Clinical and diagnostic significance of blood leukocyte ratios in young patients with stage III grade C periodontitis

Abstract

Objectives

Blood leukocyte ratios have been recently proposed as simple, rapid, cheap and easily accessible biomarkers of systemic inflammation. However, little is known about the relationship of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) with periodontitis, which might not only serve as the potential biomarkers of systemic inflammation but also aid in diagnosis/screening of severe periodontitis. Hence, the purpose of this study was to evaluate the differences in the serum levels of these leukocyte ratios in healthy subjects and patients with generalized stage III Grade C periodontitis, and their applicability in identifying patients with the risk of developing severe periodontitis.

Material and methods

The subjects were categorized into case and control group. Clinical parameters including Plaque index (PI), modified Gingival Index (mGI), Mean ratio of bleeding sites, Probing Pocket depth (PPD) and the clinical attachment loss (CAL) were assessed in both the groups. Venous blood samples were collected from subjects from both groups for the biochemical analysis and blood leukocyte ratios- NLR, PLR and LMR were calculated. The values were then subjected to statistical analysis.

Results

The results showed significantly higher NLR and lower LMR values in patients with generalized stage III grade C periodontitis. Both the blood leukocyte ratios were moderately associated with increasing clinical parameters of periodontal disease. However, the values of PLR, although found to be higher in the periodontitis group, did not make a significant difference when compared with periodontally healthy subjects. The cut-off value of >2.15 for NLR and <7.16 for LMR fairly predicted the risk of severe periodontitis in young adults.

Conclusions

NLR and LMR can provide a new insight into the relationship between periodontitis and systemic diseases and can be of potential diagnostic value in identifying patients with severe periodontitis of younger age group.

Keywords:

• Biomarker
• LMR
• NLR
• PLR
• Periodontitis

Disclosure statement

Supriya Mishra declares that she has no conflict of interest. Gazala MP declares that she has no conflict of interest. Waheda Rahman declares that she has no conflict of interest.

No potential conflict of interest was reported by the author(s).

Author contributions

SM: Concept and design of the work, drafting the manuscript, data analysis, G MP: data collection, WR: manuscript review and editing. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Data availability statement

The data that support the findings of this study are available from the corresponding author, [Mishra S], upon reasonable request.

Notes

1 UNC-15 probe, Hu-Friedy Manufacturing Co., Chicago, IL.