Ankilozan spondilit hastalarında sistemik immün inflamasyon indeksinin hastalık aktivitesi ile ilişkisi

Yıl 2025, Cilt: 18 Sayı: 1, 197 - 205, 01.01.2025

Büşra Şirin Ahısha , Nur Kesiktaş , Nurdan Paker , Yiğit Can Ahısha

https://doi.org/10.31362/patd.1494276

Öz

Amaç: Bu çalışma, ankilozan spondilit (AS) hastalarında sistemik immün inflamasyon indeksi (SII), trombositlenfosit
oranı (PLR), nötrofil-lenfosit oranı (NLR) ile hastalık aktivitesi ve fonksiyonel durum arasındaki ilişkiyi
araştırmayı amaçlamaktadır.
Gereç ve yöntem: Bu klinik kesitsel çalışmaya, Modifiye New York Kriterleri’ne göre AS tanısı almış 18-
65 yaş aralığında 90 hasta dahil edildi. Demografik veriler, trombosit, nötrofil, bazofil, eozinofil ve lenfosit
sayıları, ortalama trombosit hacmi (MPV), eritrosit dağılım genişliği (RDW), C-reaktif protein (CRP) ve eritrosit
sedimantasyon hızı (ESR) gibi laboratuvar parametreleri kaydedildi. NLR, PLR ve SII değerleri hesaplandı.
Bulgular: Çalışmaya dahil edilen AS hastalarının yaş ortalamaları 42,9±11,3 yıl idi. SII ile CRP (p=0,010,
r=0,269) ve ESR (p=0,007, r=0,282) arasında pozitif korelasyon saptandı. SII ile BASDAI (p=0,323), BASFI
(p=0,124) veya BASMI (p=0,673) arasında anlamlı bir ilişki bulunmadı. NLR ve PLR değerleri aktif ve inaktif
hastalık grupları arasında anlamlı bir fark göstermedi (BASDAI, ASDAS-CRP ve ASDAS-ESR için sırasıyla; NLR:
p=0,933, p=0,639, p=0,240; PLR: p=0,708, p=0,858, p=0,351). SII ile ESR kullanılarak hesaplanan Ankilozan
Spondilit Hastalık Aktivite Skoru (ASDAS-ESR) arasında anlamlı bir korelasyon vardı (rho=0,282, p=0,007).
Sonuç: Çalışma, SII’nin AS’de yaygın inflamatuar belirteçler olan CRP ve ESR ile pozitif korelasyon gösterdiğini
ortaya koymaktadır. SII, özellikle daha yüksek hastalık aktivitesine sahip hastalarda inflamasyonu değerlendirmek
için potansiyel bir belirteç olabilir.

Anahtar Kelimeler

Ankilozan spondilit, tam kan sayımı, inflamasyon

The relationship between systemic immune inflammation index and disease activity in ankylosing spondylitis patients

Öz

Purpose: This study aimed to investigate the relationship between the systemic immune inflammation index
(SII), platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and disease activity and functional
status in patients with ankylosing spondylitis (AS).
Materials and methods: This cross-sectional clinical study included a total of 90 patients diagnosed with
AS according to the Modified New York Criteria, aged between 18 and 65, who presented to our outpatient
clinics. Demographic data and laboratory parameters, including platelet, neutrophil, basophil, eosinophil, and
lymphocyte counts, mean platelet volume (MPV), red blood cell distribution width (RDW), C-reactive protein
(CRP), and erythrocyte sedimentation rate (ESR), were recorded. NLR and PLR values were calculated. The SII
was calculated by dividing the product of neutrophil and platelet counts by the lymphocyte count.
Results: The study included 90 AS patients (mean age: 42.9±11.3 years). Positive correlations were observed
between SII and CRP (p=0.010, r=0.269) and ESR (p=0.007, r=0.282). No significant correlations were found
between SII and BASDAI (p=0.323), BASFI (p=0.124) or BASMI (p=0.673). NLR and PLR values didn’t differ
significantly between active and inactive disease groups across all disease activity measures (BASDAI, ASDASCRP,
and ASDAS-ESR; NLR: p=0.933, p=0.639, p=0.240; PLR: p=0.708, p=0.858, p=0.351; respectively). There
was a significant correlation between SII and Ankylosing Spondylitis Disease Activity Score with erythrocyte
sedimentation rate (ASDAS-ESR) (rho=0.282, p=0.007).
Conclusion: The study suggests that SII correlates positively with CRP and ESR, common inflammatory
markers in AS. SII could be a potential marker for assessing inflammation, especially in patients with higher
disease activity.

