Inagawa Yuta, Kurata Kazumi, Obi Seiji, Onuki Yoshiyuki, Monden Yukifumi, Kurane Koyuru, Furukawa Rieko, Mitani Tadahiro, Nakamura Hirotaka, Suda Shiro, Yagihashi Tatsuhiko
Department of Psychiatry, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan.
Department of Neurosurgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan.
J Eat Disord. 2025 May 19;13(1):86. doi: 10.1186/s40337-025-01282-2.
This study aimed to evaluate the dynamics of the neutrophil-to-lymphocyte ratio (NLR) during the initial hospitalization of patients with eating disorders (EDs) and to assess its potential as a biomarker for monitoring disease severity and treatment response.
A retrospective chart review was conducted with 55 patients aged ≤ 16 years diagnosed with anorexia nervosa or avoidant/restrictive food intake disorder and admitted to Jichi Medical University Hospital between 2015 and 2021. Sociodemographic and clinical characteristics including sex, age, rate of weight gain, percentage of ideal body weight (%IBW), tube feeding treatment, and NLR were obtained. Statistical analyses used a mixed model for repeated measures to assess NLR changes regarding %IBW and other clinical factors.
The NLR at admission was lower in the malnourished state but increased with weight recovery. MMRM revealed that tube feeding treatment (β = 0.538) and restoration of %IBW (β = 0.029) significantly predicted an increase in the NLR. The interaction between tube feeding and the quadratic term of %IBW was also significant, indicating distinct patterns of NLR changes: without tube feeding, NLR increased linearly with weight recovery, whereas with tube feeding, NLR exhibited a non-linear, upward-convex parabolic trend.
These findings suggest that NLR may offer an objective recovery marker less influenced by patient self-report. Monitoring NLR before and after tube feeding may help distinguish true physiological recovery from transient stress responses, providing complementary information to conventional assessments. Further research is warranted to establish its clinical relevance.
本研究旨在评估饮食失调（ED）患者首次住院期间中性粒细胞与淋巴细胞比值（NLR）的动态变化，并评估其作为监测疾病严重程度和治疗反应生物标志物的潜力。
对2015年至2021年间在筑波大学医学部附属医院住院的55例年龄≤16岁、诊断为神经性厌食症或回避/限制性食物摄入障碍的患者进行回顾性病历审查。获取社会人口统计学和临床特征，包括性别、年龄、体重增加率、理想体重百分比（%IBW）、管饲治疗和NLR。统计分析采用重复测量混合模型，以评估NLR相对于%IBW和其他临床因素的变化。
入院时营养不良状态下的NLR较低，但随着体重恢复而升高。MMRM显示，管饲治疗（β = 0.538）和%IBW的恢复（β = 0.029）显著预测了NLR的升高。管饲与%IBW二次项之间的交互作用也显著，表明NLR变化的不同模式：无管饲时，NLR随体重恢复呈线性增加，而有管饲时，NLR呈非线性、上凸抛物线趋势。
这些发现表明，NLR可能提供一个受患者自我报告影响较小的客观恢复标志物。监测管饲前后的NLR可能有助于区分真正的生理恢复与短暂的应激反应，为传统评估提供补充信息。有必要进行进一步研究以确定其临床相关性。
