shown to be significantly increased in patients with psoriasis vulgaris compared to control subjects. In
this study, we aimed to evaluate the relationship between serum levels of NLR, PLR, MPV, and CRP and nail
involvement, presence of arthritis, duration of disease, and Psoriasis Area and Severity Index (PASI) scores in patients
with psoriasis vulgaris.
Methods: The study included 133 patients with psoriasis vulgaris that had no systemic, infectious, or autoimmune
diseases and a control group of 107 healthy volunteers. The patients were divided into two groups based on their
PASI scores: (I) mild (PASI<10) and (II) moderate-severe (PASI≥10).
Results: NLR, MPV, and CRP values were significantly higher in the patient group compared to the control group
(p=0.001, 0.003, <0.001, respectively). PLR values were lower in the patient group compared to the control group
although no significant difference was found (p=0.074). In the patient group, the MPV and CRP values were
significantly higher in the patients with moderate-severe psoriasis vulgaris compared to the patients with psoriasis
vulgaris (p=0.017 and <0.001, respectively). No significant relationship was found between the MPV and CRP values
and presence of arthritis, nail involvement, and duration of disease (p>0.05). Similarly, no significant relationship was
found between the NLR and PLR values and PASI score, presence of arthritis, nail involvement, and duration of
disease (p>0.05).
Conclusion: NLR and CRP can be useful markers of inflammation in patients with psoriasis vulgaris; however, the
absence of a correlation between NLR and the severity of disease may lead to a limitation in the clinical use of NLR.
MPV can be a better marker of inflammation compared to PLR and NLR since it was significantly higher in the patients
with psoriasis vulgaris compared to the healthy subjects and also correlated with the PASI score.
Anahtar Kelimeler
Psoriasis vulgaris neutrophil-to-lymphocyte ratio platelet-to-lymphocyte ratio mean platelet volume CRP
Kaynakça
- 1. Unal M, Kucuk A, Unal GU, et al. Mean platelet volume, neutrophil to lyphocyte ratio and platelet to lymphocyte ratio in psoriasis. Turkderm. 2015; 49: 112-6.
- 2. Gaspari AA. Innate and adaptive immunity and the pathophysiology of psoriasis. J Am Acad Dermatol.2006; 54: 67-80.
- 3. Karabudak O, Ulusoy RE, Erikci AA, Solmazgul E, Dogan B,Harmanyeri Y. Inflammation and hypercoagulable state in adult psoriatic men. Acta Derm Venereol. 2008; 88: 337-40. 4. Asahina A, Kubo N, Umezawa Y, Honda H, Yanaba K, Nakagawa H. Neutrophil–lymphocyte ratio, platelet– lymphocyte ratio and mean platelet volume in Japanese patients with psoriasis and psoriatic arthritis: Response to therapy with biologics. J Dermatol. 2017; 44: 1112-21.
- 5. Turkmen K, Erdur FM, Ozcicek F, et al. Platelet-tolymphocyte ratio better predicts inflammation than neutrophil-to-lymphocyte ratio in end-stage renal disease patients. Hemodial Int. 2013; 17: 391-6.
- 6. Krueger G, Ellis CN. Psoriasis – recent advances in understanding its pathogenesis and treatment. J Am Acad Dermatol. 2005; 53: 94–100.
- 7. Rocha-Pereira P, Santos-Silva A, Rebelo I, Figueiredo A, Quintanilha A, Teixeira F. The inflammatory response in mild and in severe psoriasis. Br J Dermatol. 2004; 150: 917-28.
- 8. Sen BB, Rifaioglu EN, Ekiz O, Inan MU, Sen T, Sen N. Neutrophil to lymphocyte ratio as a measure of systemic inflammation in psoriasis. Cutan Ocul Toxicol. 2014; 33: 223-7.
- 9. Orem A, Deger O, Cimsit G, Bahadır S. Plasma polymorphonuclear leukocyte elastase levels and its relation to disease activity in psoriasis. Clin Chim Acta.1997; 264: 49-56.
