Pellegrino Raffaello, Paganelli Roberto, Di Iorio Angelo, Bandinelli Stefania, Moretti Antimo, Iolascon Giovanni, Sparvieri Eleonora, Tarantino Domiziano, Ferrucci Luigi
Department of Scientific Research, Off-Campus Semmelweis University, Campus Ludes, 6912, Lugano-Pazzallo, Switzerland.
Saint Camillus International University of Health and Medical Sciences, Rome, Italy.
Immun Ageing. 2023 Sep 4;20(1):46. doi: 10.1186/s12979-023-00370-8.
Neutrophils and lymphocytes represent the larger percentage of all white blood cells, they vary with age, with a progressive increase of the ratio in the first years of life, and then tend to remain at similar levels in steady state condition during adult age. Neutrophils to lymphocytes-ratio (NL-ratio) was proposed as an effective and low-cost marker to monitor and predict the evolution of several clinical conditions. The main objective of the study is to analyze its temporal trend variation, over twenty years' follow-up, according to age, sex, and main clinical diagnosis, in a large representative Italian population.
The InCHIANTI study enrolled representative samples from the registry list of two towns in Tuscany, Italy. Baseline data were collected in 1998, and last follow-up visits were made in 2015-18. 1343 out of the 1453 participants enrolled were included, and consented to donate a blood sample. All subjects were assessed and followed for life-style, clinical condition, physical performance, and underwent an instrumental diagnostic session.
The NL-ratio showed a statistically significant interaction between birth-cohort and time of the study (p-value = 0.005). A gender dimorphism was recognized in the neutrophils absolute count and in the NL-ratio. Moreover, in female participants only, those who reported CHF had lower neutrophil-count and NL-ratio; whereas an increase in creatinine clearance was directly associated with NL-ratio. In male subjects, an increase of BMI was inversely associated with both NL-ratio and neutrophils-count during the follow-up; a similar association but in the opposite direction was observed in female participants.
NL-ratio is a more reliable predictor of healthy aging than absolute lymphocytes and/or neutrophils counts. It is associated with the changes induced by disease, lifestyle, and environmental challenges in the immune system. NL-ratio confirms the gender dimorphism in the occurrence of inflammation-driven diseases, thus providing additional evidence for the necessity of tailored sex-specific measures to prevent and treat such diseases.
中性粒细胞和淋巴细胞在所有白细胞中占比最大，其比例随年龄变化，在生命的最初几年呈逐渐上升趋势，成年后在稳态条件下趋于保持在相似水平。中性粒细胞与淋巴细胞比值（NL比值）被认为是监测和预测多种临床状况演变的一种有效且低成本的标志物。本研究的主要目的是分析在长达二十年的随访中，其随年龄、性别和主要临床诊断的时间趋势变化，研究对象为具有广泛代表性的意大利人群。
InCHIANTI研究从意大利托斯卡纳两个城镇的登记名单中选取了具有代表性的样本。1998年收集了基线数据，并于2015 - 2018年进行了末次随访。纳入了1453名登记参与者中的1343名，他们均同意捐献血样。所有受试者均接受了生活方式、临床状况、身体机能的评估和随访，并接受了仪器诊断检查。
NL比值在出生队列和研究时间之间显示出具有统计学意义的交互作用（p值 = 0.005）。在中性粒细胞绝对计数和NL比值中发现了性别二态性。此外，仅在女性参与者中，报告患有心力衰竭的女性中性粒细胞计数和NL比值较低；而肌酐清除率的增加与NL比值直接相关。在男性受试者中，随访期间体重指数的增加与NL比值和中性粒细胞计数均呈负相关；在女性参与者中观察到了类似但方向相反的关联。
与淋巴细胞和/或中性粒细胞的绝对计数相比，NL比值是健康衰老更可靠的预测指标。它与疾病、生活方式和环境挑战引起的免疫系统变化相关。NL比值证实了炎症驱动性疾病发生中的性别二态性，从而为采取针对性别的预防和治疗此类疾病的措施提供了额外证据。
