Academic Journal
Association of hematological inflammatory indices with disease activity and interstitial lung disease in systemic sclerosis.
| Τίτλος: | Association of hematological inflammatory indices with disease activity and interstitial lung disease in systemic sclerosis. |
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| Συγγραφείς: | Şahinoğlu I; Rheumatology Clinic, Toros State Hospital, Mersin, Türkiye., Uslu S; Division of Rheumatology, Department of Internal Medicine, Manisa Celal Bayar University School of Medicine, Manisa, Türkiye. sadouslu@gmail.com. |
| Πηγή: | Clinical rheumatology [Clin Rheumatol] 2026 Oct; Vol. 45 (10), pp. 6171-6179. Date of Electronic Publication: 2026 Aug 17. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Springer Country of Publication: Germany NLM ID: 8211469 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1434-9949 (Electronic) Linking ISSN: 07703198 NLM ISO Abbreviation: Clin Rheumatol Subsets: MEDLINE |
| Imprint Name(s): | Publication: <2008->: Heidelberg : Springer Original Publication: Brussels : Acta Medica Belgica, [1982- |
| Ιατρικοί όροι (MeSH): | Scleroderma, Systemic*/blood , Scleroderma, Systemic*/complications , Lung Diseases, Interstitial*/blood , Lung Diseases, Interstitial*/complications , Inflammation*/blood, C-Reactive Protein/analysis ; Biomarkers/blood ; Humans ; Male ; Female ; Middle Aged ; Cross-Sectional Studies ; Adult ; Severity of Illness Index ; Neutrophils ; ROC Curve ; Lymphocytes ; Case-Control Studies ; Blood Sedimentation ; Mean Platelet Volume ; Logistic Models ; Blood Platelets |
| Περίληψη: | Introduction: The current study evaluates the association of hematological inflammatory indices with disease activity and interstitial lung disease (ILD) in patients with systemic sclerosis (SSc), with particular emphasis on their potential independent predictive value for pulmonary involvement. Methods: This cross-sectional study included 51 patients diagnosed with SSc and 106 healthy controls. Hematological parameters, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), red cell distribution width (RDW), and mean platelet volume (MPV), were compared between groups. Disease activity was assessed using the European Scleroderma Trials and Research (EUSTAR) activity index, and patients were further evaluated according to the presence of ILD. Multivariable logistic regression analyses were performed to identify independent predictors of ILD. Receiver operating characteristic (ROC) analysis was used to assess the discriminatory performance of hematological inflammatory indices. Results: Compared with healthy controls, patients with SSc had significantly higher levels of NLR, PLR, SII, RDW, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), while MPV was significantly lower (p < 0.05 for all). Patients with active disease (EUSTAR ≥ 2.5) demonstrated significantly higher modified Rodnan skin score (mRSS), NLR, and SII levels compared with patients with inactive disease (p < 0.05). In analyses according to ILD status, both NLR and SII were significantly elevated in patients with ILD, whereas PLR, RDW, MPV, CRP, and ESR did not differ significantly between groups (p > 0.05). Anti-Scl-70 positivity was significantly more frequent in patients with ILD, while anti-centromere positivity was more common in patients without ILD. ROC analysis demonstrated moderate discriminatory performance for SII (AUC = 0.72) and NLR (AUC = 0.68). In multivariable logistic regression analysis, anti-Scl-70 positivity emerged as the strongest independent predictor of ILD, while NLR remained independently associated with ILD (OR 2.63, 95% CI 1.01-6.85, p = 0.047). SII did not retain statistical significance in the multivariable model. Conclusion: Hematological inflammatory indices are associated with disease activity and pulmonary involvement in SSc. Among these indices, NLR appears to be a more robust independent marker of ILD compared to SII. These findings suggest that simple hematological indices may provide additional value in the clinical assessment of patients with SSc. Key Points • Patients with SSc-associated ILD exhibited significantly higher NLR and SII levels than those without ILD. • NLR remained independently associated with ILD after adjustment for established clinical and serological factors. • NLR and SII were associated with both pulmonary involvement and disease activity, supporting their potential utility as readily available inflammatory biomarkers in SSc. (© 2026. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).) |
| Competing Interests: | Compliance with ethical standards. Disclosures: None. Ethics approval: The study was approved by Celal Bayar University School of Medicine Local Ethic Committee (Date: October 20, 2024 Decision No: 20.478.486/2705). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Open data sharing note: Raw data can be shared if requested. |
| References: | Curr Health Sci J. 2024 Jul-Sep;50(3):421-427. (PMID: 39574823) Ann Rheum Dis. 2017 Jan;76(1):270-276. (PMID: 27621285) Acta Dermatovenerol Alp Pannonica Adriat. 2020 Sep;29(3):101-107. (PMID: 32975295) Clin Rheumatol. 2026 Feb;45(2):1011-1022. (PMID: 41499017) Lab Med. 2020 Sep 1;51(5):519-528. (PMID: 32073127) Lancet Respir Med. 2016 Sep;4(9):708-719. (PMID: 27469583) Clin Rheumatol. 2020 Jan;39(1):77-83. (PMID: 31317426) Rheumatol Int. 2020 Jul;40(7):1071-1079. (PMID: 32424613) Clinics (Sao Paulo). 2020 Apr 17;75:e1450. (PMID: 32321113) Ann Rheum Dis. 2021 Feb;80(2):219-227. (PMID: 32988845) Redox Biol. 2019 Jul;25:101122. (PMID: 30737171) Eurasian J Med. 2025 Oct 23;57(3):1-7. (PMID: 41342238) Turk J Med Sci. 2016 Dec 20;46(6):1871-1874. (PMID: 28081341) Diagnostics (Basel). 2022 Dec 12;12(12):. (PMID: 36553140) J Rheumatol. 1995 Jul;22(7):1281-5. (PMID: 7562759) Lancet. 2017 Oct 7;390(10103):1685-1699. (PMID: 28413064) J Clin Med. 2020 Oct 22;9(11):. (PMID: 33105647) APMIS. 2017 Oct;125(10):863-871. (PMID: 28766758) Int J Mol Sci. 2022 Mar 26;23(7):. (PMID: 35408994) Eur J Clin Invest. 2019 Jan;49(1):e13037. (PMID: 30316204) Clin Exp Immunol. 2019 Mar;195(3):310-321. (PMID: 30430560) Arthritis Rheum. 2013 Nov;65(11):2737-47. (PMID: 24122180) Diagnostics (Basel). 2022 Oct 30;12(11):. (PMID: 36359478) Front Immunol. 2025 Aug 07;16:1621209. (PMID: 40852721) |
| Contributed Indexing: | Keywords: Biomarkers; Blood cell count; Inflammation; Interstitial lung disease; Systemic sclerosis |
| Substance Nomenclature: | 9007-41-4 (C-Reactive Protein) 0 (Biomarkers) |
| Entry Date(s): | Date Created: 20260817 Date Completed: 20260916 Latest Revision: 20261008 |
| Update Code: | 20261008 |
| DOI: | 10.1007/s10067-026-08365-8 |
| PMID: | 42606663 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1434-9949 |
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| DOI: | 10.1007/s10067-026-08365-8 |