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Research article
Guoguang Lu
Taizhou Hospital of Zhejiang Province
Corresponding Author
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Background: Axial spondyloarthritis (axial SpA)is a chronic inflammatory disorder involving the sacroiliac joints, that could lead to disability due to the failure of timely treatment. The lymphocyte-to-monocyte ratio (LMR) is an indicator of disease progression. However, its role in axial SpA remains unclear. The aim of this study was to investigate the role of LMR in axial SpA diagnosis, disease activity classification and sacroiliitis staging.
Methods: Seventy-eight axial SpA patients and 78 healthy controls (HCs) were enrolled in this study. The diagnosis of axial SpA was performed according to the New York criteria or the Assessment of Spondyloarthritis international Society (ASAS) classification criteria, whereas the staging of sacroiliitis in axial SpA patients was determined by X-ray examination. Comparisons of LMR levels between groups were performed using t test. Pearson or Spearman correlation analysis were used to assess correlations between LMR and other indicators. Receiver operating characteristic (ROC) curves were used to determine the role of LMR in the diagnosis of axial SpA.
Results: Higher neutrophil-to-lymphocyte ratio(NLR), red blood cell distribution width(RDW), platelet-to-lymphocyte ratio(PLR), mean platelet volume(MPV), erythrocyte sedimentation rate (ESR), and C-reactive protein(CRP) levels and lower red blood cell (RBC), hemoglobin (Hb), Hematocrit (Hct), LMR, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and albumin/globulin (A/G) levels were noted in axial SpA patients compared to HCs. Positive correlations were observed between LMR and RBC, Hb, Hct and A/G, whereas negative correlations were found between LMR and NLR, PLR, AST, and TBIL (P< 0.05). ROC curves showed that the area under the curve(AUC) for LMR in the diagnosis of ankylosing spondylitis was 0.803 (95% CI =0.734-0.872) with a sensitivity and specificity of 62.8% and 87.2%, respectively, and the AUC (95% CI) for the combination of ESR, CRP and LMR was 0.975 (0.948-1.000) with a sensitivity and specificity of 94.9% and 97.4%, respectively. LMR levels were lower (P<0.05) and significant differences in LMR values were observed among different stages (P<0.05).
Conclusions: Our study suggested that LMR might be an important inflammatory marker to identify axial SpA and assess disease activity and X-ray stage of sacroiliitis.
Keywords
Axial spondyloarthritis (axial SpA), Lymphocyte-monocyte ratio (LMR), X-ray, Disease activity, Stage
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CURRENT STATUS: Published
View the published article at BMC Musculoskeletal Disorders.
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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
Version 3
Posted 03 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
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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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
Version 3
Posted 03 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
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: Axial spondyloarthritis (axial SpA)is a chronic inflammatory disorder involving the sacroiliac joints, that could lead to disability due to the failure of timely treatment. The lymphocyte-to-monocyte ratio (LMR) is an indicator of disease progression. However, its role in axial SpA remains unclear. The aim of this study was to investigate the role of LMR in axial SpA diagnosis, disease activity classification and sacroiliitis staging.
Methods: Seventy-eight axial SpA patients and 78 healthy controls (HCs) were enrolled in this study. The diagnosis of axial SpA was performed according to the New York criteria or the Assessment of Spondyloarthritis international Society (ASAS) classification criteria, whereas the staging of sacroiliitis in axial SpA patients was determined by X-ray examination. Comparisons of LMR levels between groups were performed using t test. Pearson or Spearman correlation analysis were used to assess correlations between LMR and other indicators. Receiver operating characteristic (ROC) curves were used to determine the role of LMR in the diagnosis of axial SpA.
Results: Higher neutrophil-to-lymphocyte ratio(NLR), red blood cell distribution width(RDW), platelet-to-lymphocyte ratio(PLR), mean platelet volume(MPV), erythrocyte sedimentation rate (ESR), and C-reactive protein(CRP) levels and lower red blood cell (RBC), hemoglobin (Hb), Hematocrit (Hct), LMR, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and albumin/globulin (A/G) levels were noted in axial SpA patients compared to HCs. Positive correlations were observed between LMR and RBC, Hb, Hct and A/G, whereas negative correlations were found between LMR and NLR, PLR, AST, and TBIL (P< 0.05). ROC curves showed that the area under the curve(AUC) for LMR in the diagnosis of ankylosing spondylitis was 0.803 (95% CI =0.734-0.872) with a sensitivity and specificity of 62.8% and 87.2%, respectively, and the AUC (95% CI) for the combination of ESR, CRP and LMR was 0.975 (0.948-1.000) with a sensitivity and specificity of 94.9% and 97.4%, respectively. LMR levels were lower (P<0.05) and significant differences in LMR values were observed among different stages (P<0.05).
Conclusions: Our study suggested that LMR might be an important inflammatory marker to identify axial SpA and assess disease activity and X-ray stage of sacroiliitis.
Figure 1
Figure 2
Figure 3
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