Is there any association between the monocyte / lymphocyte ratio and the presence and severity of the disease in patients with psoriasis? A cross-sectional study.

Abstract

Objective: Patients with psoriasis have increased systemic inflammation and monocytes levels compared with the general population. However, the role of monocytes in modulating inflammation in these patients is not clearly known. Psoriasis patients, where inflammation plays a role, are also at risk for cardiovascular diseases. The monocyte-to-lymphocyte ratio (MLR) may reflect a systemic inflammatory status. The aim of this study was to investigate the usefulness of MLR in patients with psoriasis. Materials and Methods: A total of 180 consecutive patients who had been routinely referred to psoriasis outpatient clinic,and 40 healthy individuals were included in our case-control study between January 2015, and January 2017. Demographic features, Psoriasis Area and Severity Index (PASI) scores,and laboratory data were collected from electronic database system. Results: Patients with psoriasis had higher leukocyte, neutrophil, monocyte counts and MLR compared with control group (p=0.003, p<0.001, p=0.032, p<0.001, respectively). The PASI scores positively correlated with MLR (r=.244, p=0.001). The monocyte counts(p=0.004) and MLR (p<0.001) were significantly higher in the moderate-severe psoriasis group than in the mild psoriasis group. After adjusted for confounding factors,only MLR and body weight were found independently associated with moderate-severe psoriasis in multivariate regression analysis (p=0.005; p=0.037,respectively). The ROC analysis showed that MLR predicted moderate-severe psoriasis with a sensitivity of 84% and with a specificity of 56%, using a cut-off value of 0,192. The AUC (area under curve) was found 0.71(p<0.001). Conclusion: The MLR, an inexpensive and easily measurable variable,is significantly associated with the presence and severity of psorisis. More comprehensive studies are needed to validate and elaborate this relationship.

Keywords

• inflammation
• psoriasis
• monocyte
• lymphocyte

Psöriazis hastalarında monosit / lenfosit oranı ile hastalığın varlığı ve şiddeti arasında bir ilişki var mıdır? Kesitsel bir çalışma.

Abstract

Amaç: Psöriyazis’li hastalar, genel popülasyona kıyasla artmış sistemik inflamasyon ve monosit seviyelerine sahiptir. Bununla birlikte, bu hastalarda monositlerin enflamasyonu modüle etmedeki rolü açıkça bilinmemektedir. Enflamasyonun rol oynadığı psöriyazis hastaları kardiyovasküler hastalıklar içinde risk altındadır. Monosit-lenfosit oranı (MLO) sistemik bir enflamatuar durumu yansıtabilir. Bu çalışmanın amacı psöriyazis hastalarında MLO'nın yararlılığını araştırmaktır. Gereç ve Yöntemler: Vaka-kontrol çalışmamıza Ocak 2015 ile Ocak 2017 arasında psöriyazis polikliniğine rutin olarak yönlendirilen toplam 180 ardışık hasta ve 40 sağlıklı birey dahil edildi. Demografik özellikler, Psöriyazis Alan ve Şiddet İndeksi (PASI) skorları ve laboratuvar verileri elektronik veri tabanı sisteminden toplandı. Bulgular: Psöriyazis hastalarında kontrol grubuna kıyasla daha yüksek lökosit, nötrofil, monosit sayısı ve MLO vardı (sırasıyla p = 0.003, p <0.001, p = 0.032, p<0.001). PASI skorları MLO ile pozitif korelasyon gösterdi (r = .244, p = 0.001). Monosit sayıları (p = 0.004) ve MLO (p <0.001) orta-şiddetli psöriyazis grubunda hafif psöriyazis grubuna göre anlamlı derecede yüksekti. Karıştırıcı faktörler ayarlandıktan sonra, çok değişkenli regresyon analizinde sadece MLO ve vücut ağırlığının orta-şiddetli psöriyazis hastalığı ile bağımsız ilişkili olduğu bulunmuştur (sırasıyla p = 0.005; p = 0.037). ROC analizi, MLO'nın 0,192'lik bir cut-off değeri kullanılarak %84 sensitivite ve %56 spesifite ile orta-şiddetli psöriyazisi öngördüğünü gösterdi. EAA (eğrinin altındaki alan) 0.71 (p<0.001) bulundu. Sonuç: Ucuz ve kolayca ölçülebilen bir değişken olan MLO, psöriyazis varlığı ve ciddiyeti ile önemli ölçüde ilişkilidir. Bu ilişkiyi doğrulamak ve detaylandırmak için daha kapsamlı çalışmalara ihtiyaç vardır.

Keywords

• inflamasyon
• psöriazis
• monosit
• lenfosit

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