Evaluating the clinical application of the immune cells’ ratios and inflammatory markers in the diagnosis of inflammatory bowel disease

Main Article Content

Mamoon M.D. Al-Rshaidat https://orcid.org/0000-0003-3047-5608
Shaima Al-Sharif
Assem Al Refaei https://orcid.org/0000-0002-4592-4448
Nour Shewaikani https://orcid.org/0000-0002-5720-8924
Ahmad R. Alsayed
Yaser M. Rayyan https://orcid.org/0000-0002-0421-5143

Keywords

IBD, Crohn’s disease, Ulcerative colitis, immune cells, Inflammation, Biomarkers, Neutrophil-to-lymphocyte, Platelet-to-lymphocytes

Abstract

Objective: Inflammatory Bowel Diseases (IBDs) are chronic inflammatory conditions of the gastrointestinal tract, including Crohn’s disease (CD) and ulcerative colitis (UC). Developing methods for effective screening and diagnosis is extremely needed. Accordingly, this study aims to evaluate the potential of immune cells ratios in the diagnosis of IBD. Methods: This case-control study includes data from Jordan University Hospital (JUH) medical records for IBD patients with age- and gender-matched healthy controls. Results: This study included 46 participants, of which 56.52% had IBD, 54.35% were males, with insignificant differences in sex, age, and body mass index (BMI) between IBD patients and controls (p>0.05). In the CD group, the variables with the highest sensitivity and specificity (HSS) were neutrophil-to-lymphocyte (NLR) (75%, 80%) and platelet-to-lymphocytes (PLR) (75%, 90%), in UC group; mean corpuscular hemoglobin (MCH) (80%, 80%). In CD group, the combinations giving the HSS were PLR+NLR (76%, 90.9%), C-reactive protein (CRP)+PLR (76%, 90.9%), and CRP+NLR (73.07%, 90%). In UC group, the combinations giving the HSS were erythrocyte sedimentation rate (ESR)+PLR (76.9%, 100%), PLR+MCH (74.07%, 100%), PLR+CRP (71.42%, 100%), and PLR+NLR (71.42%, 100%). Regression analysis identified five different combinations of significance in the diagnosis of CD and UC. Higher Youden’s index was used and defined the most beneficial clinical combinations as NLR+PLR and CRP+PLR for CD, whereas ESR+PLR for UC. Conclusion: Implications to our study include the clinical application of immune cell ratios, inflammatory markers, and their different combinations along with patients’ history and physical examination findings for easier, faster, and more cost-effective diagnosis of IBDs.

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