Platelet–lymphocyte ratio and lymphocyte–monocyte ratio in inflammatory bowel disease and disease activity: A systematic review and meta-analysis

Abstract

Objective This review aimed to examine if the platelet–lymphocyte ratio and lymphocyte–monocyte ratio can be useful in determining disease activity in patients with inflammatory bowel disease. Methods PubMed, CENTRAL, Scopus, Embase, and Web of Science were searched for studies published up to 9 January 2023. Platelet–lymphocyte ratio and lymphocyte–monocyte ratio values from active and remission inflammatory bowel disease cases were compared to generate a mean difference (MD). Results Nine studies were included. Meta-analysis showed that inflammatory bowel disease patients with active disease had significantly higher values of platelet–lymphocyte ratio as compared to those in remission (MD: 63.46 95% CI: 35.74, 91.17, I2 = 89%). The values of platelet–lymphocyte ratio were significantly higher in both active ulcerative colitis and Crohn's disease patients. Meta-analysis also showed that lymphocyte–monocyte ratio values were significantly lower in active inflammatory bowel disease patients as compared to those under remission (MD: −1.28 95% CI: –1.42, −1.14, I2 = 4%). Lymphocyte–monocyte ratio values were significantly lower in both ulcerative colitis and Crohn's disease patients with active disease. Conclusion Platelet–lymphocyte ratio and lymphocyte–monocyte ratio can be useful blood-based markers in differentiating active disease in inflammatory bowel disease patients. Active cases of ulcerative colitis and Crohn's disease have high platelet–lymphocyte ratio and low lymphocyte–monocyte ratio as compared to those in remission. Further studies with a larger sample size are needed to strengthen conclusions.