Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.
Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.
Ann Epidemiol. 2019 Oct;38:11-21.e6. doi: 10.1016/j.annepidem.2019.07.015. Epub 2019 Aug 1.
The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation with established prognostic value in patients with cancer. Although high NLR is associated with poorer clinical outcomes, factors that influence the magnitude of NLR independently of disease are poorly understood.
We identified 48,023 adults who participated in the National Health and Nutrition Examination Survey (1999-2016). Demographic, socioeconomic, and lifestyle factors associated with the magnitude of NLR after adjusting for comorbidities including heart disease, cancer, diabetes, and hypertension, and medications including aspirin, were identified. Effect modification by comorbidity status and demographics was explored.
Female gender, age less than 60 years, and non-Hispanic black race/ethnicity were associated with lower NLR. Marital statuses of widowed, separated, or never married demonstrated increased NLR as compared with those who were currently married. Never-smoking and moderate alcohol consumption were associated with lower NLR. Participation in physical activity was associated with decreased NLR after adjustment for potential confounders, primarily among non-Hispanic whites.
Multiple demographic and lifestyle factors are independently associated with NLR. Sex, age, race, marital status, body mass index, physical activity, smoking history, and alcohol consumption should all be routinely collected and adjusted for to improve the accuracy of assessment of the prognostic power of NLR.
中性粒细胞与淋巴细胞比值（NLR）是一种全身性炎症标志物，在癌症患者中具有明确的预后价值。虽然高 NLR 与较差的临床结局相关，但独立于疾病影响 NLR 幅度的因素尚不清楚。
我们确定了 48023 名参加国家健康和营养检查调查（1999-2016 年）的成年人。在调整包括心脏病、癌症、糖尿病和高血压在内的合并症以及包括阿司匹林在内的药物后，确定与 NLR 幅度相关的人口统计学、社会经济和生活方式因素。探讨了合并症状态和人口统计学的修饰作用。
女性、年龄小于 60 岁和非西班牙裔黑人种族/民族与较低的 NLR 相关。与目前已婚的人相比，丧偶、分居或未婚的婚姻状况显示 NLR 增加。从不吸烟和适度饮酒与较低的 NLR 相关。在调整潜在混杂因素后，身体活动的参与与 NLR 降低相关，主要发生在非西班牙裔白人中。
多种人口统计学和生活方式因素与 NLR 独立相关。性别、年龄、种族、婚姻状况、体重指数、身体活动、吸烟史和饮酒量都应常规收集并进行调整，以提高 NLR 预后能力评估的准确性。
