Speakers - NWC 2024

Abstract

Background. There is limited evidence that carotid intima-media thickness (cIMT) and neutrophil-to-lymphocyte ratio (NLR) increase in patients with MS. Furthermore, platelet-to-lymphocyte ratio (PLR) can also increase in neuroinflammatory and autoimmune diseases, and it is better interpreted when measured along with other biomarkers, such as NLR. We aimed to assess cIMT, NLR, and PLR levels and their possible correlation in patients with MS. Methods. We included 110 patients and 110 healthy sex and age-matched controls in this case-control study. All participants underwent complete history taking and general and neurological examination. Expanded Disability Status Scale (EDSS) was used to assess disease disability. cIMT was measured with B-mode ultrasound images 10 mm before the bifurcation of the common carotid artery. Results. NLR, PLR, and cIMT significantly increased in MS patients compared to healthy controls (P<0.001). Among patients with MS, higher cIMT (P<0.001) was significantly associated with older age (P<0.001), higher BMI (P<0.001), higher EDSS scores (P=0.005), older age of disease onset (P<0.001) and SPMS type (P=0.003). Further linear regression analysis revealed that cIMT was marginally associated with higher NLR values (P=0.055). After controlling for confounding factors, cIMT was significantly associated with NLR (P=0.047), not PLR (P=0.2). The cut-off value of mean cIMT (sensitivity: 84%; specificity: 49%) for discriminating mild-to-moderate and severe disability was calculated as 0.5. Conclusion. In the remission phase of MS, NLR, PLR, and cIMT are significantly increased, and levels of higher cIMT are significantly associated with higher levels of NLR. cIMT could be used as a simple, rapid, and cost-effective inflammatory marker for MS disability, but not for the diagnosis of MS. Further multi-center studies with larger sample sizes are needed to validate the findings of this study.