Association Between Serum Neutrophil Lymphocyte Ratio and Control of Asthma

Background: Asthma is a serious global health issue. Assessment of disease control is essential in management of asthmatic patients. Recently, serum Neutrophil-Lymphocyte ratio have been evaluated in various chronic diseases and is also reported as a prognostic marker for future exacerbation in case of Chronic obstructive pulmonary disease. However, there are only limited knowledge regarding its association with asthma. Objective: To find out the association of serum Neutrophil lymphocyte ratio (NLR) in assessment of asthma control. Methods: This was a cross-sectional observational study in which 110 diagnosed cases of asthma were conveniently recruited from Respiratory medicine department of National Institute of Diseases of Chest and Hospital from June 2020 to September 2021. Asthma symptom control was assessed by asthma control test. FEV1 was measured by spirometry to detect level of airflow obstruction. Blood was collected from each subject and Complete blood count was performed by Autoanalyzer. Neutrophil lymphocyte ratio was calculated manually from CBC. All data were collected into a preformed questionnaire. After completion of data collection, analysis was done through Statistical Package for Social Science (SPSS) version 23. Results: Mean age of the study subjects was 31.6±10.9 years with male (72.7%) predominance. The mean Neutrophil-Lymphocyte ratio was 2.72±0.69. The NLR was observed to increase with increasing severity of airflow obstruction and this difference was statistically significant (p=0.001). Again, mean NLR in those with uncontrolled asthma differed significantly from those with well controlled and partially controlled asthma (p<0.05). A moderate negative correlation (r= -0.762; p=0.001) was found between NLR and Asthma control. Multivariate regression analysis revealed an independent association between Neutrophil-Lymphocyte ratio and Asthma control status. Conclusion: In this study, it was found that NLR was higher in patients with uncontrolled asthma and had a moderate association with asthma control status. Chest Heart J. 2023; 47(1) : 20-26