A comprehensive look at inflammation in RLS: assessing NLR, MLR, PLR, SII, SIRI, and microR

Year 2024, Volume: 7 Issue: 2, 219 - 223, 25.03.2024

İdris Kocatürk Özge Özen Gökmuharremoğlu

https://doi.org/10.32322/jhsm.1443422

Abstract

Aims: Restless legs syndrome (RLS) has been linked to systemic inflammation. The number of studies investigating inflammation in RLS patients is extremely limited. The purpose of this study is to examine the possible role of proinflammatory parameters in RLS, specifically neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), and microR.
Methods: The study included 100 patients admitted to the neurology outpatient clinic diagnosed with RLS using the International Restless Legs Syndrome Study Group ((IRLSSG) scale and 100 healthy controls. Hemogram results were obtained from both RLS patients and healthy controls, while ferritin, folate, vitamin D and B12, and C-reactive protein (CRP) levels were obtained only from RLS patients.
Results: The median age of the patient group was 52.50 (43-60.75), while the median age of the healthy group was 51.00 (50-53). The patient group is 37% male, while the healthy group is 34% male. It doesn't vary by age or gender (p=0.658). The two groups showed significant differences in PLR (<0.001), MLR (0.035), microR (p=0.023), and SIRI (p=0.022). There was no statistically significant difference in NLR, SII, and macroR levels between the two groups.
Conclusion: In the current study, the inflammatory variables PLR, MLR, and microR were significantly lower, and SIRI was significantly higher from healthy control groups.

Keywords

Restless Legs Syndrome, NLR, PLR, MLR, SII, SIRI, microR

Ethical Statement

KASTAMONU UNIVERSITY CLINICAL RESEARCH ETHICS COMMITTEE

Supporting Institution

NO

Project Number

2023-KAEK-156

Thanks

NO

References

• 1. Klingelhoefer L, Bhattacharya K, Reichmann H. Restless legs syndrome. Clin Med. 2016;16(4):379-382.
• 2. Olgun Yazar H, Yazar T, Özdemir S, Kasko Arici Y. Serum C-reactive protein/albumin ratio and restless legs syndrome. Sleep Med. 2019;58:61-65.
• 3. Weinstock LB, Walters AS, Paueksakon P. Restless legs syndrome--theoretical roles of inflammatory and immune mechanisms. Sleep Med Rev. 2012;16(4):341-354.
• 4. Varım C, Acar BA, Uyanık MS, et al. Association between the neutrophil-to-lymphocyte ratio, a new marker of systemic inflammation, and restless legs syndrome. Singapore Med J. 2016;57(9):514-516.
• 5. Trotti LM, Rye DB, De Staercke C, Hooper WC, Quyyumi A, Bliwise DL. Elevated C-reactive protein is associated with severe periodic leg movements of sleep in patients with restless legs syndrome. Brain Behav Immun. 2012;26(8):1239-1243.
• 6. Trenkwalder C, Högl B, Benes H, Kohnen R. Augmentation in restless legs syndrome is associated with low ferritin. Sleep Med. 2008;9(5):572-574.
• 7. Kitakata S, Furukawa S, Miyake T, et al. Association between clinical outcomes and restless legs syndrome in Japanese patients with ulcerative colitis. J Sleep Res. 2022;31(6):e13691.
• 8. Ozdogar AT, Kalron A. Restless legs syndrome in people with multiple sclerosis: an updated systematic review and meta-analyses. Mult Scler Relat Disord. 2021;56:103275.
• 9. Sarejloo S, Kheradjoo H, Haghi SE, et al. Neutrophil-to-lymphocyte ratio and early neurological deterioration in stroke patients: a systematic review and meta-analysis. Biomed Res Int. 2022;2022:8656864.
• 10. Hosseini S, Shafiabadi N, Khanzadeh M, et al. Neutrophil to lymphocyte ratio in parkinson's disease: a systematic review and meta-analysis. BMC Neurol. 2023;23(1):333.
• 11. Reyhani A, Kabaloglu V. Evaluation of inflammation in restless legs syndrome. J Turk Sleep Med. 2021;8(2):136-141.
• 12. Dowsett J, Didriksen M, Larsen MH, et al. Investigating the inflammation marker neutrophil-to-lymphocyte ratio in Danish blood donors with restless legs syndrome. PLoS One. 2021;16(11):e0259681.
• 13. Tak A, Sengul Y. Evaluation of inflammation with neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in restless legs syndrome. Turk Norol Derg. 2018;24(3):259.
• 14. Sharma D, Bhaskar SMM. Prognostic role of the platelet-lymphocyte ratio in acute ischemic stroke patients undergoing reperfusion therapy: a meta-analysis. J Cent Nerv Syst Dis. 2022;14:11795735221110373.
• 15. Güneş M, Büyükgöl H. Relationship between generalized epileptic seizure and neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and neutrophil mediated inflammation. Int J Neurosci. 2020;130(11):1095-1100.
• 16. Ozdemir HH. Analysis of the albumin level, neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio in Guillain-Barré syndrome. Arq Neuropsiquiatr. 2016;74(9):718-722.
• 17. Huang YW, Yin XS, Li ZP. Association of the systemic immune-inflammation index (SII) and clinical outcomes in patients with stroke: a systematic review and meta-analysis. Front Immunol. 2022;13:1090305.
• 18. Liu T, Gao J, Liu M. The clinical significance of systemic immune-inflammation index and platelet/neutrophil to lymphocyte ratio in Guillain-Barré syndrome. Clin Neurol Neurosurg. 2023;235:108015.
• 19. Kelesoglu S, Yilmaz Y, Elcik D, et al. Increased serum systemic immune-inflammation index is independently associated with severity of carotid artery stenosis. Angiology. 2023;74(8):790-797.
• 20. Han J, Yang L, Lou Z, Zhu Y. Association between systemic immune-inflammation index and systemic inflammation response index and outcomes of acute ischemic stroke: a systematic review and meta-analysis. Ann Indian Acad Neurol. 2023;26(5):655-662.
• 21. Shen Q, Mu X, Bao Y, et al. An S-like curve relationship between systemic inflammation response index (SIRI) and respiratory failure in GBS patients. Neurol Sci. 2023;44(9):3279-3285.
• 22. Bildirici M, Gülten S, Çalışgan N. Determination of reference intervals of hemogram with advanced clinical parameters by indirect method on Sysmex XN-1000. Turkish J Biochem. 2023;48(4):388-396.
• 23. Çığrı E, Gülten S. Assessment of micro-R/macro-R values and other hemogram parameters for the diagnosis of early neonatal sepsis. Kastamonu Med J. 2022;2(4):104-107.