Correlations between serum NLR and irisin levels and disease activity and bone density in patients with rheumatoid arthritis
Objective To explore the expression levels of serum neutrophil-to-lymphocyte ratio(NLR)and irisin in patients with rheumatoid arthritis(RA)and their correlations with disease activity and bone density.Methods A total of 123 RA patients admitted to No.215 Hospital of Shaanxi Nuclear Industry from April 2022 to April 2024 were selected as the observation group for a retrospective study.According to the disease activity,they were divided into a low activity group(27 cases),a moderate activity group(58 cases),and a high activity group(38 cases).Additionally,50 healthy adults who underwent physical examination during the same period were selected as the control group.In the observation group,there were 39 males and 84 females,aged(47.49±9.31)years,with a body mass index(BMI)of(21.41±1.72)kg/m2.In the control group,there were 14 males and 36 females,aged(48.02±10.08)years,with a body mass index of(21.39±1.66)kg/m2.Serum samples were analyzed for NLR and irisin levels,and their correlations with disease activity and bone density were assessed.Independent sample t test,ANOVA,x2 test,Spearman correlation analysis,and Pearson correlation analysis were used.Results The levels of NLR(3.35±0.83)and irisin(195.74±24.39)μg/L in the observation group were higher than those in the control group[(1.85±0.72)and(258.93±41.84)μg/L],with statistically significant differences(t=11.179 and 12.381,both P＜0.001).The levels of NLR and irisin were(2.46±0.22)and(213.84±12.27)μg/L in the low activity group,(3.15±0.31)and(195.93±16.98)μg/L in the moderate activity group,(4.39±0.55)and(184.27±9.14)μg/L in the high activity group,with statistically significant differences(F=216.474 and 35.360,both P＜0.001).The bone mineral density of femoral neck[(0.75±0.12)g/cm2],total hip joint[(0.82±0.11)g/cm2],lumbar spine[(0.84±0.09)g/cm2],and greater trochanter[(0.90±0.18)g/cm2]in the observation group were lower than those in the control group[(0.89±0.09)g/cm2,(0.96±0.08)g/cm2,(0.97±0.10)g/cm2,and(1.05±0.23)g/cm2],with statistically significant differences(all P＜0.05).Spearman correlation analysis showed that serum NLR was positively correlated with disease activity(r=0.879,P＜0.001),and serum irisin level was negatively correlated with disease activity(r=-0.615,P＜0.001).Pearson correlation analysis showed that serum NLR was negatively correlated with bone mineral density of femoral neck,total hip joint,lumbar spine,and greater trochanter(r=-0.358,-0.366,-0.525,and-0.174,all P＜0.05),and serum irisin level was positively correlated with bone mineral density of femoral neck,total hip joint,lumbar spine,and greater trochanter(r=0.378,0.430,0.352,and 0.232,all P＜0.05).Conclusion Abnormal expressions of serum NLR and irisin are closely associated with disease activity and bone density in RA patients,and can be used as effective biomarkers to evaluate the disease activity and predict the bone mineral density.
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