Is there a link between neutrophil-lymphocyte ratio and patient compliance with gluten free diet in celiac disease?

Abstract

The aim of the present study is to determine the association of neutrophillymphocyte ratio (NLR) as an objective marker for detecting compliance to diet in celiac disease (CD). Thirty-seven patients with CD and 37 healthy volunteers were enrolled to the study. At the end of the first year, the patients were divided into 2 groups considering their compliance with diet. Seven patients, who are not compliant to gluten free diet (GFD), formed the first group (group 1). Thirty patients, who are compliant to GFD, formed the second group (group 2), and 37 healthy volunteers served as the control group (group 3). NLR was significantly higher in the patient group than the controls (p < 0.0001). There was a significant difference between the NLR values at the time of initial diagnosis and after a year of treatment in group 2 patients (p < 0.0001). However, we obtained no difference in terms of NLR between the initial and the first year of treatment in group 1 patients (P > 0.05). At the end of the first year, there were significant differences between group 1 and group 2 (p = 0.007) and between group 1 and group 3 in terms of NLR (p = 0.005). Receiver-operating characteristic curve analysis suggested the optimum NLR cutoff value for patients with GFD incompatible as 2.51, with a sensitivity and specificity of 85 % and 94 %, respectively (area under curve: 0.819, 95 % confidence interval = 0.589-1.000, p = 0.009). NLR may be a promising marker in predicting the patient compliance in patients with CD. © Gülhane Tip Fakültesi 2016.