University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Istanbul-Turkey


Introduction: Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are chronic inflammatory disorders. Inflammation is the probable underlying cause of disability. Platelet indices and complete blood compounds such as neutrophils and leukocytes are used to assess inflammation. This study investigated the relation between inflammation and the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), mean platelet volume (MPV) and platelet distribution width (PDW) in RA and AS.

Materials and methods: 425 subjects aged 17-89 (mean 44.64±14.07), 225 (52.9%) female and 200 (47.1%) male, were included in this retrospective study. One hundred five subjects had RA, 216 had AS, and 104 were healthy. RA was diagnosed based on 2010 ACR/EULAR Classification Criteria and AS according to Modified New York Criteria. RA disease activity was determined using DAS28 scores and AS disease activity using BASDAI.

Results: Hemoglobin values in patients with RA were statistically significantly lower compared to the control group (p=0.001), while ESR, CRP, NLR and PLR values were higher (p=0.001, p=0.001, p=0.001, and p=0.040). No difference was determined in MPV or PDW (p>0.05). Hemoglobin, ESR, CRP and NLR values in AS patients were significantly higher than in the control group (p=0.001, p=0.001, p=0.006, and p=0.001), while PDW values were lower (p=0.027; p<0.05). No difference was determined in PLR or MPV values (p>0.05). No correlation was determined between disease activity indices and NLR, PLR, MPV, PDW.

Conclusion: Being cost-effective and easily calculated, NLR and PLR in RA and NLR in AS can be used together with ESR and CRP or as inflammation markers when these are unavailable.


Ankylosing spondylitis, inflammation, rheumatoid arthritis, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, mean platelet volume