Title
Correlation of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio with serum-ascites albumin gradient in ascites
Authors
Pradeep Nigam1, Umesh Pratap Singh2, Lokesh Tripathi3 & Awati Siddhivinayak Rajesh2,*
Affiliation
1Department of Gastroenterology, Shyam Shah Medical College and Associated Hospitals, Rewa Madhya Pradesh, India; 2Department of General Medicine, Shyam Shah Medical College and Associated Hospitals, Rewa Madhya Pradesh, India; 3Department of Pathology, Shyam Shah Medical College and Associated Hospitals, Rewa Madhya Pradesh, India; *Corresponding author
Pradeep Nigam - E-mail: pradeepmarutinihgam@gmail.com; Phone: +91 7987508186
Umesh Pratap Singh - E-mail: upsingh87@gmail.com; Phone: +91 9136464178
Lokesh Tripathi - E-mail: drlokesh99@gmail.com; Phone: +91 9755657590
Awati Siddhivinayak Rajesh - E-mail: siddhivinayakawati871@gmail.com; Phone: +91 8177927671
Article Type
Research Article
Date
Received April 1, 2026; Revised April 30,
2026; Accepted April 30, 2026, Published April 30, 2026
Abstract
Differentiating portal hypertensive from non-portal hypertensive ascites remains a common clinical challenge, especially in settings where rapid yet cost-effective diagnostic tools are limited. Serum-ascites albumin gradient (SAAG) is the standard method for etiological classification, but simple adjunctive markers may improve early assessment. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are inexpensive inflammatory indices with potential diagnostic value. Hence, this cross-sectional study included 100 adult patients with clinically and radiologically confirmed ascites between January and December 2024. Patients were classified into high SAAG (≥1.1 g/dL) and low SAAG (<1.1 g/dL) groups. High SAAG was present in 66% of patients. NLR showed a significant moderate positive correlation with SAAG (r = 0.55; P < 0.001), while PLR showed a weak but significant inverse correlation (r = −0.25; P = 0.0004). NLR >2 demonstrated higher sensitivity (87.9%) and diagnostic accuracy (76.0%), whereas PLR <90 showed higher specificity (64.7%) and positive predictive value (80.3%). ROC analysis showed moderate diagnostic performance for NLR (AUC = 0.72) and PLR (AUC = 0.71). Thus, we show that NLR and PLR may serve as useful non-invasive adjuncts to SAAG for evaluating ascites, particularly in resource-limited settings.
Keywords
Ascites, serum ascites albumin gradient, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, portal hypertension, inflammatory markers
Citation
Nigam et al. Bioinformation 22(4): 2445-2450 (2026)
Edited by
P Kangueane
ISSN
0973-2063
Publisher
License
This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. This is distributed under the terms of the Creative Commons Attribution License.