- 10. Balta S, Cakar M, Demirkol S, Arslan Z, Akhan M. Higher neutrophil to lymphocyte ratio in patients with metabolic syndrome. Clin Appl Thromb Hemost. 2013; 19: 579.
- 11. Cemil BC, Atas H. The Effect of Biological Treatment onto Systemic Inflammatory Markers and Plateletcrit in Psoriasis Patients. Dicle Med J. 2016; 43: 477-83.
- 12- Gunabatar H, Ekin S, Sunnetcioglu H, et al. The relationship between neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with obstructive sleep apnea syndrome. Dicle Med J. 2015; 42: 289-93.
- 13. Sengül E,Ozbay M, Topcu I. Relationship between Neutrophil-to-Lymphocyte Ratio and Prognosis in Patients with Deep Neck Space Infection. Dicle Med J. 2016; 43: 126-9.
- 14. Kim DS, Shin D, Lee MS, et al. Assessments of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in Korean patients with psoriasis vulgaris and psoriatic arthritis. J Dermatol. 2016; 43: 305-10. 15. Yurtdaş M, Yaylali YT, Kaya Y, et al. Neutrophilto Lymphocyte Ratio May Predict Subclinical Atherosclerosis in Patients with Psoriasis. Echocardiography. 2014; 31: 1095-104.
- 16. Ataseven A, Bilgin AU, Kurtipek GS. The importance of neutrophil lymphocyte ratio in patients with psoriasis. Clin Med Res. 2014; 3: 40–3.
- 17. Cerman AA, Karabay EA, Altunay IK. Evaluation of neutrophil-lymphocyte ratio and mean platelet volume in patients with psoriasis. SETB. 2016; 50: 137-41
- 18. Yurtdas M, Yaylali YT, Kaya Y et al. Neutrophil-tolymphocyte ratio may predict subclinical atherosclerosis in patients with psoriasis. Echocardiography. 2014; 31: 1095–104.
- 19. Chu SG, Becker RC, Berger PB, et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. J Thromb Haemost. 2010; 8: 148-56.
- 20. Incebıyık A, Uyanıkoglu H. Is there a role mean platelet volume in the diagnosis of patients with adnexal torsion? Dicle Med J. 2017; 44: 333-7.
- 21- Sahpaz P,Ulutas KT. Assessment of mean platelet volume in type 2 diabetics receiving insulin or oral antidiabetic agents. Dicle Med J. 2015; 42: 399-403.
- 22. Saleh HMA, Attia EAS, Onsy AM, Saad AA, Abd Ellah MMM. Platelet activation: a link between psoriasis per se and subclinical atherosclerosis - a case - control study. Br J Dermatol. 2013; 169: 68-75.
- 23. Coimbra S, Oliveira H, Reis F, et al. C-reactive protein and leucocyte activation in psoriasis vulgaris according to severity and therapy. J Eur Acad Dermatol Venereol. 2010; 24: 789–96.
- 24. Beygi S, Lajevardi V, Abedini R. C-reactive protein in psoriasis: a review of the literatüre. JEADV. 2014; 28: 700-11.
Psöriazis vulgaris hastalarında nötrofil/lenfosit oranı, trombosit/lenfosit oranı, ortalama trombosit hacmi ve C-reaktif protein değerleri
Öz
Amaç: Son
yıllarda nötrofil/lenfosit oranı (NLO), trombosit/lenfosit oranı (TLO),ortalama
trombosit hacmi(OTH) ve C reaktif protein(CRP)’nin sistemik inflamasyonun
önemli göstergeleri olduğu gösterilmiştir. Yapılan çalışmalarda psöriazis
vulgaris hastalarında NLO, TLO, OTH ve CRP ’nin kontrol gurubuna göre daha
yüksek olduğu gösterilmiştir. Çalışmamızda psöriazisli hastaların NLO, TLO, OTH
ve CRP düzeyleri ölçüldü ve bu parametrelerin tırnak tutulumu, artrit varlığı,
hastalık süresi ve PAŞİ skoru ile ilişkili olup olmadığı araştırıldı.
