Neutrophil: Lymphocyte Ratio and Mean Platelet Volume in Patients with Gout

Aim: Gout is a clinical syndrome with increased uric acid concentration, which is caused by inflammatory response against monosodium urate (MSU) crystals. In gout, neutrophils are involved in inflammatory response and neutrophil activation is dependent on local cytokine production. Mean platelet volume (MPV) and neutrophillymphocyte ratio (NLR) are considered as inflammatory markers in several diseases and it is reported that they may have prognostic significance. Inthe current literature, there is no study evaluating MPV and NLR in gout. In this retrospective study, we investigated the role of MPV and NLR in determining inflammation in gout disease. Material and Method: In this retrospective study, 106 patients with gout (91 men and 15 women) meeting the inclusion criteria based on patient records and 148 age- and sex-matched healthy controls (128 men and 20 women) were included. Laboratory data during attacks (group I) and intercritical period (group II) were collected for the patient group. Results: Mean age was 59.46±12.93 years in the patient group and 59.00±11.33 years in the control group. Age at first attack was 52.00±12.77 years and mean time interval between first 2 attacks was 6.00±5.52 months. There was tophus in 9 patients (8.5%) and family history of gout in 17 patients (16.0%). Compared to groupII (intercritical period) and the control, no significant difference in MPV levels was found in groupI (during attack). MPV was similar among the three groups. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were found to be significantly higher in group I compared to group II. There was significant difference in NLR among three groups. When classified according to the presence of tophus, it was seen that MPV and NLR were similar in both groups. Discussion: The finding of increased NLR during attacks and intercritical period show that patients with gout are subjected to chronic inflammation. Thus, NLR can be a simple, inexpensive, and useful diagnostic marker in gout. Studies comparing cytokine levels with NLR will be helpful in elucidating this topic