Anahtar Kelimeler

Ankylosing spondylitis, complete blood count, inflammation

Kaynakça

• 1. Rudwaleit M, Baeten D. Ankylosing spondylitis and bowel disease. Best Pract Res Clin Rheumatol 2006;20:451-471. https://doi.org/10.1016/j.berh.2006.03.010
• 2. Colglazier CL, Sutej PG. Laboratory testing in the rheumatic diseases: a practical review. South Med 2005;98:185-191. https://doi.org/10.1097/01.smj.0000153572.22346.e9
• 3. Aktas G, Sit M, Dikbas O, et al. Elevated neutrophil-to-lymphocyte ratio in the diagnosis of Hashimoto’s thyroiditis. Rev Assoc Med Bras 2017;63:1065-1068. https://doi.org/10.1590/1806-9282.63.12.1065
• 4. Posul E, Yilmaz B, Aktas G, Kurt M. Does neutrophil-to-lymphocyte ratio predict active ulcerative colitis? Wien Klin Wochenschr 2015;127:262-265. https://doi.org/10.1007/s00508-014-0683-5
• 5. Duman TT, Aktas G, Atak BM, Kocak MZ, Erkus E, Savli H. Neutrophil to lymphocyte ratio as an indicative of diabetic control level in type 2 diabetes mellitus. Afr Health Sci 2019;19:1602. https://doi.org/10.4314/ahs.v19i1.35
• 6. Kosekli MA. Mean platelet volume and platelet to lymphocyte count ratio are associated with hepatitis B-related liver fibrosis. Eur J Gastroenterol Hepatol 2022;34:324-327. https://doi.org/10.1097/meg.0000000000002219
• 7. Atak B, Aktas G, Duman TT, Erkus E, Kocak MZ, Savli H. Diabetes control could through platelet-to-lymphocyte ratio in hemograms. Rev Assoc Med Bras 2019;65:38-42. https://doi.org/10.1590/1806-9282.65.1.38
• 8. Hosein AM, Kostandinos S, Ahmad AZ, et al. The systemic-immune-inflammation index independently predicts survival and recurrence in resectable pancreatic cancer and its prognostic value depends on bilirubin levels. Ann Surg 2019;270:139-146. https://doi.org/10.1097/sla.0000000000002660
• 9. De Giorgi U, Procopio G, Giannarelli D, et al. Association of systemic inflammation index and body mass index with survival in patients with renal cell cancer treated with Nivolumab. Clin Cancer Res 2019;25:3839-3846. https://doi.org/10.1158/1078-0432.ccr-18-3661
• 10. Jomrich G, Paireder M, Kristo I, et al. High systemic immune-inflammation index is an adverse prognostic factor for patients with gastroesophageal adenocarcinoma. Annals of Surgery 2021;273:532-541. https://doi.org/10.1097/SLA.0000000000003370
• 11. Tanacan E, Dincer D, Erdogan FG, Gurler A. A cutoff value for the systemic immune‐inflammation index in determining activity of Behçet disease. Clin Exp Dermatol 2021;46:286-291. https://doi.org/10.1111/ced.14432
• 12. Kim Y, Choi H, Jung SM, Song JJ, Park Y, Lee S. Systemic immune‐inflammation index could estimate the cross‐sectional high activity and the poor outcomes in immunosuppressive drug‐naïve patients with antineutrophil cytoplasmic antibody‐associated vasculitis. Nephrology 2019;24:711-717. https://doi.org/10.1111/nep.13491
• 13. Uysal A. Investigating the presence of inflammation in lateral epicondylitis with platelet/lymphocyte ratio, neutrophil/lymphocyte ratio, and systemic immune-inflammation index. Chron Precis Med Res 2023;4:29-33. https://doi.org/10.5281/zenodo.7718532
