Çölyak Hastalarında Takip Sırasında Nötrofil/Lenfosit Oranı ve Trombosit /Lenfosit Oranı Değişiklikleri

Öz

Amaç: Çölyak hastalığı (ÇH) ön tanılı ve diyetle takip edilen hastaların nötrofil lenfosit oranı (NLO) ve trombosit lenfosit oranı (PLR) oranlarını karşılaştırmak ve gelecekte kullanılabilecek maliyet etkin parametreleri değerlendirmek takip etmek. Yöntemler: Çalışma için 2020-2023 yılları arasında Çocuk Gastroenteroloji kliniğine başvuran ve çölyak hastalığı tanısı alan hastalar retrospektif olarak analiz edildi. Kalp yetmezliği, periferik damar hastalığı, akut veya kronik enfeksiyon, kanser, hematolojik, karaciğer hastalığı ve kronik ilaç kullanımı (nonsteroid antiinflamatuar, antikoagülan) olan hastalar çalışma dışı bırakıldı. Bulgular: Çalışmaya toplam 287 hasta dahil edildi. Tedavi sonrasında en erken 3. ayda ve en geç 10. ayda (ortalama 5,4±1,6 ay) kontrol tam kan sayımı değerlerine bakıldı. Glutensiz diyet uygulayan ÇH hastalarında nötrofil değerleri anlamlı bir düşüş gösterdi. Ortalama trombosit değeri takip sırasında düştü ancak sonuç anlamlı değildi. Glutensiz diyetle lenfosit değerlerinin arttığı analiz edildi. Glutensiz diyetle tedavi edilen ÇH hastalarının ön tanı ve takip NLR (2,4 ± 1,3 vs 1,9 ± 1,1; P < 0,001) ve PLR (141 ± 65 vs 119 ± 56; P < 0,001) değerlerinde anlamlı bir azalma gösterdi . Sonuç: Glutensiz diyet uygulayan ÇH hastalarında takip sırasında NLR, PLR oranları azalmaktadır. Maliyeti düşük ve rutin olarak kullanılan tam kan sayımından elde edilen NLR ve PLR değerleri ile çölyak hastalığının takibi mümkün olabilir.

Anahtar Kelimeler

• Nötrofil/lenfosit oranı
• Trombosit/lenfosit oranı
• Çölyak Hastalığı

Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio Changes During Follow-up in Celiac Patients

Abstract

Aim: Compare the Neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) ratios of pre-diagnosis and diet-adherent follow-up patients with Celiac disease (CD) and to evaluate the cost-effective parameters that can be used in future follow-up. Methods: Patients admitted to the Pediatric Gastroenterology clinic between 2020 and 2023 and diagnosed with celiac disease were retrospectively analyzed for the study. Patients with heart failure, peripheral vascular disease, acute or chronic infection, cancer, hematologic, liver disease and chronic drug use (nonsteroidal anti-inflammatory, anticoagulant) were excluded. Results: A total of 287 patients were included in the study. After treatment, the control complete blood count value was checked at the earliest 3 months and at the latest 10 months (mean 5.4 ± 1.6 months). Neutrophil values showed a significant decrease in CD patients on gluten-free diet. The mean platelet value decreased during follow-up, but the result was not significant. It was analyzed that lymphocyte values increased with gluten free diet. Pre-diagnosis and follow-up NLR (2.4 ± 1.3 vs 1.9 ± 1.1; P < 0.001) and PLR (141 ± 65 vs 119 ± 56; P < 0.001) values of CD patients treated with gluten-free diet showed a significant decrease. Conclusion: NLR, PLR rates decrease during follow-up in CD patients adhering to a gluten-free diet. It may be possible to follow-up celiac disease with NLR and PLR values obtained from complete blood count, which are low cost and routinely used.

Keywords

• Neutrophil to lymphocyte ratio
• Celiac Patients
• Platelet to lymphocyte ratio

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