Korelasi Rasio Neutrofil Limfosit dan Kadar Vitamin D terhadap Aktivitas Penyakit Sistemik Lupus Eritematosus

Abstract

Background. Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the presence of autoantibodies against cell nuclei and immune complexes involving multiple organ systems in the body. The Lupus Foundation estimates about 1.5 million cases of SLE in America and at least 5 million cases of SLE in the world and from year to year, the number of people with lupus also tends to increase. Several laboratory findings are also associated with signs and symptoms of SLE activity including the ratio of neutrophil lymphocytes and vitamin D levels, so that the neutrophil lymphocyte ratio and vitamin D levels can be indicators for monitoring disease activity in SLE patients. Aim. To determine the relationship between the ratio of neutrophil lymphocytes and vitamin D levels to the activity of systemic lupus erythematosus. Method. This study is an observational analytic study using medical record data from central installation patients at H.Adam Malik Hospital in the period December 2019 to March 2021. The sample is calculated using the large proportion estimation formula. Then the distribution test was carried out with the Shapiro Wilk test. Bivariate analysis was carried out to determine the relationship between neutrophil lymphocyte ratio and vitamin D levels with the MEX SLED AI score using the ANOVA test if the data was normally distributed, or the Kruskal-Wallis test if the data was not normally distributed. The magnitude of the desired deviation (a) is 0.05, statistically significant if p<0.05. Results. 75 subjects participated in the study and there were 12 people (16%) experiencing mild systemic lupus erythematosus, 38 people (51%) moderate degree, and 25 people (33%) severe degree. The neutrophil-lymphocyte ratio was associated with systemic lupus erythematosus disease activity (p=0.001) and vitamin D levels were associated with systemic lupus erythematosus disease activity. Conclusion. Neutrophillymphocyte ratio and vitamin D levels are associated with systemic lupus erythematosus disease activity.