Eosinophil-to-Lymphocyte Ratio and Eosinophil Count as New Predictive Markers for Osteoarthritis

Abstract

Purpose: Despite the association between peripheral blood inflammatory biomarkers and a range of inflammatory diseases, the role of these biomarkers in osteoarthritis (OA) progression remains unclear. Additionally, whether alterations in these inflammatory markers impact the prognosis of OA patients remains an understudied area. The aim of our study was to investigate the specific associations between peripheral blood inflammatory markers and OA progression and OA-related mortality.

Methods: Data were obtained from the National Health and Nutrition Examination Survey (NHANES) database from 1999 through 2018. The primary outcomes were all-cause mortality, cardiac mortality, and renal disease mortality, with information on the corresponding mortality rates for each participant obtained through association with the National Death Index (NDI). Multivariate logistic regression models were used to examine the relationship between peripheral blood lymphocyte counts and OA, and restricted cubic spline (RCS) analysis was utilized to assess whether there was a nonlinear relationship with OA and mortality of OA patients. Interaction and stratified analyses were employed to explore the association between peripheral blood leukocyte counts and OA.

Results: This study included 1077 OA patients and 21,612 non-OA participants. In model 3 fully adjusted for covariates, eosinophil-to-lymphocyte ratio (ELR) and eosinophil (EOS) were positive risk factors promoting the development of OA (OR = 3.26, 95% CI: 1.49-7.14; OR = 1.79, 95% CI: 1.12-2.88). In stratified models for age, sex, BMI, smoking status, and alcohol consumption, the associations of ELR and EOS with OA were significantly different. RCS curves showed a J-shaped relationship between ELR and EOS and all-cause mortality in patients with OA. ELR was also found to significantly up-regulate cardiac mortality and renal mortality in patients with OA (OR = 3.92, 95% CI: 1.68-9.14; OR = 22.55, 95% CI: 6.55-77.70), while EOS was only significantly positively correlation (OR = 3.68, 95% CI: 1.94-7.01).

Conclusion: A significant relationship was found between ELR, EOS and OA. In addition, ELR and EOS were identified as potential predictors of mortality from different causes in patients with OA.

Keywords: all-cause mortality; eosinophil; eosinophil to lymphocyte ratio; osteoarthritis.

Figure 1

The flow chart portraying participant inclusion and exclusion in the current study.

Figure 2

The association of OA with ELR (A) and EOS (B) was visualized by RCS. RCS illustrated the association of all-cause mortality with ELR (C) and EOS (D), cardiac mortality with ELR (E) and EOS (F), and renal mortality with ELR (G) and EOS (H) in participants with OA.