CHSJ

Curr Health Sci J, vol. 52, no. 3, 2026

Diagnostic Performance of Complete Blood Count-Derived Inflammatory Indices in Ankylosing Spondylitis: A Case-Control Study

[Original Paper]

C.A. BOENGIU(1), A.M. BOENGIU(2), C.C. DRAGOMIRESCU(3), A.M. BUGA(4), A.L. BARBULESCU(5)


(1)Doctoral School, University of Medicine and Pharmacy of Craiova, Romania;
(2)Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania;
(3)Department of Microbiology, “Carol Davila” University of Medicine and Pharmacy, Bucuresti, Romania;
(4)Department of Biochemistry, University of Medicine and Pharmacy of Craiova, Romania;
(5)Department of Pharmacology, University of Medicine and Pharmacy of Craiova, Romania


Abstract:

Ankylosing spondylitis (AS) is an inflammatory disease associated with persistent inflammation and progressive structural damage. Conventional markers, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), may remain normal despite active disease, highlighting the need for additional biomarkers. Hematological inflammatory markers from routine blood tests have emerged as inexpensive indicators of systemic inflammation. This study assessed the diagnostic performance of hematological inflammatory indices in AS and investigated their relationship with clinical status and functional capacity. This retrospective case-control pilot study included 17 radiographic AS patients and 16 controls. Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI) were calculated. ROC analysis estimated discriminative ability, and Spearman correlation evaluated associations with BASDAI, ASDAS, and HAQ scores. NLR, PLR, SII, SIRI, and AISI were markedly elevated in AS versus controls, whereas MLR did not differ significantly. NLR had the best discriminative performance (AUC=0.930), followed by SII (AUC=0.912) and PLR (AUC=0.857). At the optimal cut-off (>3.028), NLR achieved 94.12% sensitivity and 93.75% specificity. None of the indices correlated significantly with disease activity or functional status. CBC-derived inflammatory indices, especially NLR and SII, exhibited good discriminative performance for AS, even when conventional inflammatory markers were not significantly different. Further large-scale, multicenter prospective studies are necessary to confirm these results and establish their clinical applicability.


Keywords: Ankylosing spondylitis. inflammation. biomarkers.



Corresponding: Ana Maria Buga, Department of Biochemistry, University of Medicine and Pharmacy of Craiova, Romania, e-mail: ana.buga@umfcv.ro


DOI 10.12865/CHSJ.52.03.08 - Download PDF
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