Can Neutrophil-Lymphocyte Ratio and Lymphocyte-Monocyte Ratio be Considered as Non‑Invasive Biomarkers of Disease Activity and Severity in Ulcerative Colitis?

Abstract

Some inflammatory biomarkers have been routinely used to evaluate activity and severity in ulcerative colitis (UC), but none of them seems to be pertinent apart from endoscopic interventions. The aim of this study is to evaluate the utility of neutrophil-lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR) as simple and cost-effective non-invasive biomarkers for detecting disease activity in patients with UC. Also, the correlation between both NLR or LMR and the other studied inflammatory markers in patients with UC was also investigated. Methods: We designed a retrospective study including 69 UC patients admitted to our hospital between January 2021 to January 2024. This patients were classified into two groups: Group 1 (active UC) and group 2 (inactive UC). The disease activity was assessed according to Mayo score. The White blood cell count (WBC), NLR, LMR, C-reactive protein (CRP) and fecal calprotectin (FC) were measured and recorded. Statistical analysis was performed using IBM Statistical Package of Social Sciences (SPSS) version 20. Results: Significant elevation of NLR was observed in active UC group compared to inactive UC group (2.74 ± 1.13 and 1.61 ± 0.41 respectively; p < 0.0001). The LMR values in the UC active group were significantly lower compared to patients with inactive UC (3.32 ± 1.25, 4.04 ± 1.18 respectively; p = 0.017). The receiver operating characteristic (ROC) analysis showed that the optimal NLR and LMR cut-off values for active UC was of 2.46 [sensitivity: 48.4 %, specificity: 66.7 %, AUC: 0.46] and ˂ 3.45 [sensitivity: 76.5 %, specificity: 62.9 %, AUC: 0.71] respectively. Moreover, NLR values were found to be significantly correlated with CF and CRP levels in active UC. Also, LMR showed a significant correlation with CF in patients with active UC. Furthermore, NLR and LMR were positively correlated with endoscopically severe disease. Conclusion: The present study has demonstrated that high NLR levels and low LMR levels ......