The Effect of Iron Deficiency Anemia Treatment on Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio

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Background: Both neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are cost-effective and readily available biomarkers. An increment in either NLR or PLR is an indicative of a prolonged chronic inflammatory condition and increased host inflammatory response. Iron deficiency anemia (IDA) is frequently associated in chronic disorders.Aims: We decided to investigate whether the efficient treatment of IDA should affect NLR and/or PLR values in an adult population with IDA.Methods: This was a retrospective (case-series) observational study conducted at an adult Hematology clinic in Turkey. Patients were ≥ 18 years-old, with IDA defined according to the World Health Organisation criteria. The hematological parameters, NLR, and PLR levels were noted before and after oral iron (Fe+2) repletion treatment.Results: A total of 200 patients with IDA (median age 44 years, IQR 32-52 years, women 91%) were included. NLR values did not differ significantly in terms of IDA treatment (2.07 vs. 2.01, p= .558). PLR levels were significantly decreased after IDA treatment (170.63 vs. 140.32, p< .001). The NLR and PLR were positively correlated (p= .01). A low-unremarkable inverse correlation between NLR, and serum iron levels (p= .024) and Tfsat (p= .038) was observed; a similar negative correlation was also observed between PLR, and serum iron (p= .002) and Tfsat (p= .013) levels.Conclusion: The treatment of IDA did not affect NLR, whereas it was associated with significant decrease in PLR. The NLR and PLR were positively correlated. However, both the NLR and PLR were inversely correlated with serum iron and Tfsat levels.