The role of neutrophil-lymphocyte ratio, RDW, and MPV in determining endoscopic activation in ulcerative colitis patients

Objective: In patients with histopathologically and endoscopically diagnosed ulcerative colitis, active and remission periods are determined according to Mayo endoscopic scoring, and MPV(mean platelet volume), NLR(neutrophil-lymphocyte ratio) and RDW(red cell distribution width) values are compared with healthy and normal colonoscopy patients, and whether these values will be predictable factors in endoscopic and clinical evaluation (1). It was aimed to retrospectively investigate the correlation with ESR(erythrocyte sedimentation rate), leukocytes and CRP(C-reactive protein). Materials and Methods: In the study, the files of 143 patients diagnosed with UK who applied to the gastroenterology and internal medicine outpatient clinics of Adıyaman University Training and Research Hospital between 2018 and 2021 were retrospectively scanned. In the study, 170 cases between the ages of 18-65 years, who were diagnosed with UK endoscopically and histopathologically between January 2018 and March 2021, were included in the patient group, and 103 cases who were found to be normal after colonoscopy were included as the healthy control group. Patients with a history of malignancy, rheumatological disease, known hematological disease, autoimmune disease and inflammatory disease were excluded from the study. In the study; colonoscopic findings of disease severity, CRP, ESR, RDW, MPV, neutrophil, lymphocyte, NLR, hgb(hemoglobin) Inflammation markers such as WBC(white blood cell) were detected. Patients were categorized based on their colonoscopic features and clinical findings. Patients were divided into two different groups as remission and moderate-severe disease (active disease) using Mayo endoscopic scoring. NLR, RDW and MPV values were compared between the groups. Results: The research group consisted of 378 people, consisting of UK patients in remission and active colitis, and the control group. 59.5% of the research group is male and 40.5% is female. 37.8% of the study group had active ulcerative colitis, 34.9% of them were ulcerative colitis patients in remission and 27.3% were the control group. The mean MPV was statistically significantly higher in patients in the control group than in patients in remission and active colitis. There was no statistically significant difference between the mean MPV of the patients in remission and active period. There was no statistically significant difference between the RDW averages of the patients in the active period and the patients in the control group. Neutrophil/Lymphocyte averages of the patients in the active period were statistically significantly higher than those in the remission period and the control group. There was no statistically significant difference between the Neutrophil/Lymphocyte ratio of the control group and the patients in the remission period. The parameters that change independently from the others in the transition from the remission period to the active period in patients are CRP, Platelet and MPV values. The biggest difference between remission and active periods is in CRP values. CRP increases 1.83 times during the active period compared to the remission period. MPV increases 0.35 times during the active period compared to the remission period. Platelet increases 0.01 times in the active period compared to the remission period. NLR increases 0.25-fold in the active period compared to the remission period, but it was not found to be significant. RDW decreases 0.08-fold in the active period compared to the remission period, but it was not found to be significant. Conclusion: MPV, RDW, NLR are inflammatory markers for UK. Their level can be a guide in predicting the clinical, laboratory and endoscopic activity of the disease, in follow-up and treatment. However, more comprehensive and prospective studies are needed to be able to use it.