Journal of Inflammation Research (Mar 2023)

Association of Neutrophil-to-Lymphocyte Ratio with Nutrition in Patients with Various Types of Malignant Tumors: A Multicenter Cross-Sectional Study

  • Kang L,
  • Liu X,
  • Ji W,
  • Zheng K,
  • Li Y,
  • Song Y,
  • He H,
  • Wang X,
  • Yang T,
  • Guan M,
  • Zhu G,
  • Gao Y,
  • Guan Y,
  • Wang L,
  • Li W

Journal volume & issue
Vol. Volume 16
pp. 1419 – 1429

Abstract

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Lihua Kang,1 Xiangliang Liu,1 Wei Ji,1 Kaiwen Zheng,1 Yuguang Li,2 Yanqiu Song,1 Hua He,1 Xiaomeng Wang,1 Tingting Yang,1 Meng Guan,1 Ge Zhu,1 Yangyang Gao,1 Yanjie Guan,1 Lei Wang,1 Wei Li1 1Cancer Center, The First Hospital of Jilin University, Changchun, Jilin Province, People’s Republic of China; 2College of Instrumentation and Electrical Engineering, Jilin University, Changchun, Jilin Province, People’s Republic of ChinaCorrespondence: Wei Li, Cancer Center, The First Hospital of Jilin University, No. 71 Xinmin Street, Changchun, 130021, People’s Republic of China, Tel +86-13756661267, Email [email protected]: Neutrophil-to-lymphocyte ratio (NLR) is an index of systemic inflammation. This study is to clarify the role of NLR in body functional status, nutritional risk and nutritional status in the course of tumor.Methods: A multi-center cross-sectional study of patients with various types of malignant tumors was accrued from the whole country. There were 21,457 patients with completed clinical data, biochemical indicators, physical examination, the Patient-Generated Subjective Global Assessment (PG-SGA) and Nutrition Risk Screening 2002 (NRS2002) survey. Logistic regression analysis was used to figure out the influencing factors of NLR, and four models were established to evaluate the influence of NLR on body functions, nutritional risks and nutritional status.Results: Male patients, TNM stage IV, total bilirubin, hypertension and coronary atherosclerotic heart disease (CAHD) were independent predictors of NLR > 2.5. BMI, digestive systemic tumors and triglyceride negatively affect NLR in multivariable logistic regression. NLR was an independent predictor of Karnofsky Performance Scale (KPS), fat store deficit in all degrees, moderate and severe muscle deficit, mild fluid retention and PG-SGA grade.Conclusion: Male patients and those with hypertension and CAHD are prone to systemic inflammation. Systemic inflammation significantly degrades body function status and nutritional status, increases nutritional risk and influences fat and muscle metabolism in patients with malignant tumor. Improving the intervenable indicators such as elevating albumin and pre-albumin, decreasing total bilirubin and enhancing nutrition support are imperative. Obesity and triglyceride behave like anti-systemic inflammation, which is misleading due to reverse causation in the course of malignancy.Keywords: neutrophil-to-lymphocyte ratio, inflammation, tumor, nutrition, body function

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