{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T03:10:36Z","timestamp":1791774636908,"version":"4.3.4"},"reference-count":29,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,3,14]],"date-time":"2021-03-14T00:00:00Z","timestamp":1615680000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Rheumatoid arthritis (RA) occurs more often in elderly individuals. Elderly onset RA (EORA) (onset &gt; 60 years) encompasses a specific subset of patients if compared with young onset RA (YORA) (onset at a younger age). There is a need to define reliable, simple markers to properly assess the inflammatory activity of RA. Hematological markers of systemic inflammation (Platelet-To-Lymphocyte (PLR) and Neutrophil-To-Lymphocyte (NLR) ratios) are novel measures of the inflammatory response. The goal of the study was to analyze the course of EORA vs. YORA patients and to assess associations between systemic and clinical disease activity markers, including PLR and NLR, in different subsets of patients. PLR and NLR have not previously been assessed in EORA and YORA. Methods: The study group consisted of 113 consecutive patients (63 EORA and 50 YORA). The following assessments were performed: joint counts, Disease Activity Score (DAS28), complete blood cell counts, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Results: EORA was characterized by significantly higher disease activity markers (conventional inflammatory and clinical), a lower rate of remission or low disease activity, and less frequent use of biological drugs and glucocorticoids. The NLR and PLR were positively correlated with disease activity markers. The PLR was significantly lower in EORA compared with in YORA. Conclusion: EORA and YORA patients differed significantly. In EORA, conventional disease activity markers were higher, the PLR was significantly lower.<\/jats:p>","DOI":"10.3390\/jcm10061204","type":"journal-article","created":{"date-parts":[[2021,3,14]],"date-time":"2021-03-14T22:13:10Z","timestamp":1615759990000},"page":"1204","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Systemic Inflammatory Parameters in Patients with Elderly-Onset Rheumatoid Arthritis (EORA) and Young-Onset Rheumatoid Arthritis (YORA)\u2014An Observational Study"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3916-4291","authenticated-orcid":false,"given":"Bo\u017cena","family":"Targo\u0144ska-St\u0119pniak","sequence":"first","affiliation":[{"name":"Department of Rheumatology and Connective Tissue Diseases, Medical University of Lublin, 20-954 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof","family":"Grzechnik","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Connective Tissue Diseases, Independent Public Teaching Hospital No 4, 20-954 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Kolarz","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Connective Tissue Diseases, Independent Public Teaching Hospital No 4, 20-954 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danuta","family":"G\u0105go\u0142","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Connective Tissue Diseases, Independent Public Teaching Hospital No 4, 20-954 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4345-1675","authenticated-orcid":false,"given":"Maria","family":"Majdan","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Connective Tissue Diseases, Medical University of Lublin, 20-954 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,14]]},"reference":[{"key":"ref_1","unstructured":"Klippel, J.H., and Dieppe, P.A. (1998). Rheumatoid arthritis: Classification and epidemiology. Rheumatology, Mosby. [2nd ed.]."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1676","DOI":"10.36740\/WLek201909113","article-title":"Rheumatoid arthritis in elderly people","volume":"72","year":"2019","journal-title":"Wiad. Lek."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/j.jbspin.2010.04.004","article-title":"Elderly-onset rheumatoid arthritis","volume":"77","author":"Soubrier","year":"2010","journal-title":"Joint Bone Spine"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1177\/1759720X17740075","article-title":"An autumn tale: Geriatric rheumatoid arthritis","volume":"10","author":"Kobak","year":"2018","journal-title":"Ther. Adv. Musculoskelet. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1007\/s10067-015-3031-x","article-title":"The influence of age at disease onset on disease activity and disability: Results from the Ontario Best Practices Research Initiative","volume":"35","author":"Ruban","year":"2016","journal-title":"Clin. Rheumatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"R94","DOI":"10.1186\/ar4540","article-title":"Age at onset determines severity and choice of treatment in early rheumatoid arthritis: A prospective study","volume":"16","author":"Innala","year":"2014","journal-title":"Arthritis Res. Ther."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.2147\/CMAR.S241069","article-title":"Peripheral Blood Platelet-Lymphocyte Ratio Is Good Predictor of Chemosensitivity and Prognosis in Gastric Cancer Patients","volume":"12","author":"Ohe","year":"2020","journal-title":"Cancer Manag. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1111\/jdi.12541","article-title":"High neutrophil-to-lymphocyte ratio is associated with increased carotid artery intima-media thickness in type 2 diabetes","volume":"8","author":"Li","year":"2017","journal-title":"J. Diabetes Investig."