Ab0123 Elevated Neutrophil-to-Lymphocyte and Monocyte-to-Lymphocyte Ratios Are Associated With Increased Flares and Elevated Cardiovascular Disease Risk in Gout

Background: Although gout is the most common inflammatory arthritis, there are a few tools to monitor disease activity and predict complications in gout patients. The neutrophil-to-lymphocyte ratio (NLR) and the monocyte-to-lymphocyte ratio (MLR) have been shown to associate with disease activity in gout. Objectives: To evaluate the use of neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR) as novel biomarkers to measure disease activity and predict cardiovascular disease risk in gout. Methods: Data were collected from 38 consecutive gout patients. Disease activity and 10-year risk of cardiovascular morbidity were assessed at the patient visit. Calprotectin levels were measured from patient plasma using ELISA. Cell counts and serum uric acid levels were measured from blood. Results: Levels of calprotectin, a marker of neutrophil activation, correlated with NLR (r=0.56, p=0.0004). The MLR correlated with total number of gout attacks as well (r=0.39, p=0.02). Absolute neutrophil counts and NLR levels were significantly increased in gout patients with diabetes and hypertension (p < 0.05). Further, NLR and MLR but not absolute monocyte or neutrophil counts were significantly increased in gout patients with high cardiovascular disease risk (p < 0.05). Using logistic regression analysis, gout patients having high NLR or MLR were at increased risk of high CVD risk (OR = 7.5 (1.7 – 33.0), p=0.008). Conclusion: NLR and MLR are potential biomarkers for gout flares and risk of cardiovascular morbidity in patients with gout. REFERENCES: [1] Lottmann K, Chen X, Schädlich PK. Association Between Gout and All-Cause as well as Cardiovascular Mortality: A Systematic Review. Curr Rheumatol Rep. 2012. [2] Vedder D, Gerritsen M, Nurmohamed MT, van Vollenhoven RF, Lood C. A neutrophil signature is strongly associated with increased cardiovascular risk in gout. Rheumatology. 2021. [3] Vedder D, Gerritsen M, Duvvuri B, van Vollenhoven RF, Nurmohamed MT, Lood C. Neutrophil activation identifies patients with active polyarticular gout. Arthritis Research & Therapy. 2020. Acknowledgements: NIL. Disclosure of Interests: None declared.