Evaluation of Neutrophil-to-Lymphocyte Ratio and Mean Platelet Volume in Patients with Active and Inactive Thyroid Orbitopathy

Objectives: The aim of this study was to evaluate the neutrophil-to-lymphocyte ratio (NLR) and the mean platelet volume (MPV) in patients with active thyroid orbitopathy (TO) and to compare it with that of both healthy subjects and patients with inactive TO.
Methods: Twenty patients with active TO (Group 1), 25 patients with inactive TO (Group 2), and 35 age- and sex-matched healthy subjects (Group 3) were included in this study. Patients with other systemic and ocular diseases, patients with a history of intraocular or orbital surgery, and patients using systemic drugs were excluded. The VISA (vision, inflammation, strabismus, appearance) classification scheme was used to discriminate between active and inactive TO. The neutrophil and lymphocyte counts and the MPV of all participants were recorded. The NLR was calculated by dividing the neutrophil count by the lymphocyte count, and the result was compared between groups. The optimal cut-off value was determined for NLR and MPV and the data were compared with a one-way analysis of variance test and the ’Bonferroni post-test.
Results: The mean age was 45.4±13.4, 41.0±13.7, and 42.6±14.4 years in Group 1, 2, and 3, respectively (p=0.68). The NLR was 2.11 in Group 1, 1.56 in Group 2, and 1.47 in Group 3 (p=0.03). The ’Bonferroni post-test revealed a difference between Group 1 and Group 2 (p=0.01) and between Group 1 and Group 3 (p<0.001). The MPV was 10.76 fL in Group 1, 9.94 fL in Group 2, and 8.19 fL in Group 3 (p<0.001). The results of the ’Bonferroni post-test showed a difference between Group 1 and Group 2 (p=0.04), between Group 1 and Group 3 (p<0.001), and between Group 2 and Group 3 (p<0.001). The mean cut-off value obtained from receiver operating characteristic (ROC) analysis of NLR was 1.69 (sensitivity: 72%; specificity: 66%). The mean cut-off value obtained from ROC analysis of MPV was 9.95 (sensitivity: 63%; specificity: 66%).
Conclusion: High NLR and MPV values may be indicative of active inflammation in patients with TO."

Aktif ve inaktif tiroid orbitopatili hastalarda nötrofil-lenfosit oraný ve ortalama trombosit hacminin deðerlendirilmesi

Amaç: Aktif tiroid orbitopatili (TO) hastalarda inflamasyonun bir göstergesi olarak nötrofil-lenfosit oranýný (NLO) ve ortalama trombosit hacmini (MPV) deðerlendirmek ve inaktif TO’lu hastalar ve saðlýklý bireylerin deðerleri ile karþýlaþtýrmak.
Gereç-Yöntem: Bu çalýþmaya aktif TO’lu 20 hasta (grup 1), inaktif TO’lu 25 hasta (grup 2), yaþ ve cinsiyet açýsýndan uyumlu 35 saðlýklý birey (grup 3) dahil edildi. Baþka sistemik ve oküler hastalýk öyküsü olan, göz içi ve orbita cerrahisi geçiren ve sistemik ilaç kullanan hastalar çalýþma dýþý býrakýldý. Aktif ve inaktif TO ayrýmý için VISA sýnýflandýrýlmasý kullanýldý. Bütün hastalarýn nötrofil, lenfosit ve MPV deðerleri retrospektif olarak kaydedildi. NLO, nötrofil sayýsýnýn lenfosit sayýsýna bölünmesi yoluyla hesaplandý. NLO ve MPV için optimal cut-off deðeri belirlendi. Veriler tek yönlü ANOVA testi ve bonferroni posttest ile karþýlaþtýrýldý.
Sonuçlar: Ortalama yaþ grup 1’de 45,4±13,4; grup 2’de 41,0±13,7; grup 3’de 42,6±14,4 yýl idi (p: 0,68). Grup 1’de NLO 2,11; grup 2’de 1,56; grup 3’de ise 1,47 idi (p=0,03). Bonferroni posttest farklýlýðýn grup 1 ile grup 2 (p=0,01), grup 1 ile grup 3 (p<0,001) arasýndaki farktan kaynaklandýðýný göstermekte idi. MPV grup 1’de 10,76 fL; grup 2’de 9,94 fL; grup 3’de 8,19 fL idi (p<0,001). Bonferroni posttest farklýlýðýn grup 1 ile grup 2 (p=0,04), grup 1 ile grup 3 (p<0,001) ve grup 2 ile grup 3 (p<0,001) arasýndaki farktan kaynaklandýðýný göstermekte idi. NLO için receiver operating characteristic (ROC) analizinden elde edilen ortalama cut-off deðeri 1.69 idi. (sensivite % 72, spesifite % 66) MPV için ROC analizinden elde edilen ortalama cut-off deðeri 9.95 idi.(sensivite % 63, spesifite %68).
Tartýþma: Yüksek NLO ve MPV deðerleri TO’lu hastalarda aktif inflamasyonun bir göstergesi olabilir.