Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio Changes During Follow-up in Celiac Patients
Abstract
Aim: Compare the Neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) ratios of pre-diagnosis and diet-adherent follow-up patients with Celiac disease (CD) and to evaluate the cost-effective parameters that can be used in future follow-up.
Methods: Patients admitted to the Pediatric Gastroenterology clinic between 2020 and 2023 and diagnosed with celiac disease were retrospectively analyzed for the study. Patients with heart failure, peripheral vascular disease, acute or chronic infection, cancer, hematologic, liver disease and chronic drug use (nonsteroidal anti-inflammatory, anticoagulant) were excluded.
Results: A total of 287 patients were included in the study. After treatment, the control complete blood count value was checked at the earliest 3 months and at the latest 10 months (mean 5.4 ± 1.6 months). Neutrophil values showed a significant decrease in CD patients on gluten-free diet. The mean platelet value decreased during follow-up, but the result was not significant. It was analyzed that lymphocyte values increased with gluten free diet. Pre-diagnosis and follow-up NLR (2.4 ± 1.3 vs 1.9 ± 1.1; P < 0.001) and PLR (141 ± 65 vs 119 ± 56; P < 0.001) values of CD patients treated with gluten-free diet showed a significant decrease.
Conclusion: NLR, PLR rates decrease during follow-up in CD patients adhering to a gluten-free diet. It may be possible to follow-up celiac disease with NLR and PLR values obtained from complete blood count, which are low cost and routinely used.
References
- 1. Diosdado B, van Bakel H, Strengman E, Franke L, van Oort E, Mulder CJ, Wijmenga C, Wapenaar MC. Neutrophil recruitment and barrier impairment in celiac disease: a genomic study. Clin Gastroenterol Hepatol 2007; 5(5):574-81.
- 2. Sarikaya M, Dogan Z, Ergul B, Filik L. Platelet-to-lymphocyte ratio for early diagnosis of celiac disease. Indian J Gastroenterol 2015; 34(2):182-3.
- 3. Mimidis K, Papadopoulos V, Kotsianidis J, Filippou D, Spanoudakis E, Bourikas G, Dervenis C, Kartalis G. Alterations of platelet function, number and indexes during acute pancreatitis. Pancreatology 2004; 4(1):22-7.
- 4. Karacaer C, Sert H, Tozlu M. Importance of neutrophil-lymphocyte ratio in predicting compliance with gluten-free diet in celiac Patients. The Turkish Journal of Academic Gastroenterology 2020; 19:150-55.
- 5. Oberhuber G, Granditsch G, Vogelsang H. The histopathology of celiac disease: time for a standardized report scheme for patholo‐gists. Eur J Gastroenterol Hepatol 1999; 11:1185‐94.
- 6. Sarikaya M, Dogan Z, Ergul B, Filik L. Neutrophil-to-lymphocyte ratio as a sensitive marker in diagnosis of celiac disease. Ann Gastroenterol 2014; 27(4):431-2.
- 7. Iversen R, Sollid LM. The Immunobiology and Pathogenesis of Celiac Disease. Annu Rev Pathol 2023; 18:47-70.
- 8. Mittal P, Arora D, Parashar S, Goyal R, Khan A, Chopra H, Mishra DK, Gautam RK, Dhama K. Celiac disease: Pathogenesis, disease management and new insights into the herbal-based treatments. Narra J 2023; 3(2):e147.
- 9. Gerceker E, Baykan AR, Cerrah S, Yuceyar H. Mean platelet volume can indicate dietary adherence and disease severity of celiac disease. North Clin Istanb 2022; 9(1):41-46.
- 10. Ciclitira PJ. Recent advances in coeliac disease. Clin Med 2003; 3: 166–9.
- 11. Ghoshal K, Bhattacharya M. Overview of platelet physiology: its hemostatic and non-hemostatic role in disease pathogenesis. Sci World J 2014; 2014:781857.
- 12. Balaban, D.V.; Popp, A.; Beata, A.; Vasilescu, F.; Jinga, M. Diagnostic accuracy of red blood cell distribution width-to-lymphocyte ratio for celiac disease. Revista Româna de Medicina de Laborator 2018, 26, 45–50.
