Related Experiment Video
Updated: Dec 17, 2025

Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
Published on: May 12, 2023
Evaluation of Neutrophil-to-Lymphocyte Ratio and Mean Platelet Volume in Patients with Active and Inactive Thyroid
Cemile Üçgül Atılgan1, Selam Yekta Şendül2, Pınar Kösekahya1
1Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, Altindag, Ankara, Turkey.
Objectives:
The aim of this study was to evaluate the neutrophil-to-lymphocyte ratio (NLR) and the mean platelet volume (MPV) in patients with active thyroid orbitopathy (TO) and to compare it with that of both healthy subjects and patients with inactive TO.
Methods:
Twenty patients with active TO (Group 1), 25 patients with inactive TO (Group 2), and 35 age- and sex-matched healthy subjects (Group 3) were included in this study. Patients with other systemic and ocular diseases, patients with a history of intraocular or orbital surgery, and patients using systemic drugs were excluded. The VISA (vision, inflammation, strabismus, appearance) classification scheme was used to discriminate between active and inactive TO. The neutrophil and lymphocyte counts and the MPV of all participants were recorded. The NLR was calculated by dividing the neutrophil count by the lymphocyte count, and the result was compared between groups. The optimal cut-off value was determined for NLR and MPV and the data were compared with a one-way analysis of variance test and the 'Bonferroni post-test.
Results:
The mean age was 45.4±13.4, 41.0±13.7, and 42.6±14.4 years in Group 1, 2, and 3, respectively (p=0.68). The NLR was 2.11 in Group 1, 1.56 in Group 2, and 1.47 in Group 3 (p=0.03). The 'Bonferroni post-test revealed a difference between Group 1 and Group 2 (p=0.01) and between Group 1 and Group 3 (p<0.001). The MPV was 10.76 fL in Group 1, 9.94 fL in Group 2, and 8.19 fL in Group 3 (p<0.001). The results of the 'Bonferroni post-test showed a difference between Group 1 and Group 2 (p=0.04), between Group 1 and Group 3 (p<0.001), and between Group 2 and Group 3 (p<0.001). The mean cut-off value obtained from receiver operating characteristic (ROC) analysis of NLR was 1.69 (sensitivity: 72%; specificity: 66%). The mean cut-off value obtained from ROC analysis of MPV was 9.95 (sensitivity: 63%; specificity: 66%).
Conclusion:
High NLR and MPV values may be indicative of active inflammation in patients with TO."
Related Concept Videos
The Thyroid Gland
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
Synthesis and Regulation of Thyroid Hormones
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...

