The relationship between hematological indices of systemic inflammation and disease activity in patients with rheumatoid arthritis: a retrospective cross-sectional study

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发表日期：

2026年6月7日

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Zahra Nourmohammadi,
Meysam Olfatifar,
Mohammad Reza Ahmadi,
Reyhaneh Motaghi,
Kimia Jazi,
Maryam Masoumi,
Zahra Haji khodadadi,
Mahdiye Ehsani,
Arefeh Khodaee,
Rasoul shajari

摘要

Objective

Monitoring rheumatoid arthritis (RA) disease activity is crucial for treatment optimization. Hematological indices (SII, SIRI, NLR, PLR, MLR) show promise as systemic inflammation biomarkers. This study assessed their correlation with RA disease activity versus healthy controls.

Methods

This retrospective cross-sectional study included 204 ACR/EULAR-classified RA patients and 216 age-/sex-matched controls. Complete blood counts enabled calculation of SII (neutrophils × platelets/lymphocytes), SIRI (neutrophils × monocytes/lymphocytes), NLR, PLR, and MLR. Disease activity was measured via DAS-28-ESR.

Results

RA patients (96.2% female, age 50.9 ± 12.4 years) demonstrated significantly elevated indices versus controls (94.4% female, age 47.2 ± 11.9 years): SII (722.7 ± 695.2 vs. 563.1 ± 448.9; p = 0.006), SIRI (12.36 ± 9.46 vs. 10.32 ± 5.78; p = 0.009), PLR (12.10 ± 14.40 vs. 9.64 ± 9.67; p = 0.039), MLR (0.21 ± 0.19 vs. 0.17 ± 0.08; p = 0.015). Among RA patients, active disease (DAS-28 > 2.6) exhibited significantly higher SII (780.6 ± 826.1 vs. 614.4 ± 310.4; p = 0.040) than remission. ROC analysis identified SII/SIRI as strong predictors (AUC train/test: 0.946/0.898).

Conclusion

Hematological indices were significantly higher in RA patients and associated with disease activity. SII and SIRI demonstrated superior predictive capability for active RA.

Key Points

• This retrospective cross-sectional study included 204 patients with rheumatoid arthritis and 216 age- and sex-matched healthy controls.

• Hematological indices including SII, SIRI, NLR, PLR, and MLR were significantly higher in RA patients compared to controls.

• Among these indices, SII and SIRI showed the strongest correlation with disease activity measured by DAS-28.

• SII and SIRI demonstrated excellent predictive performance for distinguishing active disease from remission, suggesting their potential as simple and cost-effective biomarkers for clinical monitoring.