Blood Neutrophil Count and Neutrophil‐to‐Lymphocyte Ratio for Prediction of Disease Progression and Mortality in Two Independent Systemic Sclerosis Cohorts
Objective To assess the predictive significance of blood neutrophil count and the ratio between neutrophil and lymphocyte count (neutrophil‐to‐lymphocyte ratio [NLR]) for disease severity and mortality in systemic sclerosis (SSc). Methods Neutrophil and lymphocyte counts were prospectively measured...
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Published in | Arthritis care & research (2010) Vol. 75; no. 3; pp. 648 - 656 |
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Main Authors | , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Boston, USA
Wiley Periodicals, Inc
01.03.2023
Wiley Subscription Services, Inc |
Subjects | |
Online Access | Get full text |
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Summary: | Objective
To assess the predictive significance of blood neutrophil count and the ratio between neutrophil and lymphocyte count (neutrophil‐to‐lymphocyte ratio [NLR]) for disease severity and mortality in systemic sclerosis (SSc).
Methods
Neutrophil and lymphocyte counts were prospectively measured in the Genetics versus Environment in Scleroderma Outcome Study (GENISOS) and the Scleroderma Lung Study II (SLS II). Forced vital capacity percent predicted (FVC%) and modified Rodnan skin thickness score (MRSS) were used as surrogate measures for disease severity. Longitudinal analyses were performed using generalized linear mixed models. Cox proportional hazards models evaluated the predictive significance of these cell counts for mortality.
Results
Of the 447 SSc patients in the GENISOS cohort at the time of analysis, 377 (84.3%) had available baseline blood neutrophil and lymphocyte counts. Higher baseline neutrophil count and NLR predicted lower serially obtained FVC% (b = −4.74, P = 0.009 and b = −2.68, P = 0.028, respectively) and higher serially obtained MRSS (b = 4.07, P < 0.001 and b = 2.32, P < 0.001, respectively). Longitudinal neutrophil and NLR measurements also significantly correlated with lower concurrently obtained FVC% measurements and higher concurrently obtained MRSS. Baseline neutrophil count and NLR predicted increased risk of long‐term mortality, even after adjustment for baseline demographic and clinical factors (hazard ratio [HR] 1.42, P = 0.02 and HR 1.48, P < 0.001, respectively). The predictive significance of higher baseline neutrophil count and NLR for declining FVC% and increased long‐term mortality was confirmed in the SLS II.
Conclusion
Higher blood neutrophil count and NLR are predictive of more severe disease course and increased mortality, indicating that these easily obtainable laboratory studies might be a reflection of pathologic immune processes in SSc. |
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Bibliography: | https://onlinelibrary.wiley.com/action/downloadSupplement?doi=10.1002%2Facr.24880&file=acr24880‐sup‐0001‐Disclosureform.pdf . Author disclosures are available at Supported by the Rheumatology Research Foundation (Future Physician Scientist Award to Ms. Wareing), the Department of Defense Congressionally Directed Medical Research Programs (grant W81XWH‐07‐01‐0111 to Dr. Mayes and grant W81XWH‐16‐1‐0296 to Dr. Assassi), and the NIH (National Institute of Arthritis and Musculoskeletal and Skin Diseases grant R01‐AR‐073284 to Dr. Assassi). ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 2151-464X 2151-4658 |
DOI: | 10.1002/acr.24880 |