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Research article
Guoguang Lu
Taizhou Hospital of Zhejiang Province
Corresponding Author
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Background: Ankylosing spondylitis (AS)is a chronic inflammatory disorder involving the sacroiliac joints, lumbar spine, thoracic spine and even cervical spine, and could leading to disability due to the failure of timely treatment. Therefore, early diagnosis is essential to for AS treatment. The lymphocyte-monocyte ratio (LMR) is a systemic inflammatory and immunological indicator for prediction of disease development and progression. However, its role in AS remains unclear. The aim of this study was to investigate the role of LMR in AS diagnosis, disease activity classification and sacroiliac arthritis staging.
Methods: Seventy-eight AS patients and 78 sex-age-matched healthy controls (HCs) were enrolled in this study. The diagnosis of AS was performed according to the New York criteria, whereas the staging of sacroiliac arthritis of AS patients was determined by X-ray examination.Comparison of between AS patients and HCs and between patients with high and low stages on LMR levels and other laboratory indicators were carried out.
Results: A higher level of NLR, RDW, PLR, MPV, ESR, CRP and lower level of RBC, Hb, Hct, LMR, ALT, AST, TBIL and A/G were noted in the AS patients compared to HCs. A positive correlation was observed between LMR and RBC, Hb, Hct and A/G, while negative correlation was found between LMR and NLR, PLR, AST, TBIL (P< 0.05). The ROC curve showed that the area under the curve of LMR was 0.803(95%CI =0.734-0.872), with a sensitivity and specificity of 62.8% and 87.2%,and the AUC (95%CI) for ESR, CRP and LMR in the combined diagnosis of ankylosing spondylitis were 0.975(0.948-1.000),with the sensitivity and specificity of 94.9% and 97.4% .Levels of WBC and NLR were higher in high X-ray stage patients, whereas levels of LMR was lower (P<0.05) and statistical differences were observed of LMR values among different stages (P<0.05).
Conclusions: Our study suggested that LMR is an important inflammatory marker that can be used to diagnosis AS and identify disease activity and X-ray stage of sacroiliac arthritis in AS patients.
Keywords
Ankylosing spondylitis (AS), Lymphocyte-monocyte ratio (LMR), X-ray, Disease activity, Stage
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CURRENT STATUS: Published
View the published article at BMC Musculoskeletal Disorders.
No community comments so far
Submission checks complete
On 12 Jan, 2021
Editorial decision: Accept
On 10 Jan, 2021
Editor assigned
On 09 Jan, 2021
Editor invited
On 09 Jan, 2021
No comments provided
Editor assigned
On 17 Nov, 2020
Submission checks complete
On 17 Nov, 2020
Editor invited
On 17 Nov, 2020
No comments provided
Editorial decision: Minor revision
On 15 Nov, 2020
Review #1 received
Received 29 Oct, 2020
Editor assigned
On 27 Oct, 2020
Reviewers invited
Invitations sent on 27 Oct, 2020
Reviewer #1 agreed
On 27 Oct, 2020
Submission checks complete
On 26 Oct, 2020
Editor invited
On 26 Oct, 2020
No comments provided
Editorial decision: Major revision
On 30 Sep, 2020
Review #1 received
Received 11 Aug, 2020
Editor assigned
On 07 Aug, 2020
Reviewers invited
Invitations sent on 07 Aug, 2020
Reviewer #1 agreed
On 07 Aug, 2020
Submission checks complete
On 06 Aug, 2020
Editor invited
On 06 Aug, 2020
Version 1
Posted 17 Jan, 2020
No comments provided
Editorial decision: Major revision
On 14 Jul, 2020
Review #2 received
Received 28 Jun, 2020
Reviewer #2 agreed
On 24 Jun, 2020
Review #1 received
Received 15 Feb, 2020
Reviewer #1 agreed
On 16 Jan, 2020
Editor assigned
On 15 Jan, 2020
Reviewers invited
Invitations sent on 15 Jan, 2020
Submission checks complete
On 14 Jan, 2020
Editor invited
On 14 Jan, 2020
First submitted
On 06 Jan, 2020
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A new preprint design is coming!