- 13. Raguzzini A, Poce G, Consalvi S, Toti E, Palmacci F, Biava M, Peluso I. Chocolate Consumers and Lymphocyte-to-Monocyte Ratio: A Working Hypothesis from a Preliminary Report of a Pilot Study in Celiac Subjects. Antioxidants (Basel) 2019; 8(10):440.
- 14. Palmacci F, Toti E, Raguzzini A, Catasta G, Aiello P, Peluso I, Biava M, Palmery M. Neutrophil-to-Lymphocyte Ratio, Mediterranean Diet, and Bone Health in Coeliac Disease Patients: A Pilot Study. Oxid Med Cell Longev 2019; 2019:7384193.
- 15. O'Grady JG, Harding B, Stevens FM, Egan EL, McCarthy CF. Influence of splenectomy and the functional hyposplenism of coeliac disease on platelet count and volume. Scand J Haematol 1985; 34(5):425-8.
- 16. Purnak T, Efe C, Yuksel O, Beyazit Y, Ozaslan E, Altiparmak E. Mean platelet volume could be a promising biomarker to monitor dietary compliance in celiac disease. Ups J Med Sci 2011; 116(3):208-11.
- 17. Vici G, Belli L, Biondi M, Polzonetti V. Gluten free diet and nutrient deficiencies: A review. Clin Nutr 2016; 35(6):1236-41.
Çölyak Hastalarında Takip Sırasında Nötrofil/Lenfosit Oranı ve Trombosit /Lenfosit Oranı Değişiklikleri
Abstract
Amaç: Çölyak hastalığı (ÇH) ön tanılı ve diyetle takip edilen hastaların nötrofil lenfosit oranı (NLO) ve trombosit lenfosit oranı (PLR) oranlarını karşılaştırmak ve gelecekte kullanılabilecek maliyet etkin parametreleri değerlendirmek takip etmek.
Yöntemler: Çalışma için 2020-2023 yılları arasında Çocuk Gastroenteroloji kliniğine başvuran ve çölyak hastalığı tanısı alan hastalar retrospektif olarak analiz edildi. Kalp yetmezliği, periferik damar hastalığı, akut veya kronik enfeksiyon, kanser, hematolojik, karaciğer hastalığı ve kronik ilaç kullanımı (nonsteroid antiinflamatuar, antikoagülan) olan hastalar çalışma dışı bırakıldı.
Bulgular: Çalışmaya toplam 287 hasta dahil edildi. Tedavi sonrasında en erken 3. ayda ve en geç 10. ayda (ortalama 5,4±1,6 ay) kontrol tam kan sayımı değerlerine bakıldı. Glutensiz diyet uygulayan ÇH hastalarında nötrofil değerleri anlamlı bir düşüş gösterdi. Ortalama trombosit değeri takip sırasında düştü ancak sonuç anlamlı değildi. Glutensiz diyetle lenfosit değerlerinin arttığı analiz edildi. Glutensiz diyetle tedavi edilen ÇH hastalarının ön tanı ve takip NLR (2,4 ± 1,3 vs 1,9 ± 1,1; P < 0,001) ve PLR (141 ± 65 vs 119 ± 56; P < 0,001) değerlerinde anlamlı bir azalma gösterdi .
Sonuç: Glutensiz diyet uygulayan ÇH hastalarında takip sırasında NLR, PLR oranları azalmaktadır. Maliyeti düşük ve rutin olarak kullanılan tam kan sayımından elde edilen NLR ve PLR değerleri ile çölyak hastalığının takibi mümkün olabilir.
References
- 1. Diosdado B, van Bakel H, Strengman E, Franke L, van Oort E, Mulder CJ, Wijmenga C, Wapenaar MC. Neutrophil recruitment and barrier impairment in celiac disease: a genomic study. Clin Gastroenterol Hepatol 2007; 5(5):574-81.
- 2. Sarikaya M, Dogan Z, Ergul B, Filik L. Platelet-to-lymphocyte ratio for early diagnosis of celiac disease. Indian J Gastroenterol 2015; 34(2):182-3.