• 14. Choe JY, Lee CU, Kim SK. Association between novel hematological indices and measures of disease activity in patients with rheumatoid arthritis. Medicina (B Aires) 2023;59:117. https://doi.org/10.3390/medicina59010117
• 15. Satis S. New inflammatory marker associated with disease activity in rheumatoid arthritis: the systemic immune-inflammation index. Curr Health Sci J 2021;47:553-557. https://doi.org/10.12865/chsj.47.04.11
• 16. Song GG, Lee YH. Red cell distribution width, platelet-to-lymphocyte ratio, and mean platelet volume in ankylosing spondylitis and their correlations with inflammation: a meta-analysis. Mod Rheumatol 2020;30:894-899. https://doi.org/10.1080/14397595.2019.1645373
• 17. Khorrampazhou N, Omranzadeh A, Fazeli B, et al. A systematic review and meta-analysis of clinical studies on ankylosing spondylitis and neutrophil to lymphocyte ratio. Curr Rheumatol Rev 2022;18:160-167. https://doi.org/10.2174/1573397117666210921114431
• 18. Akkoc Y, Karatepe AG, Akar S, Kirazli Y, Akkoc N. A Turkish version of the Bath Ankylosing Spondylitis Disease Activity Index: reliability and validity. Rheumatol Int 2005;25:280-284. https://doi.org/10.1007/s00296-003-0432-y
• 19. Machado PM, Landewé R, van der Heijde D. Ankylosing spondylitis disease activity score (ASDAS): 2018 update of the nomenclature for disease activity states. Ann Rheum Dis 2018;77:1539-1540. https://doi.org/10.1136/annrheumdis-2018-213184
• 20. Ozer HT, Sarpel T, Gulek B, Alparslan ZN, Erken E. The Turkish version of the Bath Ankylosing Spondylitis Functional Index: reliability and validity. Clinical Rheumatology 2005;24:123-128. https://doi.org/10.1007/s10067-004-0984-6
• 21. Wu J, Yan L, Chai K. Systemic immune-inflammation index is associated with disease activity in patients with ankylosing spondylitis. J Clin Lab Anal 2021;35:e23964. https://doi.org/10.1002/jcla.23964
• 22. Sariyildiz A, Benlidayi IC, Turk I, Acemoglu SSZ, Unal I. Evaluation of the relationship between blood cell markers and inflammation, disease activity, and general health status in ankylosing spondylitis. Rev Assoc Med Bras 2023;69:e20230722. https://doi.org/10.1590/1806-9282.20230722
• 23. Taha SI, Samaan SF, Ibrahim RA, Moustafa NM, El Sehsah EM, Youssef MK. Can complete blood count picture tell us more about the activity of rheumatological diseases? Clin Med Insights Arthritis Musculoskelet Disord 2022;15:11795441221089182. https://doi.org/10.1177/11795441221089182
• 24. Liang T, Chen J, Xu G, et al. Platelet-to-lymphocyte ratio as an independent factor was associated with the severity of ankylosing spondylitis. Frontiers in Immunology 2021;12:760214. https://doi.org/10.3389/fimmu.2021.760214
• 25. Al Osami MH, Awadh NI, Khalid KB, Awadh AI. Neutrophil/lymphocyte and platelet/lymphocyte ratios as potential markers of disease activity in patients with Ankylosing spondylitis: a case-control study. Advances in Rheumatology 2020;60:13. https://doi.org/10.1186/s42358-020-0113-5