Abstract: The Effect of Iron Deficiency Anemia Treatment on Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio

Burak Uz, Ilhan Dolasik, Hasan Atli and Deccane Duzenci

Background: Both neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are cost-effective and readily available biomarkers. An increment in either NLR or PLR is an indicative of a prolonged chronic inflammatory condition and increased host inflammatory response. Iron deficiency anemia (IDA) is frequently associated in chronic disorders.

Aims:We decided to investigate whether the efficient treatment of IDA should affect NLR and/or PLR values in an adult population with IDA.

Methods: This was a retrospective (case-series) observational study conducted at an adult Hematology clinic in Turkey. Patients were ≥ 18 years-old, with IDA defined according to the World Health Organisation criteria. The hematological parameters, NLR, and PLR levels were noted before and after oral iron (Fe⁺²) repletion treatment.

Results:A total of 200 patients with IDA (median age 44 years, IQR 32-52 years, women 91%) were included. NLR values did not differ significantly in terms of IDA treatment (2.07 vs. 2.01, p= .558). PLR levels were significantly decreased after IDA treatment (170.63 vs. 140.32, p< .001). The NLR and PLR were positively correlated (p= .01). A low-unremarkable inverse correlation between NLR, and serum iron levels (p= .024) and Tfsat (p= .038) was observed; a similar negative correlation was also observed between PLR, and serum iron (p= .002) and Tfsat (p= .013) levels.