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Cho, J.H., Cho, H.J., Lee, H.Y., Ki, Y.J., Jeon, E.S., Hwang, K.K., Chae, S.C., Baek, S.H., Kang, S.M., and Choi, D.J. (2020). Neutrophil-Lymphocyte Ratio in Patients with Acute Heart Failure Predicts In-Hospital and Long-Term Mortality. J. Clin. Med., 9.","DOI":"10.3390\/jcm9020557"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1111\/apm.12722","article-title":"Comparisons of neutrophil-, monocyte-, eosinophil-, and basophil- lymphocyte ratios among various systemic autoimmune rheumatic diseases","volume":"125","author":"Yang","year":"2017","journal-title":"APMIS"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Targo\u0144ska-St\u0119pniak, B., Zwolak, R., Piotrowski, M., Grzechnik, K., and Majdan, M. (2020). The Relationship between Hematological Markers of Systemic Inflammation (Neutrophil-To-Lymphocyte, Platelet-To-Lymphocyte, Lymphocyte-To-Monocyte Ratios) and Ultrasound Disease Activity Parameters in Patients with Rheumatoid Arthritis. J. Clin. Med., 9.","DOI":"10.3390\/jcm9092760"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2569","DOI":"10.1002\/art.27584","article-title":"2010 Rheumatoid arthritis classification criteria: An American College of Rheumatology\/European League Against Rheumatism collaborative initiative","volume":"62","author":"Aletaha","year":"2010","journal-title":"Arthritis Rheum."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1002\/art.1780380107","article-title":"Modified disease activity scores that include twenty-eight-joint counts: Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis","volume":"38","author":"Prevoo","year":"1995","journal-title":"Arthritis Rheum."},{"key":"ref_14","first-page":"261","article-title":"How to read radiographs according to the Sharp\/van der Heijde method","volume":"27","year":"2000","journal-title":"J. Rheumatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1905","DOI":"10.1136\/annrheumdis-2013-203249","article-title":"EULAR evidence-based and consensus-based recommendations on the management of medium to high-dose glucocorticoid therapy in rheumatic diseases","volume":"72","author":"Duru","year":"2013","journal-title":"Ann. Rheum. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"143","DOI":"10.14336\/AD.2017.0306","article-title":"A Comprehensive Review of Non-Steroidal Anti-Inflammatory Drug Use in the Elderly","volume":"9","author":"Wongrakpanich","year":"2018","journal-title":"Aging Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1470","DOI":"10.1136\/ard.2008.094730","article-title":"Influence of age on the outcome of antitumour necrosis factor alpha therapy in rheumatoid arthritis","volume":"68","author":"Radovits","year":"2009","journal-title":"Ann. Rheum. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1097\/MOH.0000000000000526","article-title":"Altered functions of platelets during aging","volume":"26","author":"Montenont","year":"2019","journal-title":"Curr. Opin. Hematol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Biino, G., Santimone, I., Minelli, C., Sorice, R., Frongia, B., Traglia, M., Ulivi, S., Di Castelnuovo, A., G\u00f6gele, M., and Nutile, T. (2013). Age- and sex-related variations in platelet count in Italy: A proposal of reference ranges based on 40987 subjects\u2019 data. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0054289"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Rundberg Nilsson, A., Soneji, S., Adolfsson, S., Bryder, D., and Pronk, C.J. (2016). Human and Murine Hematopoietic Stem Cell Aging Is Associated with Functional Impairments and Intrinsic Megakaryocytic\/Erythroid Bias. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0158369"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"16609","DOI":"10.1038\/s41598-017-16924-y","article-title":"Higher Platelet-to-Lymphocyte Ratio Increased the Risk of Sarcopenia in the Community-Dwelling Older Adults","volume":"7","author":"Liaw","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"9146042","DOI":"10.1155\/2020\/9146042","article-title":"Diagnostic Sensitivity of NLR and PLR in Early Diagnosis of Gastric Cancer","volume":"2020","author":"Fang","year":"2020","journal-title":"J. Immunol. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"10639","DOI":"10.1038\/s41598-019-47143-2","article-title":"The prognostic role of platelet-to-lymphocyte ratio in patients with acute heart failure: A cohort study","volume":"9","author":"Ye","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1007\/s00405-017-4849-4","article-title":"Platelet-to-lymphocyte ratio predicts long-term survival in laryngeal cancer","volume":"275","author":"Mao","year":"2018","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/j.semarthrit.2019.05.008","article-title":"The neutrophil-lymphocyte ratio in early rheumatoid arthritis and its ability to predict subsequent failure of triple therapy","volume":"49","author":"Boulos","year":"2019","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2122","DOI":"10.1111\/1756-185X.13400","article-title":"Relationship between neutrophil-lymphocyte, platelet-lymphocyte ratio and disease activity in rheumatoid arthritis treated with rituximab","volume":"21","author":"Sargin","year":"2018","journal-title":"Int. J. Rheum. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1111\/1756-185X.13157","article-title":"Characterization of neutrophil-to-lymphocyte ratio as a measure of inflammation in rheumatoid arthritis","volume":"20","author":"Chandrashekara","year":"2017","journal-title":"Int. J. Rheum. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"4","DOI":"10.21037\/jlpm.2016.10.02","article-title":"Red blood cell distribution width: A promising index for estimating activity of autoimmune disease","volume":"1","author":"Hu","year":"2016","journal-title":"J. Lab. Precis. Med."},{"key":"ref_29","first-page":"301","article-title":"Red Blood Cell Distribution Width in Rheumatoid Arthritis, Ankylosing Spondylitis and Osteoarthritis: True Inflammatory Index or Effect of Anemia?","volume":"48","author":"Lin","year":"2018","journal-title":"Ann. Clin. Lab. Sci."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/6\/1204\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:35:28Z","timestamp":1760160928000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/6\/1204"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,14]]},"references-count":29,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,3]]}},"alternative-id":["jcm10061204"],"URL":"https:\/\/doi.org\/10.3390\/jcm10061204","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,14]]}}}