Comparison of Neutrophil-to-Albumin Ratio and Neutrophil-to-Lymphocyte Ratio in Acute Phase Positive and Negative Ankylosing Spondylitis Patients

Decreased vertebral movements are observed in the advanced stages of the disease.Ankylosing spondylitis can also present as peripheral arthritis, which is often oligoarticular and asymmetric, frequently affecting the lower extremities and limited to the vertebrae.The most common extra-articular involvement is anterior uveitis.Other types of involvement include inflammatory bowel disease, psoriasis, apical pulmonary fibrosis, and aortic valve insufficiency (2).The disease typically begins in the third decade of life, and the male/female ratio for radiographic axial spondyloarthritis is two to one, while for non-radiographic axial spondyloarthritis it is one to one.The most common genetic association is with human leukocyte antigen-B27 (HLA-B27) (3).The incidence estimates of AS range from 0.05% to 1.4%, while the prevalence estimates range from 0.1% to 1.4% per Abs tractAim: Acute phase reactants may not always be positive in ankylosing spondylitis (AS).We herein aimed to investigate whether the neutrophil-to-albumin ratio (NAR) is useful in monitoring AS activity.Methods: One hundred nineteen patients who were followed up in the internal medicine rheumatology clinic between August 2024 and September 2024 and diagnosed with AS according to the axial spondyloarthropathy classification criteria of the Association for the Assessment of SpondyloArthritis international Society and the 1984 modified New York criteria were included in our study.The C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), NAR and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) status of the patients were recorded at two visits, before and 6 months following treatment.Results: A significant correlation was found between the initial NLR and the NLR values after 6 months, and between the initial and 6-month BASDAI values in both the CRP positive and CRP negative groups (p=0.000 and p=0.017).It was observed that the changes in individual NAR and NLR values and BASDAI values for each case were parallel (p=0.012). Conclusion:C-reactive protein values in AS are not always consistent with disease activity, but the NLR may be helpful in such cases.As for the NA ratio, we found that each patient should be evaluated individually.