Neutrophil-lymphocyte, Lymphocyte-monocyte, and Platelet-lymphocyte Ratios: Non-invasive Biomarkers for Assessing Inflammatory Bowel Disease Activity.

BACKGROUND

Inflammatory bowel diseases (IBD) necessitate cost-effective biomarkers for efficient management. This study aimed to explore the potential correlations of neutrophil-to-- lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) with IBD disease activity. Additionally, we assessed their associations with other inflammatory markers.

METHODS

We recruited 180 IBD patients with over 12 months of disease duration, categorized into two groups: Group 1 (active IBD) with 113 cases and Group 2 (inactive IBD) with 67 cases, alongside 200 group-matched healthy controls (Group 3). Hemogram, NLR, LMR, PLR, hs-CRP, ESR, fecal calprotectin (FC), and relevant parameters were recorded.

RESULTS

NLR and PLR were elevated, while LMR was decreased in active IBD patients compared to those in remission. The cutoff values for active IBD were determined as NLR > 1.98, LMR < 3.01, and PLR > 147, exhibiting sensitivity of 92%, 88%, and 91%, and specificity of 93%, 87%, and 89% respectively. Optimal cutoff values for IBD disease activity were CRP > 9.71, ESR > 24, and FC > 176. Multivariate logistic regression identified NLR, LMR, and PLR as robust parameters for discriminating IBD disease activity after adjusting for WBC, CRP, ESR, and FC markers (p < 0.05). NLR and PLR exhibited proportional increases with IBD severity, while LMR lacked such predictive capability.

CONCLUSION

NLR, PLR, and LMR emerge as simple, non-invasive, and cost-effective independent markers of IBD disease activity, complementing traditional markers like CRP and ESR.