P4291 - Neutrophil-Lymphocyte, Lymphocyte-Monocyte, and Platelet-Lymphocyte Ratios: Non-Invasive Biomarkers for Assessing Inflammatory Bowel Disease Activity

Dhruvkumar Patel, MBBS¹, Maitri M. Patel, MBBS², Dhara Patel, MD², Lalitkumar Patel, MD³, Shreel H. Patel, MD⁴, Mukundkumar Patel, MD^5
1LSU Health Science Center, Shreveport, LA; ²GCS Medical College and Research Centre, Ahmedabad, Gujarat, India; ³Narendra Modi Medical College, Ahmedabad, Gujarat, India; ⁴University of Texas Rio Grande Valley - Knapp Medical Center, Weslaco, TX; ⁵Ananya College of Medicine and Research, Ahmedabad, Gujarat, India

Introduction: Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), represents chronic gastrointestinal disorders without a cure. IBD exhibits a variable disease course, often requiring invasive, costly, and risk-laden diagnostic methods like endoscopy and histopathology. Non-invasive markers for monitoring IBD activity are needed due to the limitations of current diagnostic practices.

Methods: This prospective study included confirmed IBD cases aged 18 years or older with a disease duration of more than 12 months, recruited from a Gastroenterology Clinic and a medical college-affiliated hospital between March 2020 and December 2023. Participants were classified into active (Group 1) and inactive/remission (Group 2) disease groups, with healthy age- and sex-matched controls (Group 3). Exclusion criteria included pregnancy, infections, hematological or neoplastic disorders, chronic kidney, cardiovascular, hepatic, heart, or autoimmune diseases. A hemogram, high sensitivity-CRP, ESR, fecal calprotectin (FC), and relevant parameters were recorded. Neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), and, Platelet-Lymphocyte ratio (PLR) were calculated from hemogram.

Results: The study included 180 IBD patients (128 UC and 52 CD), with 113 in group 1 and 67 in group 2. Additionally, 200 healthy volunteers served as group 3. NLR and PLR were elevated, while LMR was decreased in active IBD patients compared to those in remission. The cutoff values for active IBD were determined as NLR > 1.98, LMR < 3.01, and PLR > 147, exhibiting sensitivity of 92%, 88%, and 91%, and specificity of 93%, 87%, and 89% respectively. Optimal cutoff values for IBD disease activity were CRP > 9.71, ESR > 24, and FC > 176. Multivariate logistic regression identified NLR, LMR, and PLR as robust parameters for discriminating IBD disease activity after adjusting for WBC, CRP, ESR, and FC markers (p < 0.05).

Discussion: NLR and PLR exhibited a proportional rise with IBD severity, while LMR lacked such predictive capability. NLR, LMR, and PLR are promising non-invasive markers for assessing IBD activity, providing significant predictive capabilities for distinguishing between active and inactive disease states. These markers offer a cost-effective and easily accessible means for monitoring IBD, aiding in the management of the disease.


Disclosures:


Dhruvkumar Patel, MBBS¹, Maitri M. Patel, MBBS², Dhara Patel, MD², Lalitkumar Patel, MD³, Shreel H. Patel, MD⁴, Mukundkumar Patel, MD⁵. P4291 - Neutrophil-Lymphocyte, Lymphocyte-Monocyte, and Platelet-Lymphocyte Ratios: Non-Invasive Biomarkers for Assessing Inflammatory Bowel Disease Activity, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.