{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T07:05:04Z","timestamp":1782975904702,"version":"3.54.5"},"reference-count":53,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2024,8,8]],"date-time":"2024-08-08T00:00:00Z","timestamp":1723075200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n<jats:title>Objective<\/jats:title>\n<jats:p>The aim of this study was to explore the potential values of Krebs von den Lungen-6 (KL-6), neutrophil to lymphocyte ratio (NLR), systemic immune inflammation (SII), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR) and red blood cell distribution width (RDW) in the diagnosis and evaluation of the severity of connective tissue disease-associated interstitial lung disease (CTD-ILD).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>A total of 140 connective tissue disease (CTD) patients and 85 CTD-ILD patients were recruited for this study at Shanxi Provincial People\u2019s Hospital from May 2022 to May 2023. Patients were divided into subgroups based on medication history and CTD subtypes to compare and analyze the clinical data and laboratory parameters of CTD-ILD patients and CTD patients. The receiver operating characteristic curve (ROC) was used to evaluate the diagnostic efficacy of KL-6, NLR, SII, PLR, MLR, and RDW in identifying CTD-ILD patients from CTD patients. A Spearman correlation analysis was conducted to elucidate the correlations between these markers and the lung function parameters of forced vital capacity (FVC, %), forced expired volume in one second (FEV1, %), and diffusing capacity of carbon monoxide (DLCO, %). Finally, binary logistic regression analysis was applied to discern the independent risk factors for CTD-ILD.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>NLR, SII, MLR, RDW, and KL-6 displayed significant statistical differences in the experimental groups. In both untreated and treated subgroups, KL-6 displayed higher values for CTD-ILD than CTD among all CTD subtypes. In untreated subgroups, there were significant differences in MLR levels between rheumatoid arthritis (RA) and RA-ILD patients and in NLR levels between Sj\u00f6gren syndrome (SjS) and SjS-ILD patients. There were also significant differences in RDW-SD between the \u201cother CTD\u201d and \u201cother CTD-ILD\u201d groups. In treated subgroups, there were significant differences in both RDW-SD and RDW-CV between RA and RA-ILD patients and in NLR, SII, MLR, PLR, and RDW-SD between \u201cother CTD\u201d and \u201cother CTD-ILD\u201d groups. ROC revealed that KL-6 emerged as the most effective predictor for CTD-ILD in both treated and untreated groups. The multivariate logistic regression analysis results showed that both KL-6 and age were independent risk factors for CTD-ILD. NLR, SII, and PLR were negatively correlated with DLCO (%) in the untreated CTD-ILD group, and KL-6 was negatively correlated with various lung function parameters in both treated and untreated CTD-ILD groups.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>KL-6 emerged as the most promising biomarker for diagnosing CTD-ILD and assessing its severity. The diagnostic value of KL-6 was unaffected by medication interference and surpassed the value of other parameters, such as NLR, SII, MLR, and RDW. The diagnostic value of RDW-SD was higher than that of RDW-CV in CTD-ILD patients. NLR, SII, MLR, and PLR have potential value in diagnosing the different types of CTD-ILD.<\/jats:p>\n<\/jats:sec>","DOI":"10.7717\/peerj.17792","type":"journal-article","created":{"date-parts":[[2024,8,8]],"date-time":"2024-08-08T08:37:30Z","timestamp":1723106250000},"page":"e17792","source":"Crossref","is-referenced-by-count":11,"title":["The clinical value of KL-6 for predicting the occurrence and severity of connective tissue disease-associated interstitial lung disease is not affected by CTD type or treatment"],"prefix":"10.7717","volume":"12","author":[{"given":"Huifang","family":"Xing","sequence":"first","affiliation":[{"name":"The Fifth Clinical Medical College, Shanxi Medical University, Taiyuan, Shanxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7712-8120","authenticated-orcid":true,"given":"Hongping","family":"Liang","sequence":"additional","affiliation":[{"name":"The Fifth Clinical Medical College, Shanxi Medical University, Taiyuan, Shanxi, China"},{"name":"Clinical Laboratory, Shanxi Provincial People\u2019s Hospital, Taiyuan, Shanxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4443","published-online":{"date-parts":[[2024,8,8]]},"reference":[{"issue":"5","key":"10.7717\/peerj.17792\/ref-1","doi-asserted-by":"publisher","first-page":"792","DOI":"10.1136\/annrheumdis-2017-211400","article-title":"2016 American college of rheumatology\/European league against rheumatism criteria for minimal, moderate, and major clinical response in adult dermatomyositis and polymyositis: an international myositis assessment and clinical studies group\/paediatric rheumatology international trials organisation collaborative initiative","volume":"76","author":"Aggarwal","year":"2017","journal-title":"Annals of the Rheumatic Diseases"},{"issue":"3","key":"10.7717\/peerj.17792\/ref-2","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1007\/s13665-022-00290-w","article-title":"Management of connective tissue disease-related interstitial lung disease","volume":"11","author":"Ahmed","year":"2022","journal-title":"Current Pulmonology Reports"},{"key":"10.7717\/peerj.17792\/ref-3","first-page":"328","article-title":"Comparison between 3 diagnostic criteria for mixed connective tissue disease. 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