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See the published version of this preprint at BMC Musculoskeletal Disorders.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Guoguang Lu
Taizhou Hospital of Zhejiang Province
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Musculoskeletal Disorders.
No community comments so far
Submission checks complete
On 12 Jan, 2021
Editorial decision: Accept
On 10 Jan, 2021
Editor assigned
On 09 Jan, 2021
Editor invited
On 09 Jan, 2021
No comments provided
Editor assigned
On 17 Nov, 2020
Submission checks complete
On 17 Nov, 2020
Editor invited
On 17 Nov, 2020
No comments provided
Editorial decision: Minor revision
On 15 Nov, 2020
Review #1 received
Received 29 Oct, 2020
Editor assigned
On 27 Oct, 2020
Reviewers invited
Invitations sent on 27 Oct, 2020
Reviewer #1 agreed
On 27 Oct, 2020
Submission checks complete
On 26 Oct, 2020
Editor invited
On 26 Oct, 2020
No comments provided
Editorial decision: Major revision
On 30 Sep, 2020
Review #1 received
Received 11 Aug, 2020
Editor assigned
On 07 Aug, 2020
Reviewers invited
Invitations sent on 07 Aug, 2020
Reviewer #1 agreed
On 07 Aug, 2020
Submission checks complete
On 06 Aug, 2020
Editor invited
On 06 Aug, 2020
Version 1
Posted 17 Jan, 2020
No comments provided
Editorial decision: Major revision
On 14 Jul, 2020
Review #2 received
Received 28 Jun, 2020
Reviewer #2 agreed
On 24 Jun, 2020
Review #1 received
Received 15 Feb, 2020
Reviewer #1 agreed
On 16 Jan, 2020
Editor assigned
On 15 Jan, 2020
Reviewers invited
Invitations sent on 15 Jan, 2020
Submission checks complete
On 14 Jan, 2020
Editor invited
On 14 Jan, 2020
First submitted
On 06 Jan, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedics
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Musculoskeletal Disorders.
Background: Ankylosing spondylitis (AS)is a chronic inflammatory disorder involving the sacroiliac joints, lumbar spine, thoracic spine and even cervical spine, and could leading to disability due to the failure of timely treatment. Therefore, early diagnosis is essential to for AS treatment. The lymphocyte-monocyte ratio (LMR) is a systemic inflammatory and immunological indicator for prediction of disease development and progression. However, its role in AS remains unclear. The aim of this study was to investigate the role of LMR in AS diagnosis, disease activity classification and sacroiliac arthritis staging.
Methods: Seventy-eight AS patients and 78 sex-age-matched healthy controls (HCs) were enrolled in this study. The diagnosis of AS was performed according to the New York criteria, whereas the staging of sacroiliac arthritis of AS patients was determined by X-ray examination.Comparison of between AS patients and HCs and between patients with high and low stages on LMR levels and other laboratory indicators were carried out.
Results: A higher level of NLR, RDW, PLR, MPV, ESR, CRP and lower level of RBC, Hb, Hct, LMR, ALT, AST, TBIL and A/G were noted in the AS patients compared to HCs. A positive correlation was observed between LMR and RBC, Hb, Hct and A/G, while negative correlation was found between LMR and NLR, PLR, AST, TBIL (P< 0.05). The ROC curve showed that the area under the curve of LMR was 0.803(95%CI =0.734-0.872), with a sensitivity and specificity of 62.8% and 87.2%,and the AUC (95%CI) for ESR, CRP and LMR in the combined diagnosis of ankylosing spondylitis were 0.975(0.948-1.000),with the sensitivity and specificity of 94.9% and 97.4% .Levels of WBC and NLR were higher in high X-ray stage patients, whereas levels of LMR was lower (P<0.05) and statistical differences were observed of LMR values among different stages (P<0.05).
Conclusions: Our study suggested that LMR is an important inflammatory marker that can be used to diagnosis AS and identify disease activity and X-ray stage of sacroiliac arthritis in AS patients.
Figure 1
Figure 2
Figure 3
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