Diz Osteoartritinde Hemogram Parametrelerinin Vücut Kitle İndeksi ile İlişkisi

Öz

Amaç: Bu çalışmada, düşük maliyetli, kolay, rutin olarak uygulanan düşük dereceli inflamasyon göstergeleri olan hemogram parametreleri ile obezite ve diz osteoartriti (DOA) şiddeti arasındaki ilişkinin araştırılması amaçlanmıştır. Materyal ve Metot: Bu çalışmaya, diz grafileri, kilo ve boy ölçümleri ve rutin laboratuvar testleri yapılmış 45-85 yaş arası 140 KOA hastası dahil edilmiştir. Kaydedilen veriler demografik bilgileri (cinsiyet, yaş), vücut kitle indeksini (BMI), rutin hemogramı ve laboratuvar parametrelerini içeriyordu. Hastalar Kellgren-Lawrence (KL) skorlarına göre iki gruba (hafif: KL 1-3, şiddetli: KL 4) ve BMI'larına göre dört gruba (BMI<25, BMI=25-30, BMI=30-35, BMI>35) ayrılmıştır. Bulgular: Bu çalışmada, serum CRP ve NLR değerleri şiddetli DOA hastalarında hafif DOA hastalarına kıyasla anlamlı derecede yüksek bulunmuştur (P<0,05). VKİ'ye göre değerlendirildiğinde, kan nötrofil lenfosit (NLR) ve nötrofil monosit (NMR) oranları hafif DOA gruplarında VKİ>30 olan hastalarda istatistiksel olarak anlamlı şekilde artmıştır. Ayrıca, şiddetli DOA gruplarında ortalama kan NLR değeri VKİ=30-35 olan hastalarda diğer gruplara kıyasla anlamlı derecede yüksek bulunmuştur. Sonuç: Bu sonuçlar, NLR ve NMR'nin klinik ortamda obezite ve hafif DOA arasındaki ilişkiye yeni bir bakış açısı sağlayabileceğini göstermektedir. Bu parametrelerin düşük maliyetli ve kolay uygulanabilmesi, hastalığın prognozunu ve seyrini belirlemede alternatif olabilir.

Anahtar Kelimeler

• Diz osteoartriti
• nötrofil/lenfosit oranı
• nötrofil/monosit oranı

Proje Numarası

none

Association of Hemogram Parameters with Body Mass Index in Knee Osteoarthritis

Öz

Objective: This study aims to investigate the relationship between hemogram parameters, which are low-cost, easy, routinely applied low-grade inflammation indicators, and severity of knee osteoarthritis (KOA) and obesity. Materials and Methods: This study involved 140 KOA patients aged 45 to 85 who underwent knee radiographs, weight and height measurements, and routine laboratory tests. Recorded data included demographic information (gender, age), body mass index (BMI), routine hemogram, and laboratory parameters. Patients were categorized into two groups based on their Kellgren-Lawrence (KL) scores (mild: KL 1-3, severe: KL 4) and four groups according to their BMI (BMI <25, BMI = 25-30, BMI = 30-35, BMI >35). Results: The findings revealed significantly elevated levels of serum Neutrophil-to-Lymphocyte Ratio (NLR) and C-reactive protein (CRP) in severe KOA compared to mild KOA (P<0.05). Evaluation by BMI demonstrated a statistically significant increase in serum NLR and Neutrophil-to-monocyte Ratio (NMR) in patients with BMI>30 in mild KOA groups, while mean blood NLR was notably higher in patients with BMI=30-35 in severe KOA groups. Conclusions: These results suggest that NLR and NMR could provide a new perspective on the relationship between obesity and mild KOA in clinical practice, presenting a cost-effective and easily applicable alternative for determining disease prognosis and progression.

Anahtar Kelimeler

• Knee osteoarthritis
• neutrophil/lymphocyte ratio
• neutrophil monocyte ratio

Destekleyen Kurum

none

Proje Numarası

none

Etik Beyan

This study was approved by the Ethics Committee of the Medical Faculty of Atatürk University (date of approval of the Ethics Committee: 30.11.2017, decision number: B.30.2.ATA.0.01.00/91).

Teşekkür

The authors are grateful to all participants for their help with sample collection

Kaynakça

1. Yunus MHM, Nordin A, Kamal H. Pathophysiological perspective of osteoarthritis. Medicina. 2020;56(11):614. doi:10.3390/medicina56110614
2. Coaccioli S, Sarzi-Puttini P, Zis P, Rinonapoli G, Varrassi G. Osteoarthritis: New insight on its pathophysiology. J. Clin. Med. 2022;11(20):6013. doi:10.3390/jcm11206013
3. Driban JB, McAlindon TE, Amin M, et al. Risk factors can classify individuals who develop accelerated knee osteoarthritis: data from the osteoarthritis initiative. J. Orthop. Res. 2018;36(3):877-880.
4. World Health Organization. Obesity 2022. http://www.who.int/nutrition/topics/obesity/en/. Accessed October 28, 2022.
5. Yazdi FT, Clee SM, Meyre D. Obesity genetics in mouse and human: back and forth, and back again. Peer J. 2015;3:e856. doi:10.7717/peerj.856
6. Wang T, He C. Pro-inflammatory cytokines: The link between obesity and osteoarthritis. Cytokine Growth Factor Rev. 2018;44:38-50.
7. McNulty AL, Miller MR, O'Connor SK, Guilak F. The effects of adipokines on cartilage and meniscus catabolism. Connect Tissue Res. 2011;52(6):523-533. doi:10.3109/03008207.2011.597902
8. Yusuf E, Nelissen RG, Ioan-Facsinay A, et al. Association between weight or body mass index and hand osteoarthritis: a systematic review. Ann Rheum Dis. 2010;69(4):761-765. doi:10.1136/ard.2008.106930

9. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16(4):494-502.
10. De Ceuninck F, Sabatini M, Pastoureau P. Recent progress toward biomarker identification in osteoarthritis. Drug Discov Today. 2011;16(9-10):443-449.
11. Richter M, Trzeciak T, Owecki M, Pucher A, Kaczmarczyk J. The role of adipocytokines in the pathogenesis of knee joint osteoarthritis. Int Orthop. 2015;39:1211-1217.
12. Bilgin S, Aktas G, Zahid Kocak M, et al. Association between novel inflammatory markers derived from hemogram indices and metabolic parameters in type 2 diabetic men. The Aging Male. 2020;23(5):923-927.
13. Liu P, Li P, Peng Z, et al. Predictive value of the neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-neutrophil ratio, and neutrophil-to-monocyte ratio in lupus nephritis. Lupus. 2020;29(9):1031-1039.
14. Rizo-Téllez SA, Méndez-García LA, Flores-Rebollo C, et al. The neutrophil-to-monocyte ratio and lymphocyte-to-neutrophil ratio at admission predict in-hospital mortality in Mexican patients with severe SARS-CoV-2 infection (Covid-19). Microorganisms. 2020;8(10):1560. doi:10.3390/microorganisms8101560
15. Shi J, Zhao W, Ying H, et al. The relationship of platelet to lymphocyte ratio and neutrophil to monocyte ratio to radiographic grades of knee osteoarthritis. Z Rheumatol. 2018;77(6):533-537.
16. Ustundag Y, Huysal K, Gecgel SK, Unal D. Relationship between C-reactive protein, systemic immune-inflammation index, and routine hemogram-related inflammatory markers in low-grade inflammation. Int J Med Biochem. 2018;1(1):24-28.
17. Altman R, Asch E, Bloch D, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum. 1986;29(8):1039-1049.
18. Tremmel M, Gerdtham U-G, Nilsson PM, Saha S. Economic burden of obesity: a systematic literature review. Int J Environ Resh Public Health. 2017;14(4):435.  doi: 10.3390/ijerph14040435
19. Christensen R, Henriksen M, Leeds AR, et al. Effect of weight maintenance on symptoms of knee osteoarthritis in obese patients: a twelve‐month randomized controlled trial. Arthritis Care Research. 2015;67(5):640-650.
20. Peker G M-PD, Köseoglu R, and Gul O. . Do body composition, hemogram and lipids differ between obese women with and without gonarthrosis? orginal artical. Ann Clin Anal Med. 2023;14(5):399-403. doi:10.4328/ACAM.21540
21. Dinçer ABK, Gülöksüz EGA, Sezer S, et al. Neutrophil/lymphocyte ratio but not platelet/lymphocyte ratio and mean platelet volume can be an indicator of subclinical inflammation in patients with Familial Mediterranean Fever. The Egyptian Rheumatologist. 2022;44(3):215-218.
22. Kumarasamy C, Sabarimurugan S, Madurantakam RM, et al. Prognostic significance of blood inflammatory biomarkers NLR, PLR, and LMR in cancer—A protocol for systematic review and meta-analysis. Medicine. 2019;98(24):e14834.  doi:10.1097/MD.0000000000014834
23. Soliman WM, Sherif NM, Ghanima IM, El-Badawy MA. Neutrophil to lymphocyte and platelet to lymphocyte ratios in systemic lupus erythematosus: relation with disease activity and lupus nephritis. Reumatol Clin. 2020;16(4):255-261.
24. Yang W-m, Zhang W-h, Ying H-q, et al. Two new inflammatory markers associated with disease activity score-28 in patients with rheumatoid arthritis: albumin to fibrinogen ratio and C-reactive protein to albumin ratio. Int Immunopharmacol. 2018;62:293-298.
25. Jeong Y, Jeon SR, Kim HG, et al. The role of platelet to lymphocyte ratio and neutrophil to lymphocyte ratio in ulcerative colitis. Intest Res. 2021;19(1):62-70.
26. Emel Atar AA. Diz osteoartrit hastalarında nötrofil/lenfosit oranı, trombosit/lenfosit oranı ve ortalama trombosit hacminin değerlendirilmesi. Cukurova Med J. 2017;42(2):329-336. doi:10.17826/cutf.306411
27. Hira S, Tamam C. Diagnostic value of hematological parameters in patients with osteoarthritis. Cukurova Med J. 2017;42(1):114-119. doi:10.17826/cutf.279696
28. Tasoglu O, Sahin A, Karatas G, et al. Blood mean platelet volume and platelet lymphocyte ratio as new predictors of hip osteoarthritis severity. Medicine. 2017;96(6).e6073. doi:10.1097/MD.0000000000006073
29. Tasoglu O, Boluk H, Sahin Onat S, Tasoglu I, Ozgirgin N. Is blood neutrophil-lymphocyte ratio an independent predictor of knee osteoarthritis severity? Clin Rheumatol. 2016;35(6):1579-1583. doi:10.1007/s10067-016-3170-8
30. Gundogdu G, Gundogdu K. A novel biomarker in patients with knee osteoarthritis: adropin. Clin Rheumatol. 2018;37:2179-2186.