Yöntemler:
Herhangi bir sistemik hastalığı, infeksiyöz hastalığı ve otoimmun hastalığı
olmayan 133 psöriazis vulgaris hastası ve 107 sağlıklı kontrol çalışmaya dahil
edildi. Hastalar PAŞİ skoruna göre hafif (PAŞİ<10) ve orta-şiddetli
(PAŞİ≥10) olarak 2 gruba ayrıldı.
Bulgular:
Hasta grubundaki NLO, OTH ve CRP kontrol grubuna göre anlamlı olarak yüksek
idi. (sırasıyla p=0.001, p=0.003, p<0.001). Hasta grubundaki TLO değeri,
kontrol grubuna kıyasla düşük olmakla beraber aralarındaki fark istatistiksel
olarak anlamlı değildi. (p:0,074) Psöriazisli hastalar arasında, OTH ve CRP
değerleri orta-şiddetli grupta, hafif gruba göre yüksekti ve aradaki fark
istatistiksel olarak anlamlıydı. (sırasıyla p:0,017, p<0.001). OTH ve CRP değerleri
ile artrit varlığı, tırnak tutulumu ve hastalık süresi arasında istatistiksel
olarak anlamlı bir ilişki saptanmadı. (p>0.05) NLO ve TLO değerleri ile PAŞİ
skoru, artrit varlığı, tırnak tutulumu ve hastalık süresi arasında
istatistiksel olarak anlamlı bir ilişki saptanmadı. (p>0.05)
Sonuç: NLO
ve CRP’ nin psöriazis hastalarında inflamasyonu göstermede uygun bir parametre
olduğu söylenebilir bununla birlikte NLO’ nun hastalık şiddetiyle korele
olmaması klinik kullanımını kısıtlayabilir. OTH’ nın psöriazis hastalarında
kontrollere göre daha yüksek olması ve PAŞİ skoru ile ilişkili olması
inflamasyon belirteci olarak kullanılmasının TLO ve NLO’ ya kıyasla daha
yararlı bir belirteç olduğunu göstermektedir.
Anahtar Kelimeler
Psöriazis vulgaris nötrofil/lenfosit oranı trombosit/lenfosit oranı ortalama trombosit hacmi CRP
Kaynakça
- 1. Unal M, Kucuk A, Unal GU, et al. Mean platelet volume, neutrophil to lyphocyte ratio and platelet to lymphocyte ratio in psoriasis. Turkderm. 2015; 49: 112-6.
- 2. Gaspari AA. Innate and adaptive immunity and the pathophysiology of psoriasis. J Am Acad Dermatol.2006; 54: 67-80.
- 3. Karabudak O, Ulusoy RE, Erikci AA, Solmazgul E, Dogan B,Harmanyeri Y. Inflammation and hypercoagulable state in adult psoriatic men. Acta Derm Venereol. 2008; 88: 337-40. 4. Asahina A, Kubo N, Umezawa Y, Honda H, Yanaba K, Nakagawa H. Neutrophil–lymphocyte ratio, platelet– lymphocyte ratio and mean platelet volume in Japanese patients with psoriasis and psoriatic arthritis: Response to therapy with biologics. J Dermatol. 2017; 44: 1112-21.
- 5. Turkmen K, Erdur FM, Ozcicek F, et al. Platelet-tolymphocyte ratio better predicts inflammation than neutrophil-to-lymphocyte ratio in end-stage renal disease patients. Hemodial Int. 2013; 17: 391-6.
- 6. Krueger G, Ellis CN. Psoriasis – recent advances in understanding its pathogenesis and treatment. J Am Acad Dermatol. 2005; 53: 94–100.
- 7. Rocha-Pereira P, Santos-Silva A, Rebelo I, Figueiredo A, Quintanilha A, Teixeira F. The inflammatory response in mild and in severe psoriasis. Br J Dermatol. 2004; 150: 917-28.
