The neutrophil-to-lymphocyte ratio is associated with multiple sclerosis

I C Hasselbalch; H B Søndergaard; N Koch-Henriksen; A Olsson; H Ullum; F Sellebjerg; A B Oturai

doi:10.1177/2055217318813183

The neutrophil-to-lymphocyte ratio is associated with multiple sclerosis

Mult Scler J Exp Transl Clin. 2018 Nov 28;4(4):2055217318813183. doi: 10.1177/2055217318813183. eCollection 2018 Oct-Dec.

Authors

I C Hasselbalch¹, H B Søndergaard¹, N Koch-Henriksen^{2

3}, A Olsson¹, H Ullum⁴, F Sellebjerg¹, A B Oturai¹

Affiliations

¹ Danish Multiple Sclerosis Center, University of Copenhagen, Denmark.
² The Danish Multiple Sclerosis Registry, University of Copenhagen, Denmark.
³ Department of Clinical Epidemiology, University of Aarhus, Denmark.
⁴ Department of Clinical Immunology, University of Copenhagen, Copenhagen, Denmark.

Abstract

Background: Subtypes of white blood cell counts are known biomarkers of systemic inflammation and a high neutrophil-to-lymphocyte ratio (NLR) has been associated with several autoimmune diseases. Few studies have investigated the NLR in multiple sclerosis (MS).

Objective: To examine the association between NLR, MS and disability measured by the MS severity score (MSSS).

Methods: Patients were included from the Danish Multiple Sclerosis Biobank. Information on patient NLR was obtained just before their first treatment and clinical information was provided by the Danish Multiple Sclerosis Treatment Register. Information on NLR from controls was collected from the Danish Blood Donor Study. Patients and controls were 1:2 propensity score matched by baseline confounders.

Results: Propensity score matching left 740 of 743 MS patients and 1420 of 4691 controls for further analyses. Odds-ratio (OR) was 3.64 (95% confidence interval 2.87-4.60, p < 0.001) for MS disease per unit increase of logarithmically transformed NLR (ln-NLR), corresponding to an OR of 2.68 for each doubling of NLR. Mean NLR was 2.12 for patients and 1.72 for controls (p < 0.001). Ln-NLR correlated weakly with patient MSSS (R ² = 0.019, p = 0.008).

Conclusion: Patients with early MS had increased levels of NLR compared to healthy controls and NLR was weakly correlated with MSSS.

Keywords: C-reactive protein; Multiple sclerosis; multiple sclerosis severity score; neutrophil-to-lymphocyte ratio; relapsing-remitting; systemic inflammation.