- 3. Mimidis K, Papadopoulos V, Kotsianidis J, Filippou D, Spanoudakis E, Bourikas G, Dervenis C, Kartalis G. Alterations of platelet function, number and indexes during acute pancreatitis. Pancreatology 2004; 4(1):22-7.
- 4. Karacaer C, Sert H, Tozlu M. Importance of neutrophil-lymphocyte ratio in predicting compliance with gluten-free diet in celiac Patients. The Turkish Journal of Academic Gastroenterology 2020; 19:150-55.
- 5. Oberhuber G, Granditsch G, Vogelsang H. The histopathology of celiac disease: time for a standardized report scheme for patholo‐gists. Eur J Gastroenterol Hepatol 1999; 11:1185‐94.
- 6. Sarikaya M, Dogan Z, Ergul B, Filik L. Neutrophil-to-lymphocyte ratio as a sensitive marker in diagnosis of celiac disease. Ann Gastroenterol 2014; 27(4):431-2.
- 7. Iversen R, Sollid LM. The Immunobiology and Pathogenesis of Celiac Disease. Annu Rev Pathol 2023; 18:47-70.
- 8. Mittal P, Arora D, Parashar S, Goyal R, Khan A, Chopra H, Mishra DK, Gautam RK, Dhama K. Celiac disease: Pathogenesis, disease management and new insights into the herbal-based treatments. Narra J 2023; 3(2):e147.
- 9. Gerceker E, Baykan AR, Cerrah S, Yuceyar H. Mean platelet volume can indicate dietary adherence and disease severity of celiac disease. North Clin Istanb 2022; 9(1):41-46.
- 10. Ciclitira PJ. Recent advances in coeliac disease. Clin Med 2003; 3: 166–9.
- 11. Ghoshal K, Bhattacharya M. Overview of platelet physiology: its hemostatic and non-hemostatic role in disease pathogenesis. Sci World J 2014; 2014:781857.
- 12. Balaban, D.V.; Popp, A.; Beata, A.; Vasilescu, F.; Jinga, M. Diagnostic accuracy of red blood cell distribution width-to-lymphocyte ratio for celiac disease. Revista Româna de Medicina de Laborator 2018, 26, 45–50.
- 13. Raguzzini A, Poce G, Consalvi S, Toti E, Palmacci F, Biava M, Peluso I. Chocolate Consumers and Lymphocyte-to-Monocyte Ratio: A Working Hypothesis from a Preliminary Report of a Pilot Study in Celiac Subjects. Antioxidants (Basel) 2019; 8(10):440.
- 14. Palmacci F, Toti E, Raguzzini A, Catasta G, Aiello P, Peluso I, Biava M, Palmery M. Neutrophil-to-Lymphocyte Ratio, Mediterranean Diet, and Bone Health in Coeliac Disease Patients: A Pilot Study. Oxid Med Cell Longev 2019; 2019:7384193.
- 15. O'Grady JG, Harding B, Stevens FM, Egan EL, McCarthy CF. Influence of splenectomy and the functional hyposplenism of coeliac disease on platelet count and volume. Scand J Haematol 1985; 34(5):425-8.
- 16. Purnak T, Efe C, Yuksel O, Beyazit Y, Ozaslan E, Altiparmak E. Mean platelet volume could be a promising biomarker to monitor dietary compliance in celiac disease. Ups J Med Sci 2011; 116(3):208-11.
- 17. Vici G, Belli L, Biondi M, Polzonetti V. Gluten free diet and nutrient deficiencies: A review. Clin Nutr 2016; 35(6):1236-41.
Details
| Primary Language | English |
|---|---|
| Subjects | Pediatric Gastroenterology |
| Journal Section | Research Article |
| Authors | |
| Early Pub Date | May 22, 2025 |
| Publication Date | May 28, 2025 |
| Submission Date | May 12, 2024 |
| Acceptance Date | December 3, 2024 |
| Published in Issue | Year 2025 Volume: 11 Issue: 2 |