- 8. Sen BB, Rifaioglu EN, Ekiz O, Inan MU, Sen T, Sen N. Neutrophil to lymphocyte ratio as a measure of systemic inflammation in psoriasis. Cutan Ocul Toxicol. 2014; 33: 223-7.
- 9. Orem A, Deger O, Cimsit G, Bahadır S. Plasma polymorphonuclear leukocyte elastase levels and its relation to disease activity in psoriasis. Clin Chim Acta.1997; 264: 49-56.
- 10. Balta S, Cakar M, Demirkol S, Arslan Z, Akhan M. Higher neutrophil to lymphocyte ratio in patients with metabolic syndrome. Clin Appl Thromb Hemost. 2013; 19: 579.
- 11. Cemil BC, Atas H. The Effect of Biological Treatment onto Systemic Inflammatory Markers and Plateletcrit in Psoriasis Patients. Dicle Med J. 2016; 43: 477-83.
- 12- Gunabatar H, Ekin S, Sunnetcioglu H, et al. The relationship between neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in patients with obstructive sleep apnea syndrome. Dicle Med J. 2015; 42: 289-93.
- 13. Sengül E,Ozbay M, Topcu I. Relationship between Neutrophil-to-Lymphocyte Ratio and Prognosis in Patients with Deep Neck Space Infection. Dicle Med J. 2016; 43: 126-9.
- 14. Kim DS, Shin D, Lee MS, et al. Assessments of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in Korean patients with psoriasis vulgaris and psoriatic arthritis. J Dermatol. 2016; 43: 305-10. 15. Yurtdaş M, Yaylali YT, Kaya Y, et al. Neutrophilto Lymphocyte Ratio May Predict Subclinical Atherosclerosis in Patients with Psoriasis. Echocardiography. 2014; 31: 1095-104.
- 16. Ataseven A, Bilgin AU, Kurtipek GS. The importance of neutrophil lymphocyte ratio in patients with psoriasis. Clin Med Res. 2014; 3: 40–3.
- 17. Cerman AA, Karabay EA, Altunay IK. Evaluation of neutrophil-lymphocyte ratio and mean platelet volume in patients with psoriasis. SETB. 2016; 50: 137-41
- 18. Yurtdas M, Yaylali YT, Kaya Y et al. Neutrophil-tolymphocyte ratio may predict subclinical atherosclerosis in patients with psoriasis. Echocardiography. 2014; 31: 1095–104.
- 19. Chu SG, Becker RC, Berger PB, et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. J Thromb Haemost. 2010; 8: 148-56.
- 20. Incebıyık A, Uyanıkoglu H. Is there a role mean platelet volume in the diagnosis of patients with adnexal torsion? Dicle Med J. 2017; 44: 333-7.
- 21- Sahpaz P,Ulutas KT. Assessment of mean platelet volume in type 2 diabetics receiving insulin or oral antidiabetic agents. Dicle Med J. 2015; 42: 399-403.
- 22. Saleh HMA, Attia EAS, Onsy AM, Saad AA, Abd Ellah MMM. Platelet activation: a link between psoriasis per se and subclinical atherosclerosis - a case - control study. Br J Dermatol. 2013; 169: 68-75.
- 23. Coimbra S, Oliveira H, Reis F, et al. C-reactive protein and leucocyte activation in psoriasis vulgaris according to severity and therapy. J Eur Acad Dermatol Venereol. 2010; 24: 789–96.
- 24. Beygi S, Lajevardi V, Abedini R. C-reactive protein in psoriasis: a review of the literatüre. JEADV. 2014; 28: 700-11.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Yazıları |
| Yazarlar | |
| Yayımlanma Tarihi | 5 Eylül 2018 |
| Gönderilme Tarihi | 4 Eylül 2018 |
| Yayımlandığı Sayı | Yıl 2018 Cilt: 45 Sayı: 3 |